Revenue Cycle

Cyberattack on Change Healthcare brings turmoil to healthcare operations nationwide

Editor’s note: If you are an HFMA member from a provider organization, consider submitting a request to join the Change Healthcare Business Continuity Workgroup (https://community.hfma.org/change-healthcare-workgroup/). Information about future calls, mitigation strategies and industry updates will be shared in this group. HFMA welcomes participants to use the discussion forum to address challenges and explore solutions with…

Nick Hut March 13, 2024

Navigating medical necessity denials: Strategies for successful resolution

Just as hospitals, health systems and physician practices are dealing with unprecedented financial and operational challenges, denied claims continue to rise — especially medical necessity denials. The impact on providers and patients is significant. Medical necessity is the term used to describe “healthcare services or supplies needed to diagnose or treat an illness, injury, condition,…

HFMA March 8, 2024

How digital patient engagement solutions can help healthcare organizations improve their existing revenue cycle

This roundtable features various healthcare professionals who breakdown what digital patient engagement solutions are being implemented and how this not only empowers patients, but also helps organizations looking to improve their existing revenue cycle.

HFMA February 29, 2024

While increasing revenue is a top goal for 2024, improving the patient experience is a close second — specially for large health systems: HFMA poll

In a recently conducted survey, 70% of 92 respondents said increasing revenue is a top priority in 2024 followed by improving the patient experience (60%) and reducing costs (55%). Review other key findings in this research report.

HFMA February 29, 2024

Healthcare Blame Game: Bloomberg Philanthropies puts $250 million into educating new healthcare workers while Patient Rights Advocate spends on spreading misinformation

Chad Mulvany, vice president of federal policy for the California Hospital Association and former HFMA policy director, discusses Bloomberg Philanthropies $250 million investment in the future healthcare workforce, as well as what will actually move the needle on price transparency.

Erika Grotto February 26, 2024

New data shows providers continuing to win most No Surprises Act independent dispute resolution cases

Providers won a large majority of disputes initiated during the first half of 2023 through the No Surprises Act’s arbitration portal for adjudicating out-of-network payments, according to newly published data. HHS and the U.S. Departments of Labor and Treasury released public-use files (available to download here under “2023 Reporting Year”) showing the outcome of every…

Nick Hut February 21, 2024

How to Optimize Your Revenue Cycle through In-depth Assessment and Strategic Process Improvements

By adopting a comprehensive approach that includes regular assessment, process optimization, staff education and measurement, healthcare organizations can enhance efficiency, reduce costs and ultimately improve their financial health. Download this report to learn more.

HFMA February 20, 2024

Hospitals reached steadier ground financially as they moved into 2024

Hospitals came into 2024 with some financial momentum, even as expenses continued to rise and pivotal decisions loomed. The year-to-date median hospital operating margin reached 2.3% in December, the high mark for 2023 and the 10th consecutive month in which margins were positive, according to monthly data from Syntellis Performance Solutions, part of Strata Decision…

Nick Hut February 12, 2024

Strategies for success: Tackling common clinical documentation integrity challenges head-on

Clinical documentation, which includes a record of exams, symptoms, diagnoses, medications, tests, treatments and other elements of a patient’s medical care, plays a vital role in creating a complete picture of an individual’s health and is needed to develop effective care plans. It also ensures that all providers who see the patient have access to…

HFMA February 9, 2024

CMS’s 2025 advance rate notice for Medicare Advantage brings potential concern for providers

Medicare Advantage (MA) health plans are projected to reap a 3.7% revenue increase in 2025, but provider payments could be affected by a decrease in plan benchmarks, per data shared in CMS’s annual advance notice. If finalized, the estimated 0.16% average reduction in base payments to plans could have consequences for care delivery, one provider…

Nick Hut February 7, 2024
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