Revenue Cycle

Health system CEO tells Congress proposed 340B changes would be harmful to organizations like his

A health system executive visited Capitol Hill recently to provide the hospital perspective on the 340B Drug Pricing Program — a viewpoint that increasingly is coming under fire among policymakers. Matthew Perry, president and CEO of Genesis HealthCare System in Zanesville, Ohio, appeared at a House subcommittee hearing June 4 to give insight on why…

Nick Hut June 10, 2024

The vital relationship between MDs and clinical documentation integrity

High-quality clinical documentation is vital for creating a complete picture of a patient’s health and medical history. Accurate records of diagnoses, medications, tests, treatments and other elements of a patient’s care are crucial in creating the most effective care plan leading to positive outcomes. The quality of a physician’s clinical documentation can also impact payer…

HFMA June 7, 2024

Personalized communication helps State provide the highest possible recovery and patient-satisfaction rates for clients

Learn about a company that combines advanced technology with human interaction to increase recoveries and patient satisfaction.

HFMA June 4, 2024

Engaging in operating rule development and adoption amidst the era of healthcare automation

Over the past two decades, the healthcare industry has collaborated to accelerate automation, alleviate administrative burdens and lower the cost of conducting common business transactions. Although much work remains to be done to streamline healthcare administration, the industry’s approach to developing and implementing operating rules to improve revenue cycle automation, independent of standards development, is…

Shawn Stack May 28, 2024

Bridging the gap: Integrating value-based care into revenue cycle management

The idea of value-based care (VBC) has existed for decades but only gained momentum since the 2017 implementation of the Merit-based Incentive Payment System (MIPS) and the Quality Payment Program (QPP). VBC incentivizes providers for quality outcomes, unlike fee-for-service models that reimburse providers for each service performed. The ultimate goal of VBC is to improve…

HFMA May 10, 2024

Annual report on Medicare financing could reduce the immediate impetus to address longstanding issues

New data on the state of Medicare funding show short-term improvement while keeping the stakes high for ensuing decades. The annual report from Medicare’s trustees shows the Hospital Insurance Trust Fund (i.e., Medicare Part A) has enough money to keep beneficiaries covered and providers paid through 2036. That’s an increase of five years from the…

Nick Hut May 9, 2024

Congressional hearings on the Change Healthcare cyberattack bring attention to providers’ continuing predicament

Two congressional hearings involving the CEO of UnitedHealth Group offered few concrete solutions to the issues surrounding the Change Healthcare cyberattack but did highlight the ongoing pressures facing healthcare stakeholders. Andrew Witty, the CEO, was questioned May 1 by the Senate Finance Committee in the morning and a House subcommittee in the afternoon. For providers…

Nick Hut May 2, 2024

Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations

CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…

Nick Hut May 1, 2024

Navigating toward successful contract negotiations with health plans

A group of healthcare leaders discuss various tactics they are using to negotiate better rates with payers and ensure payers’ commitment to accurate, timely payment.

HFMA May 1, 2024

Shawn Stack: The value of revisiting policies and processes for financial assistance

The charity care processes adopted by healthcare providers have attracted criticism in media stories focusing on the high cost of care. On a recent episode of HFMA’s “Voices in Healthcare Finance” podcast, HFMA Policy Director Shawn Stack discussed the value of revisiting financial assistance policies and processes. Below is an excerpt from the interview. Erika…

Erika Grotto April 30, 2024
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