Optimizing the revenue cycle workforce: Balancing automation with empathy to elevate the patient experience
In today’s healthcare landscape, every financial conversation shapes not just patient satisfaction, but organizational trust. As health systems work to manage rising costs and operational complexity, revenue cycle teams find themselves carrying the dual burden of protecting financial performance while supporting patient experience, often without the resources to excel at either. Automation presents undeniable advantages…
Soaring charity care grabs hospital leaders’ attention
Across the country, hospitals are reexamining their approach to uncompensated care, with first movers in this space increasing the availability of financial assistance and working harder to reduce the chances that an account will be sent to collections. And now, new data paints a picture of the collective impact of these efforts and other trends…
Reeling payers plan to increase scrutiny of providers’ coding practices
Health insurers see provider coding practices as one factor in unfavorable cost trends, several companies said during recent earnings calls. Those cost trends, in turn, have driven substandard Q2 financial results. “We know this adjustment is disappointing, and we’re taking concrete actions to address it,” Gail Boudreaux, president and CEO of Elevance Health said recently,…
Why this year’s OPPS rule could have a big impact
Nick Hut and Shawn Stack talk about the 2026 Medicare proposed rule for the Outpatient Prospective Payment System and why it could have a more significant impact on hospitals than rules from previous years. Also in this episode, Aneal Gadgil from Abridge discusses clinical documentation and coding.
Get paid what you’re owed: Smarter contracting, internal alignment can reduce denials
Hospitals and health systems are grappling with rising denial rates, particularly among commercial and Medicare Advantage plans. Years ago, denials might have been isolated friction points in the billing process; but as rates have risen, denials have become a strategic-level issue with a measurable impact on financial performance. Historically, denial mitigation efforts tended to focus on…
New data points to financial upsides in rethinking patient payment plans
According to a recent survey conducted with more than 200 healthcare finance professionals, providers struggle to obtain out-of-pocket costs from patients. Now, providers collect just 24% of patient billings, or the amount owed after insurance covered its portion.
Revenue Cycle Claims, Denials and Appeals Research Report
This report surveyed 172 healthcare executives to understand how denial challenges and payer complexities are affecting hospital revenue cycle operations.
Redefining healthcare financial KPIs in a post-COVID era: A strategic imperative
The COVID-19 pandemic compelled hospitals and health systems to rethink nearly every aspect of their operations. Nowhere was the disruption more profoundly felt than in the revenue cycle. Long-standing financial key performance indicators (KPIs) such as accounts receivable (AR) days, clean claim rates and denial percentages, quickly lost their relevance amid staffing shortages, unpredictable patient…
Insurers promise to make prior authorization processes easier for all parties
In potentially a rare dose of good news for providers about prior authorization, the health insurance industry has volunteered to scale back the process and introduce new accommodations, according to an announcement Monday. As described by the insurance lobby and the Trump administration, which convened a meeting Monday at which a large segment of the…
David Johnson: Lessons in solving the nation’s current revenue cycle dilemma
In April 1999, “The Modern Library” published its list of the top one hundred nonfiction books of the 20th century. Number one was “The Education of Henry Adams,” an intellectual autobiography written in 1905 by the great grandson and grandson of John Adams and John Quincy Adams, respectively, the second and sixth presidents of the…