Operations and Other Technology

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

The importance of digital transformation in a fraudulent environment

In this recently conducted survey, more than 85% of responding hospital financial executives said they are somewhat concerned (65.96%) or very concerned (19.15%) about potential AI-influenced fraud, including account takeovers and eventually payment fraud.

HFMA February 29, 2024

Leveraging the supply chain for cost reduction

Learn from seven healthcare finance executives about the different strategies used to help reduce their hospital's costs using technology, transparency and automation in this roundtable.

HFMA January 30, 2024

New regulations are projected to bring providers a measure of relief from prior authorization headaches

Hospitals and other healthcare providers hailed a newly published final rule designed to improve prior authorization and the electronic exchange of health information. The Interoperability and Prior Authorization rule sets requirements for Medicare Advantage (MA) health plans, state Medicaid and CHIP programs, and Medicaid managed care organizations, all of which starting in 2026 must send…

Nick Hut January 18, 2024

Deploying EPM in the cloud: 6 steps that drive value

Cloud-based enterprise performance management (EPM) offers tremendous potential for health systems, but the ability to drive value depends on a thoughtful approach that puts as little pressure as possible on existing resources, both technological and human.

HFMA December 11, 2023

4 steps healthcare CFOs can take to improve interoperability

Achieving information interoperability has long been touted as a solution to challenges that have plagued the healthcare industry for decades. For example, a health system that operates multiple electronic health records (EHRs) and systems across its facilities, hospitals and practices must undergo an extremely time-consuming and complicated process in gathering comprehensive patient records (e.g., by…

Michael Gould December 7, 2023

Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect

Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…

Nick Hut December 1, 2023

Proposed rule sets Medicare penalties for providers that commit information-blocking infractions

Hospitals and other healthcare providers would face penalties for knowingly engaging in information blocking, with the sanctions affecting their Medicare reimbursement, according to a proposed rule from the U.S. Department of Health and Human Services (HHS) and CMS. Published at the beginning of November, the rule implements some terms of the 21st Century Cures Act,…

Nick Hut November 17, 2023

Leveraging investments to strengthen resilience: Key insights

The approach health systems take to balance sheet and treasury management varies significantly. One company's managing director dives into how organizations can take a balanced-scorecard method to investments using a tier system.

HFMA October 31, 2023

FTC and HHS’s Office for Civil Rights put healthcare stakeholders on notice about the use of tracking technology

Federal regulators plan to more rigorously monitor whether tracking technologies on provider websites are impermissibly disclosing consumers’ protected health information (PHI) to third parties in violation of HIPAA. The Federal Trade Commission (FTC) and the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services last month sent a letter to…

Nick Hut August 10, 2023
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