Gail Wilensky: How the pandemic spurred a new impetus for improved care coordination
The COVID-19 pandemic proved to be a catalyst for many significant changes in healthcare delivery. Some were intentional, representing seized opportunities to improve processes. But other changes were forced on the industry as a result of constraints imposed by the pandemic. One of the most significant of these changes, for example, has been the industry’s…
Understanding the true cost to collect requires focusing on high-level KPIs
Revenue cycle management leaders from around the country share their perspectives on defining and maintaining a high-performance revenue cycle and the challenges they face in working to enhance revenue cycle management.
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.
AI-powered coding automation: The state of the art and future direction
This roundtable discussion conducted at HFMA’s 2023 Annual Conference in Nashville, Tennessee sought to understand both the opportunities and challenges that AI-powered coding automation poses for healthcare organizations.
Moody’s sees potential positive RCM impact from AI
Ratings agency Moody’s Investors Service has joined other industry players in identifying ways artificial intelligence can create efficiencies in revenue cycle management. The growing use of the technology potentially could bring accounts receivable balances down and minimize write-offs of past-due balances, according to the three authors of a report published in the company’s “Healthcare Quarterly”…
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…
Pharmacy transparency: a rising trend in the industry
After publishing my Nov. 29 blog, which delved into Cost Plus Drugs’ expansion into the specialty drug market, CVS Health revealed plans to streamline its pricing and sales approach for pharmaceuticals in retail pharmacies. This move by the pharmacy giant, which operates approximately 9,500 retail pharmacies, involves simplifying the reimbursement process for these pharmacies. The…
10 Keys to Restoring Trust in Healthcare
The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, a glut of misinformation about vaccines and other treatments, and data and privacy breaches. To examine the problem and explore solutions, HFMA’s 16th…
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…
2024 Health System Digital & IT Investments
This survey of 144 provider executives reveals their top digital and IT investment priorities for 2024 and associated challenges, opportunities, and goals.