July 2018

Cover Story

Case Study | Physician Relationships

Empowering Physicians to Become Stewards

Texas hospitals are providing physicians with a tool that gives them greater insight into the costs and risks associated with the care they provide, enabling them to lead the way to achieving the goals of value-based care.

Video

Video | Revenue Cycle

Video: Denials and the Revenue Cycle

David Dyke, former vice president of product management for Change Healthcare, discusses how to reduce denials that disrupt the revenue cycle and how to keep up with changing rules around claims. 

Early Edition

How To | Healthcare Business Trends

How to Grow High-Value Service Lines Effectively

Growing top-performing service lines can be an effective strategy for healthcare organizations to advance their business objectives.

Trend | Physician Compensation

Physician Distribution, Mobility, Fair Market Value and Compensation Surveys

An analysis of regional differences in physician compensation coupled with the general tendency against long-distance relocation shows there is no truly national market for established physicians. Rather, local market conditions must be considered in setting fair market value.

Column | CMS and MedPAC Guidelines and Trends

Who’s Afraid of a Little Risk?

The Medicare ACO modeled advanced by CMS has encountered some challenges, but it still holds promise if CMS addresses the flawed idea of retrospective attribution of patients to an ACO.

Features

How To | Population Health Management

Optimizing Physician Referrals: A Key to Successful Population Health Management

Providers should focus on improving quality, reducing costs, and delivering a positive patient experience to stage a high-functioning physician referral network.

Trend | Healthcare Business Trends

The Shift to Outpatient TKA—What’s the Big Deal?

Hospitals should prepare for the impending revenue impact of a shift of total knee arthroplasty (TKA) procedures from inpatient to outpatient settings by developing strategies to retain market share for TKA.

How To | Care Management

Optimizing Care Delivery Through Perioperative Value-Based Care

A focus on value during perioperative care can result in better financial and clinical performance.

How To | Accounting and Financial Reporting

3 Keys to Defending a Healthcare Organization’s Margins

As the healthcare industry transitions from volume-based to value-based payment, healthcare organizations must establish priorities and prepare to assume risk in select areas of focus. To do this, providers must develop an understanding of the precise costs for individual encounters, procedures, and episodes of care, and hone in on specific cost drivers.

Focus Area

Trend | Patient Financial Communications

Reinventing Medical Payments: The Urgency for Digital Transformation to Prioritize Patients

The rising cost of health care has made the need for convenience in patient payments necessary for both patients and providers.

Columns

How To | Healthcare Business Trends

Challenges and Opportunities, Part II: Responding to Health Care’s Evolving Landscape

With hospitals on the move to enter new payment arrangements and participate in programs disciplining hospital readmissions, they should consider two new approaches to healthcare. 

Trend | Innovation and Disruption

Fostering Innovation in Healthcare Finance

HFMA's 2018-19 Chair, Kevin Brennan, explains that fostering innovation while also maintaining daily operations is a challenge, but that when innovation starts at the top it can grow a culture where change is not feared.

Column | Healthcare Business Trends

Yet One More Legal Attack by Republicans on the ACA

Arguing that the removal of the insurance mandate means Affordable Care Act is no longer a tax, the DOJ has now challenged its constitutionality in court. The author also discusses some of the likely outcomes, depending on the court’s decision.

Trend | Population Health Management

The Critical Role of Health Systems in the Nation’s Response to the Opioid Crisis

Although state and federal programs dedicated to the opioid crisis are helpful, communities—specifically hospitals and health systems—must be dedicated to making improvements. 

Column | Healthcare Business Trends

Rededicating Ourselves to Building a Better Future

HFMA President and CEO Joe Fifer suggests solutions to healthcare finance leaders such as helping shape change, rather than passively observing it, or finding other ways to transition in the industry to avoid change fatigue.

Departments

Column | Analytics

Acute Care and Critical Access Hospital Occupancy Rate Variability by Location

An analysis of Medicare cost reports from 2016 shows that urban U.S. hospitals typically had higher occupancy rates than their rural counterparts, with notable exceptions in the Northeast and Arizona.

Advertising

Business Profile | Patient Financial Communications

Cedar: Reimagining the Patient Financial Experience

Cedar’s CEO and co-founder tackles the topic of patient payment and the importance of having an innovative patient financial management system.