September 2018

Cover Story

How To | Revenue Cycle

Revenue Cycle Outsourcing Requires Attention to Service Standards and Risk-Based Arrangements

When a healthcare provider chooses to outsource management of its revenue cycle, it should first make sure the arrangement with its vendor partner is well-designed, with clearly defined terms and financial incentives. 

Web Exclusives

How To | Cost of Care

New Approaches for Improving the Cost of Care

Data provided by internal and external sources can give healthcare providers valuable insight into areas for cost improvement.

How To | Revenue Cycle

Ensuring the Revenue Cycle Gets a Clean Bill Of Health

Health systems can reduce denials by using claims management tools, but their use must be supported by a commitment to ongoing process improvement within the organization.

Case Study | Clinical Decision Support

Justifying Expansion of CDI Programs: A Case Study

On hospital’s experience in broadening the focus of its clinical document improvement (CDI) program from just Medicare to all payers shows how healthcare providers can benefit financially from such a change.

Case Study | Cost of Care

Repurposing TDABC: Case Examples from a New York Hospital

Time-driven activity-based costing principles provide an excellent basis for helping healthcare organizations identify opportunities for improving their operations.

Features

Case Study | Payment Models

4 Steps for Success in a Changing Payment Landscape

The experiences of oncology practices participating in CMMI’s Oncology Care Model offer insight on how physician practices can best adapt their revenue cycle for value-based payment models.

How To | Denials Management

Success in Proactive Denials Management and Prevention

Adopting a few key best practices can help healthcare organizations reduce denials.

How To | Revenue Cycle

Technology and a Strong Patient Focus Help Providers Excel in Revenue Cycle Performance

Winners of HFMA’s MAP Award for High Performance in Revenue Cycle offer lessons learned for revenue cycle excellence.

Focus Area

How To | Revenue Cycle

Integrated Revenue Cycle: Coordination Between Insurers and Providers to Ensure Revenue Accuracy

Working together, insurers and providers can realize mutual benefits of verifying the accuracy of information.

Columns

Column | Revenue Cycle

Imagining the Healthcare Revenue Cycle of Tomorrow

HFMA will be source for all things required to create the healthcare revenue cycle of tomorrow.

How To | Technology

Protecting Against Cybersecurity Threats

With the increasing sophistication of cyberattacks in health care, hospitals and health systems must make sure they have effective cybersecurity infrastructures to protect themselves and their patients from such attacks.

Column | Healthcare Business Trends

Administration Meets Challenge to Risk-Adjustment Payments, Counter to Critics’ Assumptions

Responding to a New Mexico district court’s ruling against the risk-adjustment program established by the Affordable Care Act, CMS initially put the program’s payments to collections and payment on hold, but then took steps to reinstate the program.

Trend | Revenue Cycle

Pivoting Revenue Cycle Efforts to Resolve New Financial Realities

Shifts in payment trends require healthcare organizations to work more effectively with insurers and patients.

How To | Innovation and Disruption

Balancing Innovation and Delivery

As healthcare organizations look toward moving into the next phase of innovation, they must not lose sight of their core mission.

Column | Consumerism

The Future of Consumerism

HFMA President and CEO Joe Fifer discusses rising consumer expectations in health care and what it will take to meet them.

Departments

Column | CMS and MedPAC Guidelines and Trends

5 DRGs Are Primary Contributors to Rising Average Loss per Medicare Hospital Admission

Among Medicare admissions in 2015 to 2017, costs per admission rose more rapidly than did payments, and the impact of this trend on hospitals’ financials strongest with admissions associated with 5 DRGs.

Supplements

Executive Roundtable | Revenue Cycle

Key Considerations for Revenue Cycle Outsourcing

A roundtable discussion about the advantages of revenue cycle outsourcing and important considerations for decision making.

Executive Roundtable | Revenue Cycle

Revenue Integrity in the Pharmacy

Roundtable discussion about the importance of preserving pharmacy revenue integrity and strategies for success.

Advertising

Executive Roundtable | Leadership

HealthTrust: Solving Workforce Management Challenges

Two of HealthTrust’s senior leaders talk about strategies for optimizing the hospital workforce to improve productivity and reduce waste.