April 2019

Cover Story

How To | Enterprise Risk Management

Mastering Risk: How Healthcare Organizations Can Tap into the Power of Enterprise Risk

Healthcare organizations should adopt enterprise risk management, a coordinated approach to managing risk that looks at how each area of risk affects the organization’s operational and strategic plans.

Web Exclusive

Trend | Payment Trends

States look to Medicare-based reference pricing as the solution to price variation for employee hospital services

To reduce prices paid for hospital services delivered to their employees, Montana and North Carolina are pursuing reference pricing based on Medicare rates.

Features

How To | Value-Based Payment

How a Hospital or Health System Can Assess the Risk of Moving to Value-Based Payment

To gain a clearer understanding of the financial impact of transitioning to a value-based model, healthcare executives can learn from the experiences of another health system that has undertaken a similar migration.

Tools & Tips | Denials Management

Utilization Review: 5 Reasons Hospitals Lose Revenue

Hospitals can gain significant revenue by implementing an effective utilization review program.

Case Study | Quality Improvement

How University of Texas Medical Branch Reduced Readmission Rates Using a Data-Driven, Multidisciplinary Approach

An approach used by University of Texas Medical Branch to reduce 30-day readmission rates exemplifies how healthcare organizations can best use real-time data analytics and standardized process for this purpose.

Focus Area

Tools & Tips | Ambulatory Care

HOPDs vs. ASC: Understanding Payment Differences

The growth of ambulatory surgery centers has hospitals and health systems looking at payment in a new way.

Columns

Column | Financial Leadership

For Healthcare Finance Leaders, Imagining Tomorrow Involves Risk

If healthcare finance leaders want to reduce costs, provide better health outcomes, and improve patient satisfaction, they must seize opportunities and manage risks.

Column | Value-Based Payment

CMS Overhauls the Medicare Shared Savings Program

CMS’s Pathways to Success final rule is a challenging proposition for ACOs participating in the Medicare Shared Savings Program (MSSP).

Column | Benchmarking and Forecasting

Why Healthcare Forecasting is a Combination of Art and Science

A healthcare forecast is based on an analysis of related costs and trends, but a forecaster’s predictions also should consider the possibility of future crossroads where several vectors of change intersect.

Column | Innovation and Disruption

Confessions of an Innovation Killer

As I look back at innovation and my CFO role, I feel like I was a serial murderer of innovation.

Column | Capital Finance

An Integrated Approach Can Direct Risk and Resource Allocation

Market volatility requires hospitals to identify contributors to cash flow variability, quantify potential related risks, and identify how the risks might manifest themselves.

Column | Financial Leadership

Healthcare Finance Leaders Should Belong to the Heartbeat of Progress

HFMA President and CEO Joe Fifer shares highlights of HFMA’s new initiative to reinvent the membership experience.

Advertising

Q&A | Finance and Business Strategy

Peer Review Spotlight: SEI

In this article, SEI discusses how its OCIO services help healthcare organizations navigate the biggest challenges in healthcare.

Trendsetter | Business Intelligence

Cracking the Code on Physician Practice Performance

In this article, Premier discusses how it works with medical groups and health systems to better leverage business intelligence to identify and seize performance improvement opportunities.