March 2022

Cover Story

Article | Revenue Cycle

Revenue cycle staff shortages push leaders to adapt quickly

The pandemic-driven workforce shortage is leading to significant changes in revenue cycle management operations at many hospitals and health systems.

Features

How To | Cost Effectiveness of Health

6 ways to ease physicians’ burden from coding, documentation and risk adjustment

The COVID-19 pandemic has heightened the need for U.S. health systems to gain physician cooperation in documenting and coding patient risk. Yet these organizations also should be mindful of the administrative burden many physicians feel from having to perform these processes, which has contributed to feelings of burnout among them. This article describes six steps hospitals and health systems can take to help ease the administrative burden for physicians, which is necessary to ensure the future quality and effectiveness of the nation’s healthcare system.

How To | Payment Reimbursement and Managed Care

8 ways healthcare providers can smooth the DRG audit process

A health system’s financial sustainability depends on its being paid appropriately for the services it delivers. Yet routine payer audits can all too often result in downgrades of a health system’s billed diagnosis-related groups (DRGs), resulting in lower payment. It therefore behooves health systems to be well prepared for such audits and thoroughly understand why payers’ are most inclined to take such action.

Article | Revenue Cycle

How LifePoint Health revamped its revenue cycle

Executives for the non-urban focused health system wanted to get all of its hospitals using a single revenue cycle management approach.

Columns

Column | Leadership

The pandemic isn’t the only reason for deferred care: Many transgender adults regularly forego care due to discrimination in healthcare settings

People defer care for many reasons. HFMA Chair Tammie Jackson shares how to make patients feel welcome and promote health equity, focusing on transgender adults.

Column | Cost Effectiveness of Health

Paul Keckley: Improving nutrition in the U.S. starts with addressing the elephants in the room

Good nutrition remains elusive for many Americans because they face obstacles in being able to make healthy choices. These “elephants in the room” can only be addressed by policymakers, with the engagement of healthcare and other sectors of society.

Column | Leadership

Jill Geisler: Do you have what it takes to be a first-class mentor?

Column | Cost Effectiveness of Health

David Johnson: Cracks in the foundation, Part 2: Overcoming healthcare’s artificial economics

In normal markets, demand for services at given prices drives supply. Healthcare reverses the equation so demand for services is driven by the supply of healthcare facilities and practitioners, says hfm columnist David Johnson. In this second column in his series examining structural defects of the U.S. healthcare system, Johnson challenges these “artificial economics” and describes how cutting-edge health systems will apply new, more customer-focused economics to become the future market leaders.

Column | Healthcare Business Trends

Ken Perez: Healthcare assailed by a labor crisis, with pharmacy technicians particularly affected

The healthcare sector lost more than half a million workers from February 2020 to September 2021, contributing to labor shortages in the sector. An often-overlooked yet important element in this trend is the acute shortage among pharmacy technicians, who play a vital role in the delivery of pharmacy services.

Column | Cost Effectiveness of Health

Joe Fifer: Cost effectiveness of health: Why now?

HFMA President and CEO Joe Fifer addresses the urgency of making the shift toward cost effectiveness of health.

Departments

Column | Leadership

Healthcare lawyer Paul DeMuro takes new position with Nossaman LLP

HFMA members Paul DeMuro and Angie Swearingen have accepted new positions. HFMA remembers Gary Lampi and Milan “Doc” Barto, two former National Board members.

News | Coronavirus

News Briefs: Report finds unwillingness to get the COVID-19 vaccine drove healthcare job cuts in January

A roundup of top news for healthcare finance professionals.

Supplements

Trendsetter | Patient Experience

Covenant Health sees a 4.6-fold ROI by automating workflows for philanthropic medical financial aid programs

Read about this solution that combines artificial intelligence (AI) with live, human patient advocates to find philanthropic programs, appropriately match and apply those programs to patients and convert uncompensated care to cash.

Article | Medicaid Payment and Reimbursement

Medicaid eligibility: Strategies to provide care access and maximize reimbursement

Is your hospital or healthcare system constantly seeking ways to help patients access care through Medicaid while maximizing their own reimbursement? Look no more as this sponsored survey unveils effective solutions for these challenges.

Article | Technology ROI

PMMC’s Contract PRO helps hospitals see an average 10 to 1 ROI

When the time comes to renegotiate payer contracts, one company’s contract management system “provides managed care leaders with the ability to model all commercial payer contract terms to quickly understand the impact on net revenue.”

Executive Roundtable | Denials Management

Simplifying the revenue cycle while building resilience

“Several senior financial leaders discuss their organizations’ revenue cycle management (RCM) optimization initiatives, focusing on a variety of strategies, including eligibility checks, denials prevention programs and automation.”

Article | Supply Chain Management

Premier’s ERP solution specifically addresses healthcare organization challenges

A company that addresses unique healthcare challenges through supply chain, finance and workforce management solutions provides advice for successful implementation of a new product or service.