Revenue Cycle Management

"Clinical integration" and "organizing for value" are two key themes at the HFMA 2014 ANI conference. Both are crucial in preparation for the transition from a fee-for-service reimbursement system. Here's an example of how one health system is preparing, by teaming with a health plan on a new care management venture.

Of the states that built their own health insurance exchanges that are now operational, Washington, Kentucky and Minnesota enjoyed some successes that might be replicated.

Medicare's ACOs have had mixed early outcomes, but some commercial accountable care ventures, including PPO plans, are showing promise.

With Congress delaying the date for ICD-10 compliance to Oct. 1, 2015, you have a great opportunity to re-assess your organization's implementation progress. Make sure these six crucial tasks are on your ICD-10 punch list.

The Affordable Care Act was designed to make medical care less expensive for the American public; it was not intended to put healthcare providers out of business. But a recent analysis of U.S. hospitals suggests the law could contribute to the demise of hundreds of poor performers.

Hospitals in states that have expanded Medicaid eligibility under the Affordable Care Act are already bringing in fewer self-pay and charity care patient cases, according to an analysis by the Colorado Hospital Association.

As providers continue adjusting to the reimbursement changes wrought by the Affordable Care Act, it appears increasingly likely that hospitals will place more emphasis on collecting payments at the point of service.

The American Hospital Association is asking federal Medicare leaders to stem the practice of using sample hospital audit data to extrapolate overpayments eligible for recovery. The lack of clarity regarding standards for short patient stays has clouded the issue.

States' taxing of Medicaid managed care organizations to raise revenue for state-share Medicaid payments may be illegal, according to the HHS Inspector General. If so, this raises serious questions that could shake up MCO financing models.

Patient satisfaction surveys suggest patients are unsatisfied and hospitals must do more to engage them. New technologies and techniques can help organizations find new ways to involve patients in their care and connect them with their caregivers.