Accounting & Financial Management
One of the major arguments against the ICD-10 transition are the financial costs to medical practices. Sure, there are accusations of bureaucratic overreach, but the anti-ICD-10 argument is primarily financial. So why not offer providers an incentive?
For the second year in a row, Humana ranked first in overall performance among 148 payers, according to the 2014 PayerView Report. The report ranks health insurers according to specific measures of financial, administrative and transactional performance.
Many hospitals focus their efforts to mitigate risk associated with the ICD-10 transition and associate that with revenue. But what about your current risk of penalty associated with value-based purchasing and with Patient Quality Reporting System programs?
The federal government and a number of hospitals may want to transition to a new Medicare reimbursement model. But there are still billions of dollars in disputed fee-for-service claims waiting to be settled, sowing animosity between health systems and the feds.
While majorities of healthcare providers see value-based payment models becoming the reimbursement status quo in coming years, fewer than one-in-three say the reward is worth the risk.
Value-based purchasing introduces the potential for unintended consequences, and needs to be monitored to avoid disparities between hospitals. But it's too early to claim that VBP puts disproportionate share hospitals at a disadvantage.
According to a study published this week in Health Affairs, the Great Recession did not have a permanent negative financial impact on vulnerable hospitals, such as safety net facilities, or those considered financially weak prior to the recession. However, this doesn't mean these same hospitals will fare so well in coming years.
The Recovery Audit Contractor, or RAC, program is on vacation. CMS has slowed down audit activity in advance of new contracts. Still, this is no time for hospitals to get complacent about their audit management programs.
Increased admissions drove revenue gains for Tenet Healthcare Corporation and Community Health Systems in the first quarter of 2014 compared to 2013. Both for-profit hospital firms appear confident midway through Q2.
Determining insurance eligibility and estimating patient payment are two of the most overlooked steps in patient engagement and the revenue cycle process. Yet, they're also two of the simplest things a provider can do to maximize revenue and profitability.