Revenue Cycle Management

Chief financial officers at hospitals and health systems must track a multitude of difficult financial issues these days. One question, however, always stops a conversation cold: Why are our reimbursements declining?

Although there are some indications of a possible lull, hospital systems are still buying up private physician practices at a high rate. With that come concerns about maintaining the revenue cycle during transition, but there are steps hospitals can take to smooth the process.

Last month the Centers for Medicare & Medicaid Services published its proposed rule to update the Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System rates and policies for calendar year 2015. Here's what you need to know.

If hospitals want to survive the new healthcare environment, they can't simply brace themselves for the Centers for Medicare & Medicaid Services' new reporting measures -- they must proactively improve their quality scores.

Money Atwal, who is both CFO and CIO at Hilo Medical Center in Hilo, Hawaii, shares with Healthcare Finance News how his organization is counteracting declining reimbursements and resources.

When it comes to speeding up the revenue cycle, the hospital pharmacy has its own part to play.

As payers and employers put pressure on providers to assume more financial risk, providers are struggling to assess the impact of the risk they have already assumed.

Medicaid beneficiaries deserve the same access to healthcare services and products as people with commercial insurance or Medicare. But since Medicaid pays doctors and hospitals 27 to 65 percent less than commercial health plans, it makes it awfully difficult for providers to be payer agnostic.

With patients paying more out-of-pocket costs and exchanges increasing the number of plans providers deal with, having financial counselors in a practice may become a necessity.

Even though it has not been determined what impact the health insurance exchanges will have on hospital finances, there are steps hospitals can take to increase the likelihood of positive effects on their revenue cycles.