Revenue Cycle Management

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.

New revenue streams can offset financial losses experienced by providers due to lower utilization, especially within the hospital setting. One way providers can grow revenue is by offering health insurance products.

Aggregated clinical data are essential to managing population health. But analyzing the financial health of various service lines is a complex undertaking.

Hospitals are educating their staff and reworking their processes to comply with Medicare's two-midnight rule, which will likely reduce hospital revenue by shifting patients from inpatient to outpatient status.

Keeping a hospital's revenue cycle healthy while transitioning to outcome-based quality payments requires both a "hard" and "soft" approach.

While gamification is trending in the healthcare sector today for engaging patients, CFOs may wonder how useful video gaming can be for managing costs.

Lack of preparation, even with the implementation delay, spells revenue cycle disruption.

Many not-for-profit hospitals are still struggling to align revenue with capital deployment and expenses, a challenge that may grow as patients come in covered by exchange plans and Medicaid.

The potential exists for an unprecedented slowdown in receivables turnover as the Affordable Care Act marches toward full implementation. The importance of having a plan in place to mitigate this problem cannot be overstated.

As a result of the push towards accountable care, increased patient census no longer translates to higher revenue for hospitals. Unless costs are managed internally, higher patient volume may instead lead to narrower margins, if not outright red ink.