How Self-Pay Balances Are Threatening Your Revenue Stream

Healthcare organizations are seeing their margins shrink; and when margins are tight, a high-performing revenue cycle becomes evermore vital. After all, failing to collect the dollars associated with performed services can quickly turn a profitable organization into a floundering one. When it comes to collecting these dollars, self-pay balances are becoming an increasingly important variable that must be factored into revenue cycle equations. Continue reading

The HealthKit Revolution, Part 1: A Game-Changing Idea

Anyone who has upgraded to IOS8 or an iPhone 6 may have noticed the appearance of a new little app called HealthKit.  Considering the number of health apps that get shoved in our faces (looking at you, Nike), many of you may be inclined to delete it without a second thought. But here’s the thing – it’s not like every other health app.  Why else would a forward-thinking company like Apple be willing to make it standard functionality on its latest products? This leads us to wonder whether the HealthKit platform might just have what it takes to garner mass appeal and long-term staying power. Continue reading

Three Trends Shaping Outpatient Orthopedic Care

In recent years, orthopedic providers have watched a prolonged period of reimbursement stability come to an end. A significant number of elective procedures and a robust stream of revenue from ancillary services had largely shielded orthopedic providers from the reimbursement declines experienced by many other specialties. That, in turn, resulted in little change to orthopedic care delivery.

But shrinking reimbursement levels and new payment models are now directly affecting orthopedic physician practices.  Payors and providers are seeking cost-saving opportunities amid high growth expectations. As a result, a dynamic environment is developing in which health systems and orthopedic physicians alike are looking to restructure and optimize the delivery of orthopedic care in the outpatient setting.

While orthopedic providers continue to navigate this new environment, the following outpatient trends are expected to continue taking shape in 2015: Continue reading

Revenue Cycle – A Path to Integration

Managing a revenue cycle has never been the most glamorous component of running a healthcare organization. Preregistering patients, collecting co-payments, submitting claims, and ultimately obtaining reimbursement for services is a costly and cumbersome process. It’s also an essential one, since this is how healthcare providers are paid for the work they do.

Revenue cycle management takes on added layers of difficulty – and importance – in a healthcare landscape characterized by increasing alignment between hospitals and physicians. As the industry responds to shrinking reimbursement and the pressure to operate in a value-based care environment, more and more physician groups are turning to hospital employment or affiliation as a means of ensuring financial stability. As a result, leaders are waking up to discover that their hospitals have become health systems seemingly overnight. Continue reading

CMS Targets New Payment Model for Oncology

On February 12, 2015, the CMS Innovation Center released details for a new payment and care delivery model designed to improve coordination for cancer care. The Oncology Care Model (OCM) is aimed at physician practices that administer chemotherapy and bill for services under the Medicare Physician Fee Schedule. Continue reading