Denial management in healthcare – sounds like a topic that Chief Financial Officers and Revenue Cycle Directors are very interested in. However, in today’s environment, where every bit of lost…
Category: Assessment & Benchmarks
Key Performance Indicators for Healthcare
There are a lot of people offering key performance indicators (KPIs) or healthcare metrics for the healthcare industry. If you are a physician or medical group, should you consider developing…
Medical Practice Valuation: What factors matter most?
A medical practice valuation (especially from a consultant!) may seem like a black box: some data goes in and a number comes out. Fortunately, the components and process are a…
Medical Billing Revenue Cycle – 4 Key Takeaways
Authors have spilled a lot of digital “ink” lately describing the medical billing revenue cycle. We used to just say medical billing or hospital billing. Now we label it much…
What is Value-Based Care? 5 Observations in 5 Minutes!
Value-based care: a term we hear about a lot these days. There are also its synonyms, value-based reimbursement, and value-based payments. Although they are often used interchangeably, they really can…
Value-Based Reimbursement in Healthcare – 2 minute introduction
Value-based reimbursement in healthcare, or VBR, is the movement of care from fee-for-service-based models to care with incentives based on quality. The traditional fee-for-service model has incentivized quantity. Value-based reimbursement…
Medical Revenue Cycle in 9 Steps
The medical revenue cycle is the process of managing a patient’s account from the beginning, when they are pre-screened for financial coverage and their account is created, to the final…
Value-Based Reimbursement Transition
Value-Based Reimbursement-laying the groundwork for a transition to it is crucial. As healthcare spending continues to rise, the Centers for Medicare & Medicaid Services (CMS) is looking for ways to…
Physician Practice Revenue Cycle – 8 Basic Best Practices
The physician practice revenue cycle is the one thing which will sustain a practice to provide patient care without undue “cash flow problems.” Even if you have a premier healthcare…
Revenue Cycle Services in Healthcare – 3 Tactical Outsourcing Observations
It’s a decision all healthcare organizations must struggle with at some point when assessing their revenue cycle services: Does it make more sense to outsource revenue cycle services or keep…
Value-Based Reimbursement Models
There’s a reason the healthcare industry is shifting toward value-based reimbursement models and away from volume-based care. Value-based care reimburses healthcare providers based on the quality of care they provide,…
How to Increase Medical Practice Collections – avoid these 4 mistakes!
If you’re wondering how to increase medical practice collections, start by making sure you’re avoiding 4 common mistakes. Let’s look closer. The challenge to increase medical practice collections The…
Revenue Cycle Management Solutions in Healthcare – 9 plus 9
With the trending shift away from fee-based service and toward value-based care, it will become even more essential to find revenue cycle management solutions in healthcare, which are effective. Healthcare organizations…
CMS Value-Based Payment Goals
In April of 2019, the Centers for Medicare and Medicaid Services (CMS) announced it is rolling out a new set of CMS value-based payment goals. It’s called the CMS Primary…
Revenue Cycle Management Process in Medical Billing – 5 Steps
Anyone who knows anything about medical billing knows there are serious issues when you’re trying to integrate a Revenue Cycle Management (RCM) process in medical billing. An essential understanding of…
Pay-for-Performance-Reimbursement
In this post, we explain “pay for performance reimbursement”, what it is, and how it measures quality of care. Then we’ll explore some working examples. The concept of this method…
Outcome-Based Reimbursement
A lot is said these days about Outcome-Based Reimbursement in healthcare. But what exactly is that, and how does it work? Let’s take a look. Five years ago, most of…
Healthcare Revenue Cycle Process
The healthcare revenue cycle process is a non-organic process – non-organic because steps cannot be reversed, skipped or circumvented to save time or collect money faster. Missing or skipping a…
Fee-for-Service vs. Value-Based Reimbursement
The cost of medical care has outpaced inflation for several years now, and it shows no signs of slowing. Despite skyrocketing costs, care quality is not improving under the traditional…
Revenue Cycle Management Outsourcing
According to a recent Black Book Survey, revenue cycle management outsourcing stood at $11.7 billion at the close of 2017 and is expected to climb to $23 billion by 2023….