Rural Hospitals Continue to Face Healthcare Revenue Cycle Management Challenges

Rural hospitals are currently facing a unique set of healthcare revenue cycle management challenges that may force them out of business if not addressed properly. Should this happen, the country's rural population can possibly be left without any available healthcare options in their area. After all, rural hospitals are sparsely located throughout the land.

From 2010 to August 2017, a disturbing trend continues to haunt the healthcare industry. According to recent data from the University of North Carolina's G. Sheps Center for Health Services Research, as many as 80 rural hospital closed during the said period. Read more from this blog: http://bit.ly/2xR3ieq

The Key to Lowering Patient Cost is Value-Based Healthcare Revenue Cycle Management

A certain point has been made clear during the recent Value-Based Care Summit in Chicago by Xtelligent Media. In enabling healthcare organizations to align their healthcare revenue cycle management with value-based reimbursements, they need to start breaking down both financial and clinical siloes that have been established using the fee-for-service payment models. Moreover, everyone in each healthcare organization must learn to work together better.

According to Carmela Roberts, JD, CEO and Administrator of Valley OB-GYN Clinic in Michigan, there is a need to promote collaboration among all hospital staff, including those serving operational, financial and clinical duties. This, according to her, would be the key to developing a value cycle instead of the traditional healthcare revenue cycle.

Balancing Quality Services and Cost Efficiency

The value cycle looks to cover all the processes that can optimize financial, operational and clinical opportunities to achieve the best possible health outcomes at the lowest possible cost. As such, it would include a number of traditional revenue cycle management components, including charge capture, claims management, compliance and pricing. Read more from this blog: http://bit.ly/2vbey6Y

Healthcare Revenue Cycle Management: A Drop in Prices, Spending and Employment

The healthcare industry saw lower numbers in the first quarter of the year. Records showed that prices, spending and employment took a fall from June 2016 to April 2017. This downward trend occurred three years after healthcare spending was accelerated.

According to statistics, healthcare prices dropped 1.9% from March to April this year. It’s only 1.6% higher than that of last year, marking the lowest annual growth rate since June 2016. Healthcare employment growth, on the other hand, fell by 10,000 per month since 2016, while healthcare spending declined by 0.5% during the same period.

These figures came amid the controversies surrounding the Trump administration’s plans to repeal Obamacare and the recent proposed budget cuts that will affect Social Security Disability Insurance. There are various reasons for the drop and slow growth in healthcare prices, spending and employment. Read more from this blog. http://bit.ly/2uYpLFK

Challenges in Healthcare Revenue Cycle Management and How Hospitals Can Weather the Storm

Last year, local hospitals reported good records despite the challenges in revenue cycle management. Increasing operating costs, regulatory issues, flat reimbursements and the switch from patient volumes to lower-paying outpatient and observation services didn’t faze many healthcare providers. Thanks to a strong stock market and lower tax-exempt bond costs, hospitals continued to do well.

While this is good news, providers can’t be complacent now with the changes and regulations awaiting the Affordable Care Act. Under the Trump administration, the U.S. House Republicans recently gave the greenlight to a bill that would revise the 2009 Obamacare. It still needs to get the approval of the Senate, but many are concerned about the impact it will have if it’s passed.

Repealing the Expansion of Medicaid

One of the major concerns is Medicaid expansion. If the bill pushes through and removes that program, it will affect people who are enrolled in it, along with the revenue of their associated hospital. St. John Providence Health System in Warren, for example, has seven hospitals and 670,000 people enrolled in Medicaid. Non-profit hospitals like these will be the hardest hit when Medicaid expansion is repealed.

Read more from this article: http://bit.ly/2qiL4ik

Medicaid Expansion Shown to Improve Healthcare Revenue Cycle Management

Operating a healthcare facility is no mean feat. For hospital executives, the task involves not only providing excellent medical care to patients, but it also means keeping a business afloat. After all, a hospital is an expensive venture to run—almost all of its manpower are highly skilled professionals, and the facility uses advanced equipment to help diagnose and treat ailments.

As such, keeping a healthy bottom line is crucial to any hospital’s survival. However, unpaid medical bills prove to be an all too real threat. According to a report from The Tennessean, about half of all hospital bills go unpaid. Healthcare executives know that potential bad debt can hobble their facility’s ability to deliver excellent care to the infirm.

Read more on this article: http://bit.ly/2pC1vbZ

Monitoring the Metrics of Healthcare Revenue Cycle Management Poses Benefits to Revenue Stream

 

Amid high-deductible health plans and healthcare consumerism, providers are experiencing changes in revenue sources. However, many of them still face challenges in cash flow and payment collection. According to one study, although hospital receiving offices collect from 35% of their patients, the total amount accounts for only 19% of patient financial responsibility.

One way to keep the cash flowing is to monitor revenue cycle management metrics. With regular monitoring, healthcare organizations and systems create the ability to gain maximum reimbursement and improve the assessment of their billing departments. These metrics should be carefully selected and tracked to inform providers of where their flows currently stand and whether they are heading in the right direction, based on their goals and objectives.

Rate of First Pass Payment Recovery

Experts say that organizations should be receiving a first pass recovery rate of at least 80% to ensure that they are able to close out receivables accurately and on time. Monitoring this metric allows providers to determine efficiency in terms of getting full payment for insurance claims at first pass. Due to submitting claims a second time around wastes time and money, hospitals must strive to collect on the initial submission. They should focus on checking whether claims are processed instantly and closed on time. Read more on this article. http://bit.ly/2mMqNSZ

The Effects of a Trump Presidency on Value-Based Care and Healthcare Revenue Cycle Management

Differences in political opinion aside, the United States will undergo significant policy changes under a Trump administration. The Republican party say they want a total repeal of the Affordable Care Act (ACA). In reality, legislators know that a complete repeal is impossible without Democratic support and doing so would leave at least 20 million previously uninsured Americans, who were covered through health exchanges, without health insurance again.

For this reason, value-based care will most likely remain with some ACA changes affecting healthcare revenue cycle management.

Possible ACA Changes Under Trump’s Administration

A number of popular Republican provisions plan to revise the ACA. Republicans want to remove tax subsidies for premiums, decrease Medicaid expansion and reduce taxes levied to pay for some of the ACA’s provisions. House Speaker Paul Ryan (R-WI) talked about a framework for maintaining preventive services, population health management and provision of broad coverage. Read more from this blog: http://bit.ly/2m0QG1P

New Technologies That May Affect Your Healthcare Revenue Cycle Management for the Better

Throughout time, technology has changed the way people live. This prominently occurs in the healthcare industry, which has a constantly changing landscape that relies on technology for so many things. If your hospital is to have success and grow as a result of new technological advances, you need to be aware of the following trends.

Revolutionary Software

The truth is, human error is always going to affect hospitals’ profits and, ultimately, healthcare revenue cycle management. These errors generally occur in the patient intake process, as there is a lot of patient information to document and keep up with. It’s only natural that errors sometimes occur throughout the day. Fortunately, new and improved software are being developed to reduce these errors so hospitals can generate maximum profits.  Read more from this blog: http://bit.ly/2jkXlDE

Eligibility for Medicaid Program and the Joint ACO Model: What to Know

As of 2015, there are at least 73 million people benefitting from the government’s Medicare program, according the Kaiser Family Foundation. As it turns out, it’s not just helping underprivileged citizens get the quality healthcare they deserve, but it’s also helping hospitals protect their bottom line.


Indeed, eligibility services—wherein specialists help patients determine their eligibility for Medicaid benefits—have helped hospitals avoid potential bad debt by helping minimize out-of-pocket costs. Since the Medicare program is subsidizing medical care costs, there is a lower probability that outstanding hospital bills will become debt.Read more from this blog: http://bit.ly/2imyium

Quarantine Costs Strain Revenue Cycles

Now that the Ebola outbreak has reached U.S. soil, it's up to hospitals and medical facilities around the country to keep it in check. The cost: $1,000 an hour.

At least, that's the figure experts came up with after computing the cost of Thomas Duncan's treatment at Texas Health Presbyterian in Dallas. During his nine-day confinement, Duncan racked up between $18,000 and $24,000 per day, according to a Bloomberg report. Including indirect costs, his total bill may reach half a million dollars.

Knowing the Disability Benefits for Children

Having a disabled child can be a heartbreaking experience for any parent. The emotional toll that this exacts on any caregiver is staggering and the attendant financial cost can be steep. The difficulties can seem insurmountable, but there are ways to get help; one of these is to apply for social security benefits for your child.

The benefits available for your disabled child come in two types: Social Security Disability Insurance and Supplemental Security Income. The two are often confused, each is distinct from the other. First, SSDI is dependent on whether the parent has paid for social security benefits in the past, while the SSI looks at the limited resources of the family and the disability of the child. The child’s disability should be severely limiting, and that he or she must have had it for more than a year.

SSI is also more limiting since it has no dependent benefits. This means that families under SSI receive only what the plan offers. SSDI is more flexible—for the disabled sole wage-earner, for instance. SSDI allows to provide fifty percent each (of the main claimant’s benefits) to the disabled’s spouse and dependents for as long as the awarded disability payments fall within the 150%-180% total maximum range, and not more.

To claim benefits from SSDI or SSI, the parent of a disabled child must apply for them. Though it can be relatively uncomplicated to accomplish this, most people need help from federal benefits eligibility services like DECO Recovery Management to ensure that they stand a higher chance for approval.