Rethinking Revenue Cycle Management Services in the Face of Bundled Payments

There has never been an era when the healthcare industry has seen such an upheaval quite like the past decade. With the passing of the landmark Affordable Care Act (ACA), millions of previously uninsured Americans now have a safety net to rely on should they fall ill.

However, the influx of new patients also means that there has been a renewed focus on providing quality care. On the flip side, providing quality care also often means higher costs of treatment. Now more than ever, healthcare providers are forced to juggle these two seemingly opposed aspects of the business. Read more from this blog: http://bit.ly/2ycHbjE

Revenue Cycle Management Services and Its Relevance for the Future

If there’s any remaining doubt as to the relevance of revenue cycle management services to healthcare institutions, new research studies showing an upward trend for the industry in the next several years ought to quell them.

According to the studies, the global healthcare RCM market is projected to grow by as much as 5% in terms of compound annual growth rate (CAGR) come 2021. Because physicians are the biggest users of RCM software, it only goes to follow that they will also be the ones benefitting the most from this development.

With the implementation of upgraded and updated RCM services, they could easily improve on their overall processes and clear their administrative tasks more efficiently. The most obvious benefit coming from all of this is a better leeway to pay more attention and provide topnotch care to their patients who matter most. Read more from this blog: http://bit.ly/2wp6EoM

Revenue Cycle Management Services and a Decrease in Healthcare Program Enrollees

The confusion regarding the state of the country’s healthcare program continues on, and this time the effects are being more widely felt than ever. On the frontlines are healthcare providers who have reported a significant decrease in the number of enrollees over the past year.

It’s no wonder how this development came to be. With the change of administrations and a twice-failed attempt at repealing and replacing the existing Obamacare, there has been a lot of concern as to what kind of new program will be finally implemented.

Higher Risk, Low Returns

Healthcare providers are now talking about how much more difficult it is to keep the business afloat, mainly because they are not able to hit the numbers in enrollment they had been expecting. Read more from this blog: http://bit.ly/2uptG18

The Advent of Online Billing Portals Spurs Revenue Cycle Management Services to Adjust

How familiar is your health care facility with the primitive payment options available to patients? If you only have a simple username and password system for a third party payment site, you’re already behind the times when it comes to new technologies that streamline revenue cycle management services.

Recent evidence reveals concerning trends in healthcare collections. Patients are now expected to assume more responsibility for the cost of their health care, which means hospitals are required to be much more upfront about the portion of the bill each person is expected to pay. While patient satisfaction may increase, many bills might go unpaid and healthcare facilities might begin to suffer if suitable processes aren’t in place to collect these payments.

Some Background on Online Payments

Due to concerns over patient confidentiality, online payment methods inherently involve complex or hardly simple procedures. A common method involves an online form completed by patients who convey their payment details on the form. The snarl in this method develops when a revenue cycle management worker must then re-enter these details to manually process the payment.

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

To Reverse the Rate of Unpaid Bills, Outsource Your Revenue Cycle Management Services

Over the tenure of the American Health Act (ACA), some observers have blamed it for the rise of unpaid patient bills at hospitals. Following the failure of House Republicans to replace the ACA with their own American Health Care Act, hospitals have come up with a new strategy to deal with a rising volume of unpaid bills. They bill the patient before any medical service is actually done. Hospitals are forced to try out this option because insured Americans are still required to spend thousands of dollars before their actual insurance payments ensue.

The ACA Has Led to Greater Unpaid Bills Over Time

In recent years, the ACA extended insurance coverage to as many as 20 million Americans. Initially, this allowed hospitals to reduce debt from uninsured patients who had originally been unable to pay their medical bills.

As time went on, however, more Americans on ACA plans have chosen insurance with low monthly payments, resulting in a trade-off with dire consequences. Patients now have to deal with higher out-of-pocket costs the moment they need medical care. As a result, hospitals must deal with a higher percentage of unpaid bills as patients continue to face the same dilemma over and over again when it comes to healthcare plans. Read more on this article: http://bit.ly/2qgYrz7

Revenue Cycle Management Services: Turning the Focus to the Consumers

Chronic and life-threatening illnesses are not the only factors that can burden patients. Financial stress is another major issue that many of them face when they get to a hospital to seek treatment. Filling out patient forms, filing for insurance claims and settling the bill, among others, can be a tedious process as well. Given all these, getting quality healthcare can be quite challenging for patients.

This is why hospitals are urged to create a consumer-focused revenue cycle management (RCM) program. Consumer-focused means that the process is designed to make it easier for patients to access information, fill out the necessary papers and make payments, among others. Since the entire treatment process starts and ends with the RCM, it’s important for hospitals to make it patient-friendly. In this way, hospitals can tend to their patients beyond their medical needs.

Hospitals can make their RCM more consumer-centric by creating efficient scheduling, registration and payment systems, among others. It can be done in several ways, including the following:Read more from this blog. http://bit.ly/2mMrhc1

ACA Repeal, Medicaid Rollback, and the Importance of Revenue Cycle Management Services to Hospitals

With talks of an Obamacare repeal getting louder–and more certain–as Republican congressional leaders have promised under the new administration, uncertainties about the future of its many beneficiaries are raised as well.

Medicaid is just one of the systems that will be affected should the Repeal & Replace program finally take place. While the White House has given previous reassurance that Medicaid will not be cut off, the proposed restructuring could still end up doing exactly just that.

The Relevance of Medicaid Changes

Prior to the implementation of Obamacare, Medicaid was mostly availed of by pregnant women, parents, disabled, the elderly and low-income children. Under Obamacare, Medicaid was expanded to include individuals who would not otherwise have been able to afford private insurance, but also were not deemed low-income enough to qualify for Medicaid. Read more from this blog: http://bit.ly/2mBeGFu

Medicaid Changes That Could Affect Revenue Cycle Management Services

Medicaid, a jointly-funded Federal-State health insurance program for low-income people, continues to grow in size and importance. It’s now 2017, and there will be some major changes to this system, particularly with the number of people getting accepted into this sought-after program. This ultimately affects your hospital’s revenue cycle, thereby affecting the services and practices you employ in the future.

Medicaid Expansion Continues to Gain Traction

State interest in Medicaid expansion continues to grow. According to research, Medicaid has spiked to over 72 million enrollees since Obamacare and 31 states have expanded their Medicaid programs under the Affordable Care Act. Research links these expansions to coverage gains, reductions in hospital care costs and state budget savings.

These growth trends may also reflect economic downturns. Individuals who lose their jobs have declining incomes, allowing them to qualify and enroll in this program. At the surface, this seems great because they are getting coverage they couldn’t otherwise afford. Unfortunately, this increases Medicaid spending so that ever-growing demands can be met. Read more from this blog: http://bit.ly/2k7pHOH

Expanding the Medicaid cut

Medicaid is gradually becoming a favorable healthcare insurance option for families under the Affordable Care Act. After years of coverage for pregnant women, children, and persons with disabilities, the law allowed eligibility for Medicaid for parents in the lower-income bracket or single adults with no kids.

The Medicaid expansion was one of the major provisions at stake in the ACA cases decided by the Supreme Court in June 2012. The Supreme Court upheld the Medicaid expansion, but limited the federal government's ability to penalize states that don't comply. Therefore, where it was originally mandatory for states to expand Medicaid, now it’s effectively optional.

Update Your Medicaid for More Serious Diseases

Recent health scares such as Ebola have been a great cause of concern around the world. State health officials in South Carolina, in particular, have been conducting the necessary steps to address potential cases of Ebola and other serious viral diseases by means of a statewide referral system that allows patients to get immediate medical attention.

Common Questions about Medicaid Eligibility

Many Maryland residents have lauded the passing of the Affordable Care Act (or “Obamacare” as it is commonly called). Of course, many of your patients are probably unaware that there are already laws that seek to make medical care affordable for people, especially those in dire financial straits. Case in point: the Medical Assistance program or Medicaid.

This provision was created in 1965 to assist low-income individuals who are either under 21 or over 65 years old, pregnant, disabled (or caring for a child who is), or responsible for children under 21 years old.

As with any law, though, expect your patients to have plenty of questions about Medicaid eligibility. Below are some that you might encounter:

Where Can I Get Application Forms?

To make things easier, the state has made application forms available online. Your patients may download them from: http://mmcp.dhmh.maryland.gov/docs/QMB-Application-02-10-rev.pdf.

What Services are covered by Medicaid?

Medicaid covers a variety of medical services such as ambulatory surgical center services, laboratory and x-ray services, and even mental health management, among many others.

What if I Make Too Much Money?

If a person makes too much money to qualify for Medicaid, they may still take advantage of this program via the “step down” procedure. This requires the applicant to show that his or her medical expenses exceed their income.

If you need help explaining the full benefits of Medicaid and assisting patients to enroll, you can tap third-party specialists like DECO Recovery Management.