Blog Archives

Most Bang: Impactful Metrics For RCM

Analyzing Your Revenue Cycle

Analyzing your revenue cycle from start to finish can lead to recouping significant revenue dollars for your organization. Knowing what are the most impactful metrics sets revenue cycle experts apart.

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Posted in Financial, Financial Analysis, Services

Understanding Value Based Reimbursement

Understanding Value Based Reimbursement

The healthcare industry has undergone major changes since the rollout of the Affordable Care Act and now a new type of reimbursement model is putting traditional incentive based payment models on the shelf for good. Value based reimbursement, which ensures that providers are rewarded for performance, quality, and cost reduction (instead of number of services provided), is a model that will help shape the future of healthcare.

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Posted in Financial, Financial Analysis, Health Care Reform, Health Insurance

4 Key Points to Consider When Choosing a Healthcare Accreditation

URAC, NCQA, TJC How To Choose an Healthcare Accreditation Body

Last week we introduced Gwen Roberts, SVP of BHM’s Consulting Division and discussed common questions that come up when organizations start the accreditation journey, focusing mainly on choosing between URAC and NCQA health plan accreditation. This week we are focusing on four key elements organizations should consider when deciding between healthcare accreditation bodies. Since many organizations have very diversified programs and levels, it’s important to understand the culture and expectation of your own organization first. Here are four helpful points that you can use as a guide as you begin your journey towards accreditation.

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Posted in Accreditation, Financial Analysis, NCQA Accreditation, Organizational Analysis, Services, URAC Accreditation, Webinar

One Month – Four Exciting Healthcare Web Events: Take Your Organization to the Next Level

Healthcare Web Events

End of the Year Healthcare Web Events You Won’t Want to Miss! The end of the year is here, and as promised we have put together an exciting schedule of healthcare web events for the month of December.  We have

Posted in Accreditation, Care Coordination, Compliance, Financial, Financial Analysis, NCQA Accreditation, PCHCH Accreditation, Physician Advisor/Peer Review, Specialty Pharmacy Accreditation, Uncategorized, URAC Accreditation

5 Ways Revenue Cycle Management (RCM) Reduces Errors & Increases Revenue

5 Ways Revenue Cycle Management Reduced Error & Generates Revenue

With new advances in the way medical information is transcribed, stored and transferred, technology has created more variables to a provider’s success than ever before. Between tangling with mountains worth of paperwork, handling claims denials and riding the learning curve of new systems like EHRs and ICD-10 coding, there can be lots of room for error and, consequently, potential revenue that slips through the cracks.

Luckily, revenue cycle management systems are here to help. They can streamline a vast array of your most intensive processes — like admitting, coding, balancing budgets, billing and filing claims — in order to provide a supreme level of oversight and control. This control in turn helps you avoid common RCM problems that lead to lost revenue, profitability and productivity.

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Posted in Clinical Operations Improvement, Financial, Financial Analysis, Revenue Cycle Improvement, Services

Cutting Costs Through the Medical Loss Ratio & Independent Review Organizations

Cutting Costs through IROs, medical loss ratio, healthcare

Healthcare spending is on the rise. The federal government has begun several initiatives to control costs, increase efficiency, and increase quality. A couple of these initiatives as outlined in the ACA are the Medical Loss Ratio and the increased prominence of Independent Review Organizations.

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Posted in Financial, Financial Analysis, IRO, Physician Advisor/Peer Review

8 Helpful Questions To Jump-Start Your Accreditation Journey

jump start your accreditation journey

Thinking about accreditation? Here are 8 helpful questions that you can use as a guide to help ease your organization into the accreditation process. We will group the eight questions into four simple steps, in order to help you jump-start your accreditation journey with ease.

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Posted in Accreditation, Clinical Analysis, Clinical Operations Improvement, Compliance, Financial Analysis, NCQA Accreditation, Operational Analysis, Pharmacy Accreditation, Specialty Pharmacy Accreditation, Strategic Planning, URAC Accreditation

The 5 Biggest Challenges Healthcare Leaders are Facing in 2015

healthcare challenges 2015

2015 has been a big year of change for many healthcare systems. With this change, healthcare leaders have been faced with many challenges, including complying with new federal regulations and making strategic moves towards better care. We’ve compiled a list of the five biggest challenges we’ve found healthcare leaders facing this year.

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Posted in Big Data, Clinical Analysis, Financial, Financial Analysis, Health Care Reform, Population Health, Quality Improvement Programs, Services

3 Big Healthcare Trends To Watch in 2015


If you read our post “Healthcare Top 5 Trends,” you know know that healthcare trends from specialty pharmacy to accreditation have been gaining traction this year. We have been keeping an eye on three additional healthcare trends that we expect to hugely impact the healthcare industry through the end of the year and continuing on to 2016. From ICD-10 to telehealth, let’s explore these important trends and what they mean for healthcare!

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Posted in Accountable Care Organizations, Clinical Analysis, Financial Analysis, Health Care Reform, Healthcare IT, Telehealth and Telemedicine

Pharmacy May Be The Answer To Reducing Healthcare Costs


Back in March, we talked about how the role of the pharmacist in the healthcare ecosystem has been expanding over the past decade. In addition to simple medication fulfillment, pharmacist now complete crucial patient aftercare, education, and vaccination administration. Many believe as the role of the pharmacist expands, they could become the key to reducing all kinds of healthcare costs. Here are three ways pharmacy is helping save costs for healthcare.

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Posted in Financial, Financial Analysis, Readmissions, Revenue Cycle Improvement

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