Revenue Cycle Improvement Archives - BHM Healthcare Solutions

CDC: America’s Uninsured Rate Rising During Trump’s First Year

The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.

2018-05-22T20:26:47+00:00 By Emily Immer|Health Insurance, Revenue Cycle Improvement, Trends|

Trump Administration Plan To Lower Drug Prices and Reduce Costs

The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.

2018-05-15T16:48:27+00:00 By Emily Immer|Health Insurance, Revenue Cycle Improvement, Trends|

Study: Hospital Prices Show ‘mind-boggling’ Variation

The prices hospitals negotiate with health insurance companies vary enormously within and across geographic regions in the United States, according to a new study coauthored by Zack Cooper (Yale), Stuart Craig (University of Pennsylvania), Martin Gaynor (Carnegie Mellon), and John Van Reenen (London School of Economics).

2018-05-15T16:49:40+00:00 By Emily Immer|Financial, Financial Analysis, Health Insurance, Revenue Cycle Improvement, Trends, Uncategorized|

Drug Prices Major Factor For Choosing A Payer Plan

A number of recent reports point to drug prices as the leading factor for choosing insurance coverage, particularly Medicare Advantage Plan. Payers must prioritize decision factors for signing and retaining members, meaning payer involvement in pricing and rebates directly influence member growth.

2017-12-12T18:12:11+00:00 By Eric Duchinsky|Health Insurance, Revenue Cycle Improvement, Trends|

5 Medical Cost Pressures Shaping 2018

The era of volatile swings and double-digit growth in employer medical costs appears to be ending. With medical cost trend hovering in the single digits for several years, the industry has been waiting for the inflection point when spending will take off. But that spike appears unlikely to happen. The New Health Economy is settling into a “new normal,” typically characterized by more attenuated fluctuations and a single-digit trend.For four years, medical cost trend has hung between 6 and 7 percent, seeming to settle into a “new normal.” PwC’s Health Research Institute (HRI) anticipates a 6.5 percent growth rate for calendar year 2018, half a percentage point higher than in 2017.

2017-07-11T18:11:23+00:00 By Eric Duchinsky|Financial, Financial Analysis, Health Insurance, Revenue Cycle Improvement, Trends, Uncategorized|

Top 5 Largest Health Plans in the United States

The largest health plans share more things in common than you might imagine. Striving for the high quality patient care comes to mind. How about striving for process efficiency? Absolutely. Integrating continuous improvements move these organizations ahead of the rest.

2017-04-25T23:07:46+00:00 By Eric Duchinsky|Financial Analysis, Revenue Cycle Improvement, Trends, Uncategorized|

Hurdles Blocking Faster Reimbursement Processes

Imaging faster reimbursement cycles must include reviewing processes on both sides of the payer/provider relationship. Too many decades of combative mudslinging makes a comprehensive review and retooling difficult. New organizational structures, like ACOs, begin breaking down barriers allowing for collaborative improvements.

2017-04-10T21:35:57+00:00 By Eric Duchinsky|Financial Analysis, Revenue Cycle Improvement|

4 Targets For Resource Improvement

Many hospitals are currently asking themselves, "How can we improve our revenue cycle in 2015?" This topic is also one many C-suite executives are facing in 2015, which is proving to be another year of vast changes. Financial departments will have to stay on top of contract management, as well as planning for shifts in how payments are received. Today, we've put together a list of 5 ways healthcare providers can reboot their revenue cycles and stay ahead of those changes that impact the bottom line.

2017-04-02T13:27:55+00:00 By Eric Duchinsky|Revenue Cycle Improvement, Services, Uncategorized|

Data Management Is Denial Management

You know your reimbursement process needs attention when the response to an adverse determination is to resend the exact same paperwork through the pipeline. In a few cases, the ROI on a resend appears reasonable, but peel back the band-aid and you will find a process needing attention. Understanding data management is denial management begins the healing process.

2017-06-22T13:09:31+00:00 By Eric Duchinsky|Quality Improvement Programs, Revenue Cycle Improvement, Uncategorized|

Payers and Providers Value-Based Care Reimbursement

Value-based care reimbursement models (VBR) are becoming a popular choice for many healthcare providers and payers, as fee-for-service, (and traditional incentive based payment models), are phased out. According to a recent McKesson survey “Journey to Value: The State of Value-Based Reimbursement in 2016," 58% of payers and hospitals are planning to adopt value-based care reimbursement models.

2017-09-20T17:09:35+00:00 By BHM Marketing|Population Health, Revenue Cycle Improvement, Uncategorized|

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