Revenue Cycle News Update – June 6, 2019
This regular feature showcases the most vital recent news stories in healthcare IT and revenue cycle management.
Here are the top stories since our last news roundup, as well as what you’ll need to know in the next few weeks.
Medicare / Medicaid News
In a recent analysis by Ernst & Young LLP for the American Hospital Association, researchers found the value of community benefits translated to 13.7 percent of total hospital expenses in 2016. Half of the expenses resulted from financial assistance for patients and hospitals absorbing the losses from Medicaid and other government underpayments.
Another way you can help your bottom line is by finding and collecting insurance-eligible self pays so you can submit claims and collect your money.
The new “Primary Care First” program, which was announced April 22 by the Centers for Medicare & Medicaid Services (CMS), aims to pay primary care doctors who see Medicare patients through a fee for office visits while also paying a monthly per-beneficiary amount for care coordination and other behind the scenes work that doctors do.
Private Payer News
Patients are paying more for their healthcare services, making effective cost-of-care conversations a skill that providers need to successfully treat patients. Additionally, providers are now relying more on their patients for revenue capture, but their workflows don’t align with the new trend in healthcare.
There are tools you can use to understand what the patient’s benefits are up front, so you can get paid promptly.
The hospital revenue cycle has become increasingly complex in recent years, including the adoption of advanced payment models and the rise of self-pay accounts. That’s why hospitals and other healthcare providers are exploring whether to invest in software to automate revenue cycle functions.