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Reduce Denials with These Four Tips to Uncover Hidden Coverage
A recent report by The Kaiser Family Foundation showed that claim denials are on the rise, with some plans reaching up to 80% in denials. Based on...
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5 min read
A recent report by The Kaiser Family Foundation showed that claim denials are on the rise, with some plans reaching up to 80% in denials. Based on...
Read More8 min read
On May 11, 2023, the federal Public Health Emergency (PHE) will expire, and along with the Consolidated Omnibus Act, will impact coverage for millions of Americans on Medicaid. This is arguably the biggest thing to happen to Medicaid since the passing of...
6 min read
Hospitals grapple with many complex issues that impact their financial health—staffing shortages, policy changes, retail competitors. However, one of the top financial impacts is fairly simple: missed insurance reimbursement due to eligibility denials.
7 min read
HIMSS ’23 saw more than 35,000 attendees, as healthcare executives from around the world gathered to tackle the industry’s toughest challenges. Several themes emerged from the conference surrounding interoperability, health equity, cybersecurity, and...
10 min read
Last week, key customer executives from FinThrive gathered for two days in Sarasota, Florida. The discussion was electric, innovative, engaging, and transformative. Seema Verma, former CMS Administrator, and Donald Rucker MD, former National Coordinator...
9 min read
Welcome to the April 2023 edition of Revenue Management Insights. This month, we'll be discussing several important trends that are impacting the healthcare industry, including hospital margins, patient volumes, labor shortages, and the end of the...
8 min read
Medical debt is more than a financial problem. Research is beginning to show that, for millions of Americans, medical debt leads to poor health outcomes.
7 min read
More than 1.5 million people—including nearly 750,000 children—lost their Medicaid coverage in 2018, according to a study conducted that year. Researchers determined it was most likely due not to ineligibility but to paperwork barriers.
8 min read
Welcome to the March edition of Healthcare Revenue Management Insights. Just as we’re starting to see flowers poking up through the snow (those of us in Colorado, at least), hospitals have reason this spring to be cautiously optimistic that things are...
6 min read
The Father of Population Health says America needs a new strategy for primary care.
12 min read
From top analysts to hospital board rooms, healthcare leaders have emphasized a consistent theme for 2023: an end-to-end approach to revenue cycle management (RCM). End-to-end capabilities featured prominently in the Everest Group’s recent Revenue Cycle...
8 min read
It’s about time: hospitals finally posted a positive margin in December according to Kaufmann Hall’s latest flash report. That’s just one piece of a generally optimistic outlook on the rest of 2023 that several analysts recently shared. Let’s dig into...
6 min read
Approximately 20% of the new drugs approved in the last several years have known racial and ethnic differences in disposition. Still, the most recent data snapshot on diversity and inclusion from the U.S. Food & Drug Administration revealed that 75% of...
7 min read
Health organizations are zeroing in on Social Determinants of Health, removing socioeconomic barriers to healthcare and social services in order to improve patient outcomes. In the process, they’re also improving the financial health of the entire...
6 min read
If we were designing the healthcare system from scratch, Brook Ward says most of us would have a clear vision for what it should look like.
7 min read
2022 was a tough year for healthcare providers… and patients. For providers, expenses outpaced revenue, driven up by the labor shortage, premium-priced outsourcing services and inflationary supply costs. For patients, job instability, insurance...
9 min read
New year, new data! While the numbers from the end of 2022 continue to show the same challenges faced throughout the year – negative margins, staffing issues, inflation, unpredictable volumes – there is hope on the horizon. Recovery seems to be on the...
6 min read
The average healthcare patient account bounces back and forth between payers and providers multiple times before it gets anywhere near payment.That’s why the current state of revenue cycle management may best be described as a competitive tennis match....
5 min read
Maintaining a healthy chargemaster is a key component to preventing revenue leakage but can also be labor intensive and time-consuming. With thousands of ongoing line-item updates, limited staff and compliance issues coupled with price transparency...
9 min read
As 2022 draws to a close, we reflect on one of the worst financial years for U.S. hospitals. The latest reports are showing the 10th straight month of negative margins, labor issues persist and volumes have yet to stabilize. Not what we want to see as we...
9 min read
For those who question the far-reaching impact of political determinants of health, Population Health Professor Geoffrey Roche recounts this story:
7 min read
Let’s be honest: navigating healthcare is a difficult and stressful experience for consumers. At a time when almost everything in our lives has gone digital – booking flights, making dinner reservations, getting a ride, ordering groceries, you name it –...
8 min read
While the “Great Resignation” of the post-COVID era has strained virtually every industry, healthcare sits on top of the list. Providers have lost 20-30% of their workforce since 2020, and the projections to return to normal range estimate several years...
11 min read
2022 has been one of the worst financial years for hospitals1 and most US hospitals and health systems are in a tight spot, to put it mildly. Between lower volumes, staffing shortages, higher costs, and outrageous denial rates, hospitals have been...
5 min read
For modern healthcare to realize its true potential, revenue cycle management needs a new vision. The future requires a connected and holistic approach that empowers the providers, payers and patients who make the healthcare economy. Current processes...
6 min read
At Becker’s 7th Annual HIT RCM Conference in Chicago, FinThrive’s Chief Innovation Officer John Yount was joined by Brad Tinnermon, VP of Revenue Cycle and Revenue Integrity at Banner Health, and Matt Leary, VP of Finance at Centura Health. Read on to...
4 min read
Amending your overall collections strategy—to focus more on total collections versus average cost to collect—can help ensure you get the best return on your investment.According to a recent survey from AHIMA, the average net patient revenue for US...
7 min read
Data shows that only 20% of a patient’s health outcomes are influenced by their access to and quality of healthcare. That leaves 80% to be determined by other factors, such as where we live, work, play, go to school, and get our groceries. These...
6 min read
As a health plan, you are likely familiar with the National Committee for Quality Assurance (NCQA). A government agency whose mission is to “work for better health care, better choices, and better health,” the NCQA offers a wide variety of programs for...
7 min read
It’s that time of the year: changing seasons, fresh starts, new relationships, and a nice sprinkle of chaos. We’re not talking about going back to school – we’re talking open enrollment.
5 min read
Imagine if the power of health plans could truly be unleashed. If they were fully invested in improving the health of the lives they serve, connecting members to meaningful wellness tools, helping people navigate complex healthcare networks, supporting...
5 min read
FinThrive has been recognized as one of the Best Workplaces in Healthcare by Great Place to Work and Fortune. Our values –customer-centric, agile, reliable and engaged – guide us in everything that we do. These values lead us on the path to achieving our...
6 min read
The Great Resignation has hit the healthcare industry from all angles. The loss of clinical staff has hurt the frontline of many health systems.
However, what many do not realize is that revenue cycle teams are inundated with claims, denials and requests...
6 min read
A lot has changed with revenue management in the last three years, especially the transition from traditional onsite employees to remote employees, leading to persistent staffing gaps.
5 min read
In May 2022, more than 400 healthcare finance leaders reported revenue cycle workforce shortages, with almost 20% seeing 30 or more vacancies.
6 min read
Healthcare continues to become increasingly complex. Member health outcomes and financial measures are managed by disparate systems that trap information in silos, causing inefficiency, introducing human error, and causing friction between members,...
4 min read
A consumer-centric patient financial experience is critical. While other industries have mastered the art of customer engagement, hospitals and healthcare systems are largely behind in terms of meeting customers where they’re at. Per a NextGen survey,...
5 min read
Our lives changed significantly during the pandemic—lost jobs, cross-country moves, pay cuts and lost or changed health insurance. Healthcare behavior also changed. A survey released by the Prevent Cancer Foundation found that 43% of people surveyed had...
6 min read
The benefits of automating your revenue management processes are clear. From reduced costs to enhanced care, happier patients to more satisfied staff, automation delivers measurable value at each stage of the revenue cycle.
While healthcare leaders...
8 min read
Today’s health care leaders know that tackling unchecked costs requires innovation and digital transformation. But where do you start? Automation has virtually infinite applications across the revenue cycle – where will it make the greatest impact?
We...
6 min read
The current state of healthcare is incredibly costly for providers, payers, and patients. In 2020, hospitals lost $42.7 billion to uncompensated care. They spent $500B on administrative costs, $395B on waste, and $90B on inflated pricing. Payment cycle...
4 min read
So much of our overall health is impacted by various socioeconomic factors, which don’t involve ever stepping foot into a doctor’s office, clinic or hospital. Social determinants of health—commonly referred to as SDOH—and healthcare utilization have an...
5 min read
Ongoing COVID-19 challenges and its emerging aftermath have left people struggling—financially, personally and socially. Especially those most vulnerable. Given how closely financial health is linked to overall wellness,1 it’s important to recognize that...
4 min read
Good RCM = Good REM for CFOs
Healthcare is one of the hardest hit sectors amid COVID-19 and the “Great Resignation.” The industry has lost an estimated 20% of its workforce since 2020.1 Burnout, fear of exposure to COVID-19, salary offerings, and a focus...
3 min read
Over the past 24 months, already-thin hospital margins were further exacerbated by COVID-19. Hospitals are seeing up to $50 million in revenue leakage per facility per year from underpayments from payers, poor claims management, denials, under and...
5 min read
Uncompensated care is a universal pain point for healthcare organizations—rising by $1.1 billion in 2020 to $42.7 billion.1 And while it may not be possible to eliminate it, there are initiatives you can put in place today to lessen its impact.
4 min read
For a hospital CFO, the COVID-19 pandemic shifted priorities and emphasized cost containment and innovation in reimbursement models. It has forced leaders to take a hard look at their revenue management processes. In fact, per a recent...
4 min read
In 2020, 47% of hospitals saw increases in bad debt and uncompensated care.1 Incomplete or inaccurate patient demographic information, an unverified primary payer, resource constraints and more contribute to this deficit. At a time when margins are...
4 min read
To improve patient financial experiences and protect profitability, healthcare financial leaders need a strategy that focuses on end-to-end revenue management.
3 min read
In 2020, hospitals across the U.S. saw their median operating margin drop by 55.6%.1 The Coronavirus Aid, Relief, and Economic Security Act (CARES) helped offset escalating expenses, but the pandemic hasn’t been the only factor contributing to ongoing...