FinThrive Blog

11 min read

Healthcare Revenue Management Insights: Q3 2023

Welcome to the third quarter 2023 edition of the healthcare industry insights! Continued recovery is occurring as we start to close out 2023. Per normalized data from the September KaufmanHall report, we have seen over seven months of positive margins....

6 min read

Addressing Medicare Bad Debt Reimbursement Issues in Healthcare

Navigating reimbursements for the Medicare program has been a long-standing challenge for many providers. With the government reimbursement landscape constantly shifting due to policy changes, complex regulations and nuances related to patient coverage,...

8 min read

Discover the Power of Friendship, Inclusivity and Innovation on National Certification Nation Day

Every year, Great Place to Work’s National Certification Nation Day shines a spotlight on organizations that have gone above and beyond to create a positive and fulfilling workplace for their colleagues. On this day we recognize and celebrate the...

9 min read

Becker's Hospital Review: 8th Annual Health IT + Digital Health + Revenue Cycle Annual Meeting

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

6 min read

Navigating Year-End Updates: Adapting to Evolving Healthcare Machine-Readable File Regulations

The recent proposal introduced by the Centers for Medicare & Medicaid Services (CMS) on July 31, 2023, outlined significant changes to the Price Transparency initiative, specifically focusing on the machine-readable file (MRF).

11 min read

Q&A: Benefits of Using Chargemaster Data for HEOR

Adoption of chargemaster data in health economics and outcomes research (HEOR) is typically less common than more prevalent real-world datasets such as claims or EHR data, primarily due to chargemaster being a hospital specific dataset. However,...

6 min read

2023 Trends Report: How Healthcare RCM Leaders Embrace Change

By Jeff Becker, Vice President, Portfolio Solutions, FinThrive

Introduction

Earlier this year, FinThrive partnered with AlphaSights to conduct a comprehensive body of research among RCM leaders. This initiative was designed to gather the latest trends...

5 min read

What You Missed at HFMA Region 8 Mid-America Summer Institute

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

The 2023 HFMA Region 8 Mid-America Summer Institute (MASI) was a great educational conference. There were about 400 folks in attendance, ranging from large health systems and critical access...

6 min read

Preventing Claim Denials: 6 Top Reasons Claims Are Denied and How to Avoid Them

Claim denials can be a frustrating and costly experience for both healthcare providers and patients—in 2022, the costs of claim denials rose 67%. To prevent claim denials and ensure a smooth, efficient revenue cycle management process, it’s important to...

7 min read

Compliance as the Cornerstone: Building Revenue, Cutting Costs and Delivering Exceptional Patient Care

In the healthcare industry, compliance is essential to protect providers from potential and significant legal or financial risks. However, compliance can also serve as a cornerstone for building revenue, cutting costs and delivering exceptional patient...

4 min read

The Growing Challenges of Hospital Denial Management

Several recent trends in the healthcare market have worsened the urgent issue of hospital denial management. Hospitals are grappling with the collection of their rightful payments, and each of these new developments poses an added threat. Let's explore...

8 min read

What is Revenue Cycle Management in Healthcare?

Medical practices, health systems and hospitals’ primary goals are to provide life-saving care and keep patients healthy. Like any other business, however, these healthcare organizations must also focus on their own financial health to stay afloat....

11 min read

Healthcare Revenue Management Insights: Q2 2023

Hospitals are starting to see some daylight as we approach the second half of 2023. Per normalized data from a recent June Kaufman Hall report, signs of recovery continue with three consecutive break-even months. Volumes have continued to stabilize, with...

10 min read

What You May Have Missed at HFMA 2023 – Industry Trends and More

By Greg Lanier, Chief Growth Officer, FinThrive

2023 HFMA Annual did not disappoint! I was honored to be at such an electric event amongst many health system, hospital, provider, and business partner leaders across the country. The Gaylord Opryland...

5 min read

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 these findings, combined with a shifting payer mix, it’s estimated that 52% of patients will have...

8 min read

3 Ways Providers Can Navigate the End of the Public Health Emergency

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

Uncover Missed Health Insurance Coverage with Automation

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 2023 Insights

By Greg Lanier, Chief Growth Officer, FinThrive

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...

10 min read

FinThrive Customer Advisory Board – Insights to Transform our Industry

By Greg Lanier, Chief Growth Officer, FinThrive

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,...

9 min read

Healthcare Revenue Management Insights: April 2023

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

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...

8 min read

Improving Health Outcomes by Reducing Medical Debt

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

Third-party Data Ensures Compliance with Medicaids New Maintenance of Effort Provisions

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

Healthcare Revenue Management Insights: March 2023

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

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...

6 min read

3 Ways to Reinvent Primary Care

The Father of Population Health says America needs a new strategy for primary care.

12 min read

End-To-End RCM: A Vision for the Future with a Strategy that Starts Now

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...

9 min read

Healthcare Revenue Management Insights: February 2023

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

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...

6 min read

Drug Effectiveness and Pharmacy Experience Start with Equitable Clinical Trials

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

4 Ways to Deliver ROI by Addressing Social Determinants of Health

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

3 Ways Regional Health Systems Can Improve Community Health

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

The Results Are In: See How the Everest Group Ranked 15 Top RCM Platforms

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...

10 min read

Healthcare Revenue Management Insights: January 2023

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

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...

7 min read

Health Data Collaboration Can Save Our Healthcare Economy

By Brian Urban, Head of Payer Marketing, FinThrive

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...

5 min read

4 Must-Dos for a Healthy, Compliant Chargemaster

By Sherry Nardi, Solution Strategy Director, FinThrive 

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...

9 min read

FinThrive Monthly Insights: December 2022

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

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...

9 min read

3 Ways to Address Political Determinants of Health and Advance Health Equity

For those who question the far-reaching impact of political determinants of health, Population Health Professor Geoffrey Roche recounts this story:

7 min read

The No-Risk Strategy for Elevating Patient Experience

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

Outsmart the Labor Shortage with People-First Technology

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

FinThrive Monthly Insights: November 2022

By Jonathan G. Wiik, Vice President, Health Insights, FinThrive

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,...

5 min read

Revolutionizing Claims Management Through Robotic Process Automation

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

Empowering Providers, Payers and Patients: Financial Excellence for All

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

Maximize Reimbursements: Tips to Improve Your Collections Strategy

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

SDOH Data Drives Community Health and Healing

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

The New NCQA Standard that Health Plans Can’t Afford to Ignore

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

Open Enrollment: 3 Ways Health Plans Can Improve Member Experience

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

Advice to Health Plans: Don’t Let Secondary Insurances Break the Bank

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

A Caring Culture: Why FinThrive Was Just Named One of the Best Workplaces in Healthcare

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

Your Health System Needs AI to Bridge the Staffing Shortage Gap

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

Four Reasons Robotic Process Automation Improves Your Revenue Cycle

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

Streamline Your Revenue Cycle Workflow with RPA

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

Health Plans’ Top 5 Challenges, Solved: Quick Tips for Improving Member Outcomes and Engagement

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

The Path to Frictionless Patient Financial Experience: Three Reasons to Invest in Digital Check-in Technology

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

3 Ways SDOH Data Helps Health Plans Succeed

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

Five Simple Steps to Advance Your Autonomous Revenue Cycle Strategy

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

The Three Best Automation Investments

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

Four Ways That Automated Revenue Management Unlocks Real Value

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

5 Ways Healthcare Organizations are Using SDOH to Make a Difference

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

Using Social Determinants of Health Data to Forge an Equitable Future

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

Three RCM Tips to Combat Staffing Shortages

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

It’s Time to Transform the Healthcare Economy

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

Four Strategies to Reduce Uncompensated Care

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

Emerging Revenue Management Approaches for 2022

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

Three Common Sources of Missed Coverage

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

Emerging Trends in Revenue Management

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

Capture Hard-to-Find Insurance Coverage

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...