The Key to Lowering Patient Cost is Value-Based Healthcare Revenue Cycle Management


A certain point has been made clear during the recent Value-Based Care Summit in Chicago by Xtelligent Media. In enabling healthcare organizations to align their healthcare revenue cycle management with value-based reimbursements, they need to start breaking down both financial and clinical siloes that have been established using the fee-for-service payment models. Moreover, everyone in each healthcare organization must learn to work together better.

According to Carmela Roberts, JD, CEO and Administrator of Valley OB-GYN Clinic in Michigan, there is a need to promote collaboration among all hospital staff, including those serving operational, financial and clinical duties. This, according to her, would be the key to developing a value cycle instead of the traditional healthcare revenue cycle.

Balancing Quality Services and Cost Efficiency

The value cycle looks to cover all the processes that can optimize financial, operational and clinical opportunities to achieve the best possible health outcomes at the lowest possible cost. As such, it would include a number of traditional revenue cycle management components, including charge capture, claims management, compliance and pricing. Read more from this blog:

Healthcare Revenue Cycle Management: A Drop in Prices, Spending and Employment


The healthcare industry saw lower numbers in the first quarter of the year. Records showed that prices, spending and employment took a fall from June 2016 to April 2017. This downward trend occurred three years after healthcare spending was accelerated.

According to statistics, healthcare prices dropped 1.9% from March to April this year. It’s only 1.6% higher than that of last year, marking the lowest annual growth rate since June 2016. Healthcare employment growth, on the other hand, fell by 10,000 per month since 2016, while healthcare spending declined by 0.5% during the same period.

These figures came amid the controversies surrounding the Trump administration’s plans to repeal Obamacare and the recent proposed budget cuts that will affect Social Security Disability Insurance. There are various reasons for the drop and slow growth in healthcare prices, spending and employment. Read more from this blog.

Challenges in Healthcare Revenue Cycle Management and How Hospitals Can Weather the Storm


Last year, local hospitals reported good records despite the challenges in revenue cycle management. Increasing operating costs, regulatory issues, flat reimbursements and the switch from patient volumes to lower-paying outpatient and observation services didn’t faze many healthcare providers. Thanks to a strong stock market and lower tax-exempt bond costs, hospitals continued to do well.

While this is good news, providers can’t be complacent now with the changes and regulations awaiting the Affordable Care Act. Under the Trump administration, the U.S. House Republicans recently gave the greenlight to a bill that would revise the 2009 Obamacare. It still needs to get the approval of the Senate, but many are concerned about the impact it will have if it’s passed.

Repealing the Expansion of Medicaid

One of the major concerns is Medicaid expansion. If the bill pushes through and removes that program, it will affect people who are enrolled in it, along with the revenue of their associated hospital. St. John Providence Health System in Warren, for example, has seven hospitals and 670,000 people enrolled in Medicaid. Non-profit hospitals like these will be the hardest hit when Medicaid expansion is repealed.

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