ICD-10 has presented monumental preparation challenges to U.S. healthcare providers, who have had to overhaul their billing departments and systems and retrain their staffs. And many may now think the heavy lifting is done, according to a recent survey of industry executives conducted by HealthLeaders Media and The SSI Group, Inc. But while providers may successfully get a bill out the door with a valid ICD-10 code, they may not be prepared for a payment delay or an actual drop in revenue when the payer sends it back for more details.
How CDI is Revolutionizing the Transition to Value-Based Care
September 30, 2015
Creating a state-of-the-art clinical documentation improvement (CDI) program isn?t just about boosting coding accuracy. It?s a key strategy in managing the transition from volume-based to value-based care, say healthcare leaders. That transition is a risky endeavor that is putting hospital and physician financial performance to the test. As hospitals participate in new care and business models aimed at improving value, leaders must ensure that their organizations are able to maintain reimbursement levels, effectively treat the chronically ill?especially in outpatient settings?and gather accurate data that will allow them to assess performance and segment their varying populations. While some organizations often believe they are leaving revenue on the table because of documentation and coding issues, CDI offers numerous opportunities for improving financial performance, finds a recent HealthLeaders Media survey of 149 healthcare executives at provider organizations.
Insights on Reimbursement Risk From a True Industry Insider
September 21, 2015
Financial stability is top of mind for every healthcare organization. Recent industry activity, such as announcements from the Centers for Medicare & Medicaid Services (CMS) and large payer organizations earlier this year, show a definite shift away from traditional fee-for-service reimbursement models. Provider organizations looking to position themselves to thrive in the emerging value-based healthcare system must make decisions around taking on risk, and the extent of that risk, in their reimbursement arrangements. Here, Elena White, Optum’s vice president of risk, quality, and network solutions, discusses how providers are approaching decisions around risk-based contracts in the new healthcare economy.
Managing Financial Performance: New Frameworks for Traditional Challenges
September 16, 2015
A recent HealthLeaders Media Intelligence survey asked respondents to rank their top challenges impacting financial performance and to identify specific areas of concern within each of those issues. Their top three issues were system implementation and interoperability, recruiting and retaining talent, and reengineering the revenue cycle. On the surface, it's tempting to think these findings aren't surprising. Yet emerging external factors, including the cumulative effects of the HITECH Act (meaningful use), the Affordable Care Act, and an aging U.S. population, are creating new frameworks in which to view and solve these traditional problems.
Empowering Patient-Centered Care With a Complete View of the Medical Record
September 3, 2015
Even as the move to electronic health records (EHR) progresses in earnest, there are a myriad of challenges involving legacy data systems. Chief among these challenges is the cost of maintaining obsolete systems solely for the patient information they contain. When up to 70% of a typical IT budget is spent on maintaining the current IT infrastructure and application portfolio, organizations have little left to invest in much-needed innovation. According to a recent HealthLeaders Media Survey, many organizations are still adjusting after their migration to a new EHR system. Hospitals need to get a better grasp on all forms and sources of data that they have—and the data they don’t yet have—so that the right information can be delivered to the right individual, and in the right context, at the point of care.
Results from a recent HealthLeaders Media Council survey of 126 senior leaders indicate a shift taking place as workforce management initiatives are expected to deliver more than reduced labor costs. Now, hospitals and health systems are seeking to find ways to better develop and deploy their workforce to improve the patient experience, including both clinical outcomes and patient satisfaction.
Join executives from Anderson Regional Medical Center and an industry acuity-based staffing expert as they discuss the shift toward strategies that improve patient outcomes and the success factors necessary to achieve this.