Beyond Medical Needs: The Intersection Between Social Determinants of Health and Clinical Outcomes

By: Ida Habibi
Date: April 18, 2018

A growing body of research calls for healthcare organizations to address the nonmedical needs of their patients—or social determinants of health. The University of Wisconsin Population Health Institute’s County Health Rankings attributes 80% of an individual’s overall health to their physical environment, health behaviors, and socioeconomic factors, whereas only 20% is determined by their medical […]

Pulse Check: Save Costs By Strategically Analyzing Self-Pay Payments!

Many organizations choose to outsource self-pay accounts because of the time it requires to follow up with patients for payments. At an organization I’ve worked with recently, self-pay accounts were outsourced immediately after discharge to a self-pay vendor. Strategically analyzing the payment breakdowns of the self-pay accounts can help organizations generate more revenue and reduce […]

4 Key Themes From HBI’s 2018 Revenue Cycle Thesis

In the first half of each year, the HBI Revenue Cycle Academy publishes its annual Thesis in which we set forth our research agenda for the foreseeable future, based on the interactions we have with our valued members. The Thesis also provides members with a summary of the top projects their peers are working on, […]

Using Ride-Hailing Services to Improve Patient Experience

These applications are used to arrange rides—typically in privately-owned vehicles— via smartphones. For healthcare, these services are being positioned to help patients travel between home and appointments. Investigating Transportation Barriers Studies have shown that missing appointments may adversely affect patients’ quality of life and lead to an increased need for emergency care and preventable hospitalizations, […]

Pulse Check: Ensure Proper Level of Care

Recently, in auditing accounts, I have seen a frustrating trend of claims being denied because staff obtained an authorization for the incorrect level of care. For a large number or accounts, authorization for observation services had been obtained, but inpatient services were ultimately provided and billed, thus rendering the authorizations useless. The various commercial payers […]

Edge and Fog Computing Offer New Possibilities

Date: April 10, 2018

As the year progresses, health IT professionals, particularly those in the infrastructural realm, are looking for opportunities to better serve and support a geographically-disperse delivery model. Those at the forefront of foundational infrastructure development are predicting a number of changes and potentially disruptive implementations, but it can be difficult for some to effectively gauge the […]

Reimbursement & Regulations: CDM Updates, Cardiac Device Credits, and Revenue Code 456

Though you are hopefully already aware, on April 1, 2018, Medicare updated the Hospital Outpatient Prospective Payment System (OPPS). It is now paying for nonpass-through drugs, biologicals, and therapeutic radiopharmaceuticals that are not acquired through the 340B Program at the average sales price plus 6%. It is important to update your charge description master to […]

3 Building Blocks to Revenue Cycle Improvement

Throughout HBI’s frequent surveying, as well as the 1,000s of conversations our teams held with revenue cycle leaders throughout the course of the last year, three main objectives become overtly clear. Today, healthcare leaders such as yourself are focused on A) reducing costs and/or increasing cash flow, B) improving patient satisfaction, and C) engaging staff. […]

Pulse Check: Improving Upfront Collection Processes with Service Deferral Programs

More and more healthcare leaders and hospitals are turning to service delay/deferral programs to boost patient collections and accelerate cash flow. However, some still on the fence worry about decreased patient satisfaction should a deferral policy be implemented. Having worked in healthcare consulting for nearly a decade, with experience in both patient satisfaction and revenue […]