It’s a perfect storm of financial pressures facing healthcare provider organizations – from rising costs to labor shortages to constrained capacity – that stymies revenue growth. Growing challenges with payer payments only exacerbate these issues. According to a Kaufman Hall report, 73% of leaders surveyed said claims denials, which was the top revenue cycle issue in 2022, had increased in 2023.
The cost of denials is staggering. A recent data analysis revealed that providers spent nearly $20
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AR/VR in Healthcare: Why Collaboration is its Most Important Use
Throughout history, new and emerging technologies have helped revolutionize and advance the field of medicine, allowing medical professionals to develop groundbreaking new procedures, work towards cures to previously incurable diseases, and much more. Healthcare practitioners are always looking for ways to use emerging technologies to transform their work, and today one of the top technologies available to revolutionize the healthcare space is Augmented Reality (AR) and Virtual Reality
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Healthcare Cybersecurity: 5 Steps to Prepare for a Ransomware Attack
It's not a matter of if but when an organization will face a security incident. In 2023, the healthcare industry faced its toughest year, with over 124 million health records breached in a total of 725 hacking incidents, according to The HIPAA Journal. This trend shouldn’t come as a surprise given how hospitals and medical offices are relatively lucrative and easy targets for cyberattacks due to the combination of outsourced services and solutions, legacy systems, and varying degrees of network
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The Digital Advantage: Augmenting the Healthcare Customer Experience
When interacting with industries such as retail, hospitality, and finance, we’ve all become accustomed to quick, effective, and personalized customer service. It’s no surprise that when it comes to healthcare, consumers are now seeking a better customer experience on par with the quality of the clinical care they have come to expect. Today’s members and patients are looking for their health plans and providers to accommodate their technology preferences and provide convenient, empathetic, and
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Reduce Medical Costs by 5.3%: Active Member Engagement for Employers
Employers incur approximately $575 billion each year due to their employees’ poor health, and the number of employees who spend at least $100,000 a year on medical care rose by 50% between 2013 and 2021., Much of these costs are driven by fragmented care, improper benefits utilization, and poor health literacy.
Today, members have greater choices regarding where they receive their care. In a single year, they may use an urgent care center, a pharmacy clinic, a retail clinic, a specialist, and
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The Future of Human Health May Require Unlocking Access to Our Health Data
The synergy of artificial intelligence (AI) and medical imaging has opened new horizons for healthcare. AI-mediated computer vision has been in use in oncology for more than 20 years; however, its arrival in other medical fields, notably dentistry, is more recent. Dentistry is particularly notable here, because while relatively few people have seen an oncologist, almost everyone sees a dentist at least every few years. The application of AI in dentistry, thus, extends to a much broader
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Interoperability: How Hospitals Share Healthcare Data Can Cost Lives, We Can All Do Better
Patient data interoperability sounds like industry jargon, but it’s a vital piece of providing timely and accurate patient care. Since 1996, when the Health Insurance Portability and Accountability Act (HIPAA) became law, there have been good advances in patient data interoperability, but as a whole, the industry has not embraced them.
Sharing data through faxing and CDs is still very common. As recently as 2023, between 30 and 47 percent of hospitals across all sizes reported still
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Putting 2024’s Split/Shared Services Billing Regulations into Practice
Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule. The most notable change within the new regulations, which took effect on Jan. 1, 2024, is the finalization of CMS’s definition of the “substantive portion” of a split/shared evaluation and management (E/M)
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Maximizing Provider Directory Data to Improve Care Access and Quality
In 2022, the Centers for Medicare & Medicaid Services (CMS) proposed the creation of a centralized physician directory. The proposal sought to address three pressing challenges facing both healthcare providers and patients within the United States healthcare system:
Fix the pervasive issue of inaccuracies and inconsistencies in provider directories. Studies have consistently revealed high error rates in directory listings, with inaccuracies ranging from incorrect contact information to
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The AI Blueprint: An Implementation Guide for Revenue Cycle Leaders
Applying artificial intelligence (AI) solutions in hospitals and health systems can be overwhelming for leaders due to AI’s complexity (it’s not one technology, but several) and rapid proliferation. This is in addition to the usual technology hurdles within healthcare that include data quality and accessibility, interoperability, and clinical validation and adoption. Finally, with any new solution, there’s the concern of return on investment: Will implementing the latest solutions pay off for my
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