Medical billing and collections
Medical billing and collections ensure financial stability. Patient collections bridge gaps, securing payments directly from consumers. This financial stability enables providers to maintain high-quality care, invest in IT and sustain operations, ultimately enhancing patient outcomes and the overall delivery of healthcare services.
Top Stories
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News
12 Nov 2024
Physician compensation totals 84% of medical group expenses
Medical groups might rethink operations in light of new Kaufman Hall data about physician compensation and overall employee investment/subsidy. Continue Reading
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01 Nov 2024
CMS, CFPB take on improper medical collections in Medicare
CMS and CFPB have issued a joint statement outlining prohibitions against medical debt collection for Medicare members exempt from cost-sharing. Continue Reading
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11 Jan 2022
40 Hospitals in NY Forced to Stop Elective Surgery As COVID-19 Surges
The New York State Department of Health reported that 40 hospitals in the state must stop performing in-hospital elective surgery as COVID-19 cases rise. Continue Reading
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10 Jan 2022
Study: Hospital Merger in NY Improved Quality, Outcomes
NYU Langone Health Brooklyn experienced better health outcomes and improved satisfaction rates following a hospital merger, according to a new study. Continue Reading
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06 Jan 2022
NorthShore, Edward-Elmhurst Health System Complete 9-Hospital Merger
The hospital merger is expected to impact over 4.2 M residents across Illinois and exceed over $5B in annual revenue within the first year. Continue Reading
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06 Jan 2022
Providers Face Hiring Crunch As Nursing Workforce Recovers
The COVID-19 pandemic had a dramatic impact on the nursing workforce and healthcare delivery organizations, a new study shows. Will the trends last though? Continue Reading
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05 Jan 2022
New Contract Ends Record 301-Day Nursing Strike Over Staffing Issues
After 9 months of negotiating with nurses at St. Vincent Hospital, a new contract will include assault pay, staffing improvements, increased wage and benefits, and improved workplace safety. Continue Reading
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05 Jan 2022
Hospital Revenue Margins Remain Depressed as Labor Expenses Rises
Hospital revenue margins and volumes remain low, while expenses increase due to labor shortages, high costs, and global supply chain issues. Continue Reading
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04 Jan 2022
IU Health Holds Pricing Flat Amid Hospital Price Transparency Push
At a recent hospital price transparency forum, the Indiana health system said year-over-year pricing will remain flat as part of a larger push for patient affordability. Continue Reading
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04 Jan 2022
96% of Healthcare Facilities Hired Temporary Health Professionals
Healthcare facilities addressed workforce shortage of permanent healthcare workers by hiring more temporary health professionals. Continue Reading
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29 Dec 2021
Consumers Don't Pay Patient Financial Responsibility After Bad Experience
More than one-third of consumers state that dissatisfaction around understanding the administrative experience will prevent them from paying patient financial responsibility. Continue Reading
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23 Dec 2021
UPMC Launches In-House Travel Staffing Agency Amid Nursing Shortage
The travel staffing agency was formed in hopes of drawing in healthcare staff amid the nationwide nursing shortage. Continue Reading
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22 Dec 2021
Multiple Hospital Affiliations Linked to Greater Medical and Drug Cost
Clinicians with multiple hospital affiliations are associated with an increased in clinician service use, greater procedure breadth, and higher spending costs across both medical and drug services. Continue Reading
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21 Dec 2021
WI Hospitals Sued 37% More Patients Over Medical Debt
A new study found that hospitals In Wisconsin sued patients at an increasing rate and garnished more wages Continue Reading
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16 Dec 2021
Urgent Care Utilization Pivots to Testing, Immunization
As a result of the pandemic, urgent care utilization is shifting to COVID-19 testing and immunization. Continue Reading
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15 Dec 2021
US Healthcare Spending Tops $4.1T Amid COVID-19 Pandemic
Healthcare spending increased by 9.7% in 2020 largely because of the impacts of the COVID-19 pandemic, CMS reports. Continue Reading
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15 Dec 2021
Study Identifies Major Issue with Hospital Price Transparency Rule
A new study shows that independent practitioners are often involved in hospital-based “shoppable” services, indicating a gap in the hospital price transparency rule. Continue Reading
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14 Dec 2021
Some Hospitals, Health Systems Go Back on Vaccine Mandates
The decisions have come after several courts temporarily stopped enforcement of COVID-19 vaccine mandates for healthcare workers. Continue Reading
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14 Dec 2021
Healthcare Employment Faces a Long Recovery After Pandemic
A new report shows that healthcare employment and revenue rates remained low compared to the industry’s pre-pandemic rates. Continue Reading
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13 Dec 2021
Most Americans Face Medical Debt Owe Over $2000
An annual survey revealed that many Americans are forced to delay healthcare services and forego financial commitments due to medical debt causing financial burdens on patients. Continue Reading
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13 Dec 2021
4 Barriers Providers Face with Preventing Surprise Medical Bills
A recent survey from AKASA highlights the key barriers hospitals and health system face as they try to prevent surprise medical bills for their patients. Continue Reading
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07 Dec 2021
Studies Find Physician Compensation Gaps By Setting, Gender
Two separate studies show that physician compensation is lower among female physicians and those working in practices acquired by hospitals or health systems. Continue Reading
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03 Dec 2021
CMS Provides Guidance on Good Faith Estimates for No Surprises Act
The federal agency has provided templates and guidance for providers and facilities required to give good faith estimates as part of the No Surprises Act. Continue Reading
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01 Dec 2021
Labor Shortages Drive Up Hospital Expenses as Margins Decline
Health system and hospital expenses remained high in October, contributing to declining operating margins for the second consecutive month, Kaufman Hall reports. Continue Reading
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24 Nov 2021
Study: 30% of Healthcare Workers Not Fully Vaccinated
A CDC analysis shows that nearly one-third of healthcare workers are unvaccinated against COVID-19 risking transmission to patients were not fully vaccinated against COVID-19 by mid-September. Continue Reading
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23 Nov 2021
Private Equity Nursing Homes Linked to Lower Quality, Higher Costs
Quality of care for residents declined after private equity acquired nursing homes, resulting in more emergency department visits and Medicare spending. Continue Reading
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23 Nov 2021
Lawmakers Accuse Nurse Staffing Agencies of Price Gouging
Lawmakers are urging the White house to investigate price gouging by nurse staffing agencies. Continue Reading
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19 Nov 2021
Private Equity-Backed Air Ambulances Major Culprit of Surprise Bills
New research shows that air ambulance rides provided by companies owned by private equity firms were more likely to end in surprise bills. Continue Reading
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18 Nov 2021
NY Hospitals Place Liens Against Patient Homes Over Medical Debt
A new report found that 56 non-profit hospitals in New York placed liens against thousands of patient homes over medical debt. Continue Reading
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15 Nov 2021
Medical Group Revenue Declines Underscore Need for Efficiency
Medical group revenue and other financial performance declines are not sustainable, according to AMGA. Continue Reading
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12 Nov 2021
70% of Adults Worry About Healthcare Affordability
According to a nationwide survey a large percent of adults have concerns in regards to healthcare affordability and costs. Continue Reading
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11 Nov 2021
The Role of Finance, Revenue Cycle in Advancing Health Equity
CFOs and other healthcare finance leaders play a critical role in developing and executing health equity strategies, industry experts emphasized at HFMA’s Annual Conference. Continue Reading
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10 Nov 2021
Few Physicians Accurately Estimate Patient Out-of-Pocket Costs
A recent study highlighted that 79% of physicians were unable to advise patients on out-of-pocket costs despite an industry-wide push for pricing transparency. Continue Reading
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10 Nov 2021
Patient Financial Assistance with Hospital Bills Increased in 2021
The number of patient financial assistance transactions increased in the past year, indicating that patients continue to require help with navigating their hospital bills. Continue Reading
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09 Nov 2021
HFMA Annual: Finance Leaders Need to Change the Culture of Medicine
Finance leaders will need to consider care delivery changes and how the culture of medicine must shift to elevate care, says Robert Pearl at the 2021 HFMA Annual Conference. Continue Reading
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09 Nov 2021
Analysis: 10 Most Cost-Efficient Hospitals in the US
The Lown Institute analysis uses Medicare claims data and patient mortality rates to identify the most cost-efficient hospitals in the US and those that could save Medicare by boosting efficiency. Continue Reading
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08 Nov 2021
Over One Third of Physicians Disagree with COVID Vaccine Mandate
While many physicians disagree with the COVID vaccine mandate, the federal government recently released a rule requiring vaccination by January 4th. Continue Reading
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02 Nov 2021
LifePoint Health, Kindred Healthcare Form New Company
Healthcare companies LifePoint Health and Kindred Healthcare to create new healthcare brand, ScionHealth. Continue Reading
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02 Nov 2021
Hospital Service Lines Shift After Private Equity Acquisition
A new study explores how service lines changed after private equity acquisitions of acute care hospitals. Continue Reading
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01 Nov 2021
Healthcare Expenses Continue to Rise, While Hospital Volumes Decline
On the other hand, physician groups experienced significant revenue and productivity gains over the last two quarters despite fast-rising healthcare expenses. Continue Reading
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29 Oct 2021
Higher Healthcare Utilization, Intensity Drive Healthcare Spending
Healthcare spending has increased over the past decade due to higher utilization rates and intensity of services, AHA found. Continue Reading
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27 Oct 2021
Delaying Surgery Cost Hospitals, How They Can Prevent Revenue Losses
New studies from the American College of Surgeons show how much revenue hospitals lost by delaying elective surgical care during the first wave of the pandemic. Continue Reading
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26 Oct 2021
“Great Resignation” Hits Healthcare Hard As Physician Burnout Persists
Healthcare appears to be the sector most impacted by the “Great Resignation” of 2021, but COVID-19 isn’t the only driver—physician burnout from healthcare system issues persists. Continue Reading
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26 Oct 2021
AdventHealth, Ascension Look to Unwind Partnership After 7 Years
The health systems said they are seeking to break down AMITA Health, a joint operating company that serves residents of the greater Chicago area. Continue Reading
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19 Oct 2021
Nursing Turnover Costs Hospitals Up to $6.5M Each Year
Nursing turnover increased over the last year and now stands at 18.7%, according to a new analysis. Continue Reading
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19 Oct 2021
Hospital Revenue Cycle Transformation Needed to Boost Performance
75% of healthcare leaders experienced adverse revenue cycle impacts during the pandemic, underscoring the need for hospital revenue cycle transformation. Continue Reading
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18 Oct 2021
CMS Increases Wages to $15/Hour for HealthCare.Gov Call Center Staff
The agency has increased wages during Medicare Open Enrollment to help retain and recruit talent—a pressing issue also impacting provider organizations. Continue Reading
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18 Oct 2021
Are Healthcare Merger, Acquisitions Key to Maintaining Access to Care?
A new analysis published by the AHA shows that healthcare mergers and acquisitions kept some hospitals operating, maintaining access to care for patients. Continue Reading
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13 Oct 2021
AHA Asks CMS to Retract Plans for Inpatient Rehab Facilities Review
The review choice demonstration would increase administrative burden for inpatient rehabilitation facilities and perpetuate the history of inadequate Medicare audits, according to AHA. Continue Reading
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13 Oct 2021
Physician Compensation, Staffing to Take Big Hit from 10% Medicare Cut
Healthcare organizations are considering major changes to physician compensation and staffing if Congress does not prevent several planned Medicare payment cuts. Continue Reading
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12 Oct 2021
Patient Financial Engagement Technology Going Beyond Collections
A new KLAS report shows that patient financial engagement technology should do more than process payments so providers can boost revenue while improving the patient experience. Continue Reading
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11 Oct 2021
Clinical Labor Costs Increased by $24B During Pandemic
Yearly clinical labor costs are soaring for hospitals and health systems desperately seeking qualified talent to treat rising COVID-19 cases and other patients. Continue Reading
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08 Oct 2021
Healthcare M&A Activity Slows, But Deal Value Increases
Kaufman Hall said it’s a new era for healthcare M&A activity, as hospitals and health systems seek partners to recover from the ongoing COVID-19 pandemic. Continue Reading
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06 Oct 2021
Jefferson Health, Einstein Healthcare Finalize Merger
More than two years after their initial announcement to merge, Jefferson Health and Einstein Healthcare Network have finalized their healthcare merger. Continue Reading
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06 Oct 2021
Cerner’s Next Step With Revenue Cycle Management Technology
A new patient accounting product aims to improve consumer-oriented care and advance enterprise-wide management, bringing revenue cycle management technology to the next level. Continue Reading
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05 Oct 2021
Maternal, Surgical Care Eliminated After Rural Hospital Mergers
A new study finds that rural hospital mergers are associated with the elimination of key community needs, such as maternal/neonatal and surgical care. Continue Reading
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29 Sep 2021
Health Centers Get $1B in Federal Funds to Modernize Facilities
The funding from the American Rescue Plan Act will be used to construct, renovate, or expand health centers to boost pandemic response, the Biden-Harris Administration said. Continue Reading
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28 Sep 2021
Hospital Groups Challenge FTC Opposition to NJ Hospital Merger
The hospital groups told an appeals court that FTC’s opposition to the hospital merger deal between Hackensack Meridian Health and Englewood Healthcare Foundation was flawed. Continue Reading
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28 Sep 2021
Hospital Volumes Dipped in August As Delta Variant Surged
Despite surges in COVID-19 hospitalizations, hospital volumes were down in August, keeping margins down with them. Continue Reading
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27 Sep 2021
As Revenue Cycle Management Expands, Automation Is Key
Revenue cycle management is no longer just what happens in the business office, now hospitals must coordinate patient access, CDI, quality, and other aspects of care in order to get paid. Continue Reading
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27 Sep 2021
Nursing Homes, Assisted Living Facilities Facing Staffing Shortages
Nursing homes and assisted living facilities across the country are experiencing poor workforce conditions, including staffing shortages and fear of closures. Continue Reading
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27 Sep 2021
Open Revenue Cycle Reveals Opportunities for Patients, Providers
An open revenue cycle taps APIs to create seamless workflows for both patients and providers, while also offering cost-effective solutions to the revenue cycle's most pressing challenges. Continue Reading
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24 Sep 2021
Physician Practice Interruption Increased Due to COVID-19 Pandemic
Physician practice interruptions peaked during April 2020 for physicians billing for Medicare as a result of low healthcare utilization during the pandemic. Continue Reading
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23 Sep 2021
Hospitals Slated to Lose $54B in 2021 As Pandemic Rages On
Financial losses stemming from the ongoing COVID-19 pandemic will leave more than a third of US hospitals with negative operating margins by year’s end, a new report shows. Continue Reading
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22 Sep 2021
Rural Hospital Mergers Associated with Improved Patient Outcomes
A new study linked rural hospital mergers to a steeper decrease in mortality rates for certain inpatient conditions compared to independent rural hospitals. Continue Reading
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17 Sep 2021
Intermountain Healthcare Signs Letter of Intent to Merge with SCL Health
Intermountain and SCL Health plan to merge and form a new health system that will prioritize patient wellbeing and improve access to care. Continue Reading
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15 Sep 2021
How Nebraska Medicine Turns Claims Data into Revenue Cycle Strategy
Claims data can be used for more than reimbursement. At Nebraska Medicine, claim analytics are transforming the data into revenue cycle strategy. Continue Reading
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09 Sep 2021
Beaumont Health, Spectrum Health Formalize Healthcare Merger Plans
The organizations formally agreed to pursue their healthcare merger plans and create Michigan’s largest health system. Continue Reading
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03 Sep 2021
Healthcare Bankruptcies on the Decline Despite Ongoing Pandemic
A new report shows an unprecedented drop in healthcare bankruptcies, the first decline observed in more than 13 quarters for the normally distressed industry. Continue Reading
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01 Sep 2021
How to Achieve Hospital Resilience, Prepare for Future Health Crises
Health systems must establish comprehensive hospital resilience to better prepare for future possible COVID-19 surges and other challenges. Continue Reading
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31 Aug 2021
Updated Study From AHA Shows Hospital Mergers Saving Millions
Building on its previous analysis, the AHA reestablishes its claim that hospital mergers reduce healthcare costs, despite well-known contradicting data. Continue Reading
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31 Aug 2021
Patient Medical Debt Lawsuits Decline After Hospitals Called Out
An update to a popular study calling out Virginia hospitals for suing over unpaid patient medical debt shows that hospitals are now suing fewer patients. Continue Reading
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30 Aug 2021
COVID-19 Hospitalizations to Negatively Impact Hospital Margins
Fitch Ratings is predicting a negative impact on hospital margins for non-profit organizations in areas with rising rates of COVID-19 hospitalizations. Continue Reading
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30 Aug 2021
Top 3 Practice Management Strategies for Ongoing Success
Physician practices are recovering from devastating losses over the past year. Leaders share their practice management strategies for ongoing success. Continue Reading
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30 Aug 2021
How the Digital Front Door, Practice Enhances Patient Experience
As consumers seek more virtual, self-service options, providers can leverage the digital front door and more to improve the patient experience and revenue. Continue Reading
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27 Aug 2021
Hospital Revenue Cycle Automation Adoption Sees 12% Increase
Revenue cycle automation in health systems and hospitals has increased compared to last year’s data despite the ongoing global pandemic. Continue Reading
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26 Aug 2021
Physician Compensation Creeps Up While Productivity Dives
The latest data from AMGA shows that COVID-19 had a significant impact on physician compensation and productivity. Continue Reading
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25 Aug 2021
Healthcare Spending, Utilization Remain Low in 2021
Healthcare spending and utilization plummeted during COVID-19 and remain low in 2021, potentially leading to poor financial health for providers as PRF money runs out. Continue Reading
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24 Aug 2021
Healthcare Financial Recovery Takes a Hit from Delta Surge
The Delta variant has hindered healthcare financial recovery for both hospitals and physician groups as margins narrowed in July. Continue Reading
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24 Aug 2021
Preventable COVID-19 Hospitalizations Cost Health System Over $2B
A new analysis finds that over 100K COVID-19 hospitalizations could have been prevented with vaccines, resulting in billions of dollars in costs for the US health system. Continue Reading
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23 Aug 2021
Nursing Home Staff Must Get Vaccinated or Risk Medicare Funding
President Biden announced that all nursing homes must require their staff to get vaccinated against COVID-19 or risk losing Medicare and Medicaid funding. Continue Reading
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20 Aug 2021
AMA Finalizes CPT Codes for Third Doses of Moderna, Pfizer Vaccines
AMA announced that the CPT codes for the third doses of the Moderna and Pfizer COVID-19 vaccines are finalized and ready for the upcoming booster shot administrations. Continue Reading
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18 Aug 2021
Nurse Staffing Shortage Drives Hospital Readmissions, High Spending
A recent GAO report revealed that nurse staffing shortages can result in an increase in hospital readmissions and higher Medicare spending. Continue Reading
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17 Aug 2021
Americans Agree Nurse Compensation is Too Low, Execs Overpaid
An AP-NORC poll reveals that Americans on both sides of the aisle agree that nurse compensation is low, and 70% of respondents say that hospital executives are overpaid. Continue Reading
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13 Aug 2021
3 Hospital Price Transparency Strategies for Compliance, Patients
Hospital price transparency is now a requirement from CMS, but providers should be going beyond the rule to ensure transparency meets patient demands, too. Continue Reading
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12 Aug 2021
HCA Hospital Slapped with Healthcare Antitrust Lawsuit
The healthcare antitrust lawsuit alleges that the North Carolina hospital raised prices after a merger and HCA has failed to comply with hospital price transparency requirements. Continue Reading
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11 Aug 2021
Nurse Practitioners Pass Physicians As Most Recruited Providers
Nurse practitioners surpassed physicians as the most recruited providers for the first time in 27 years, a new Merritt Hawkins report revealed. Continue Reading
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10 Aug 2021
Tenet Healthcare Corporation Announces New CEO
Saum Sutaria will replace Ron Rittenmeyer as CEO of Tenet Healthcare Corporation on Sept. 1, 2021, according to a new announcement. Continue Reading
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09 Aug 2021
NJ Hospital Merger Put on Pause After District Court Ruling
The US District Court of New Jersey granted a preliminary injunction against the proposed hospital merger between Hackensack Meridian Health and Englewood Health. Continue Reading
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05 Aug 2021
Primary Care Faces Existential Threat Over Healthcare Workforce Woes
40% of primary care clinicians worry that the field won’t exist in five years as many in the healthcare workforce experience burnout and plan to leave the field. Continue Reading
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05 Aug 2021
What Revenue Cycle Can Do to Prepare for Surprise Billing Compliance
Surprise billing compliance will have impacts throughout the revenue cycle, so preparation now is key to meeting the January 1st deadline. Continue Reading
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04 Aug 2021
When Medicare Fiscal Pressure Grows, Hospital Cost Shifting Follows
A study correlated a hospital’s Medicare patient mix with lower revenue and a higher chance of acquisition, which may lead to consolidation-induced hospital cost shifting. Continue Reading
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04 Aug 2021
Hospital Operating Margins Remain Tight as COVID-19 Expenses Rise
Kaufman Hall reports that hospital operating margins remain tight despite promising revenue gains in June, likely due to rising expenses triggered by the Delta variant. Continue Reading
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03 Aug 2021
3M and Waystar Partner to Create Hospital Revenue Cycle Solution
3M and Waystar partnered to provide an artificial intelligence-driven hospital revenue cycle solution that aims to improve reimbursement and compliance efforts. Continue Reading
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02 Aug 2021
AMA Unveils CPT Codes for Third Dose of Pfizer COVID-19 Vaccine
AMA announced an updated CPT code specific to a potential third dose of Pfizer’s COVID-19 vaccine in the event that the FDA authorizes an additional dose. Continue Reading
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02 Aug 2021
KLAS: Comparing Staff Scheduling Vendors for Workforce Management
A new KLAS report evaluates customer experiences of using nurse and staff scheduling vendors for workforce management and workload balancing. Continue Reading
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02 Aug 2021
Why Health Systems Should Adopt a Clinically Driven Revenue Cycle
A clinically driven revenue cycle drives results by limiting claim denials, boosting clean claim rates, and improving quality and coordination of care. Continue Reading
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29 Jul 2021
Can Behavioral Science Reduce Healthcare Worker Vaccine Hesitancy?
Targeted email reminders driven by behavioral science may be effective at reducing healthcare worker vaccine hesitancy, new research shows. Continue Reading
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28 Jul 2021
AMA Supports COVID-19 Vaccine Mandates for Healthcare Workers
AMA and other major healthcare groups voiced support for COVID-19 vaccine mandates for all healthcare workers as cases rise and vaccination rates slow. Continue Reading
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27 Jul 2021
Self-Insured Employers Have Little Say in Hospital Price Negotiations
Self-insured employers lack significant market power and have little control over hospital price negotiations, a recent study reveals. Continue Reading
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27 Jul 2021
Medicaid Expansion Associated with Less Medical Debt Collections
States that expanded Medicaid in 2014 experienced a 45% decline in the mean flow of medical debt collections by 2020 compared to states that didn’t expand Medicaid. Continue Reading
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26 Jul 2021
Hospital Staffing Shortages a Concern with Mandatory Vaccinations
Many hospitals—with the AHA’s support—are requiring COVID-19 vaccinations among healthcare personnel, but some leaders fear the policies could worsen hospital staffing shortages. Continue Reading