Hospitals & Healthcare

6 strategies to improve your appeal processes

HBI’s research in recent years has indicated a wide range of appeal outcomes among healthcare providers. For example, respondents to one survey noted first-pass success rates anywhere from 6% to 85%, with about half reporting between 40% and 65%. Such variation may be at least partially explained by the wide range of contributing factors, such […]

Key considerations when choosing and installing an infant security system

Define Your Requirements Before shopping for systems, hospitals should review their existing infrastructure— including security systems, human resources, hardware and software support, technology devices, storage facilities, and IT services—to support a smooth integration of infant protection solution. Hospitals can form an interdisciplinary team of clinicians, safety representatives, nursing leadership, and educators to outline the facility’s […]

Going to the gemba: healthcare supply chain’s lean transformation

Created for the manufacturing sector in Japan, Lean Process Improvement is a philosophy and a set of tools that can help organizations optimize their performance. In the last 30 years, Lean has become ubiquitous in multiple industries beyond manufacturing, such as grocery and retail. Now it is increasingly finding its way into healthcare, with numerous […]

Pbms acquire managed care companies: what this means for providers

Healthcare spending in the United States remains exorbitant—in 2017, the U.S. spent twice as much per capita on healthcare than similar Western nations. This spending is putting stress on all stakeholders, including pharmaceutical companies, pharmacy benefit managers, payers, providers, and patients. Among all stakeholders, PBMs currently face the most pressure. Their notoriety for not passing drug […]

4 ways hospitals and health systems can reduce cesarean section rates

Almost one-third of births in the United States occur via cesarean section—that’s twice the 10-15% rate the World Health Organization considers ideal. Although some of these C-sections are lifesaving, many others are performed unnecessarily due to some patients believing common myths about the procedure—such as C-sections being easier on the body than vaginal births—or providers being overly […]

Pulse check: reduce discharged not final billed

Does your organization struggle with getting bills out the door within a timely manner? You are not alone. Many organizations have identified discharged not final billed (DNFB) as an opportunity within their organization for 2018. It is already difficult for providers to get reimbursed on time because of the ever-growing impact of denials. Learning how […]

5 things to know about the joint commission’s new stroke certificate

With May being American Stroke Month, the American Stroke Association and American Heart Association are placing a special emphasis on broadcasting prevention strategies and promoting symptom awareness. Though hospitals and health systems are similarly concentrating on prevention efforts, many are also working to gain The Joint Commission’s new stroke certificate: Thrombectomy-Capable Stroke Center. Created in collaboration with ASA and AHA, […]

IV acetaminophen: Is it worth the cost?

In the midst of the opioid epidemic, hospitals and health systems are constantly looking for ways to alleviate pain that minimize opioid use. Acetaminophen remains a viable alternative, though organizations are making a concerted effort to restrict its intravenous use and promote oral administration. All of this started when IV acetaminophen was approved by the […]

Considering the impacts of the fasb’s new revenue recognition standards

New accounting standards issued by the Financial Accounting Standards Board will significantly alter how organizations recognize bad debt, though what that will mean for the revenue cycle is still uncertain. The rules took effect after December 15, 2017, for public healthcare entities and are set to take effect after December 15, 2018, for all others. […]

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 […]