Showing posts from April, 2022

Investor-Owned Health Systems Linked to Most Low-Value Care

Higher amounts of overuse among health systems were associated with investor ownership and the number of primary care physicians. Overuse of low-value services was most often seen in healthcare systems that had more beds, had fewer primary care physicians, had more physician practice groups, and were investor-owned, according to a John Hopkins University study published in JAMA Health Forum.  “Wasteful care is physically, psychologically, and financially harmful to patients,” the researchers stated in the study. “Health systems may play an important role in the overuse of health care. They balance financial interests when making decisions about strategic consolidations or new service lines, complying with state and federal regulations, and aiming for high-quality care delivery and best patient outcome.” In the cross-sectional analysis, researchers used Medicare claims between March and August 2021 to identify the utilization of 17 low-value services across 3,735 hospitals. In addition

Key Ways to Improve Access to Claims Data for a Smoother Revenue Cycle

Claims data access is a major obstacle for providers, impacting revenue cycle management. With the right technology, providers can reap the benefits of electronic claims payment adoption. Healthcare claims contain a wealth of information. Each service line on a claim paints a picture of a patient’s healthcare journey, including their quality of care as well as the cost of that care. Claims data is key to improving population outcomes, reducing total cost of care, and improving the overall experience for patients and providers. However, providers oftentimes cite barriers to accessing claims data. Top challenges include data quality and completeness of claims data, while research has also shown that providers struggle to integrate claims data from multiple sources and convert claims data into more useful information. The challenges of claims data access have prevented providers from gleaning key insights on their patients and care delivery, researchers found. Some providers have also sa