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 addi...

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...

Members of Congress want the White House to investigate nurse staffing agencies after receiving reports of price gouging. A bipartisan group of 195 Congress members wrote to the White House COVID-19 Response Team Coordinator Jeffrey Zient requesting an investigation into reports of alleged price gouging by nurse staffing agencies. The bipartisan group of lawmakers, led by Representatives Peter Welch (D-VT) and Morgan Griffith (R-VA), accused some nurse staffing agencies of increasing their prices to profit from the pandemic.  The members of Congress want the enlistment of federal agencies to determine if this conduct is the result of anticompetitive activity or if it violates consumer protection laws. “We urge you to ensure that this issue gets the attention from the federal government it merits to protect patients in dire need of life-saving health care treatment and prevent conduct that is exacerbating the shortage of nurses and straining the health care system,” the lawmakers s...

A report shows that overall healthcare employment remains below pre-pandemic rates. However, ambulatory care employment rates have fully recovered. January 26, 2022 – In 2021, healthcare employment experienced no significant growth. However, ambulatory care employment saw an increase in jobs exceeding pre-pandemic rates, an analysis from Altarum revealed . Healthcare employment gained 63,000 jobs, a modest 0.4 percent rise, compared to employment rates in December 2020. Meanwhile, employment in the ambulatory care sector, such as provider offices, clinics, labs, and home health agencies, increased by 3.1 percent in 2021.  The report showed that employment decreased for the nursing and residential care sectors by 4.7 percent. Additionally, the hospital sector experienced a 0.6 percent drop in jobs.  Ambulatory care jobs rose by 242,000 jobs last year, while hospitals experienced a loss of 33,000 jobs and nursing and residential care jobs fell by 46,000.  Over three-fourths...

Finding senior-level revenue cycle talent is the most challenging for healthcare organizations, but even entry-level roles take an average of 84 days to fill. The Great Resignation and other employment challenges are hitting revenue cycle management, a new survey of hospital and health system leaders indicates. The survey commissioned by healthcare operations company AKASA surveyed 514 chief financial officers and revenue cycle leaders at hospitals and health system across the US using the Healthcare Financial Management Association’s (HFMA’s) Pulse Survey program. The survey was fielded between Sept. 30, 2021, and Oct. 17, 2021. Survey results revealed that the cost of recruiting revenue cycle talent is significant and the timelines to fill open positions is long. An open entry-level revenue cycle position cost hospitals and health systems $2,167 for recruitment, on average, according to the survey. Additionally, finance leaders said it takes an average of 84 days to fill the role d...

We can count on the cost of providing quality medical care to continue to rise even while having to face forces that lower reimbursement to providers in the healthcare industry. It is easy to get caught up in the day to day operations of your medical practice management and lose your focus on the financial health and trajectory of your practice. Take some time every month to examine the bottom line affect of the systems that are in place in the office. Try to be objective as you review your own routines and habits as well as those of your staff. What follows is a non-exhaustive list of areas to consider as well as suggestions on some steps to take to increase profitability.  Examine the Revenue Cycle There are a number of steps between collecting a patient’s insurance information and closing their account as paid in full, each of which can have an affect on a medical practice’s net income. Each month, take a look at the overall revenue cycle to insure there are no obvious snags or ...

The healthcare insurance industry is in somewhat of a flux at the moment, which can cause problems for any practices that aren’t paying careful attention to what’s going on. For example, patients are being held more responsible for health insurance costs than insurance payers, which is evidenced by the rising co-payments and deductibles. This can be a problem for medical practices due to the fact that patients tend to pay much slower than insurance payers, which means that if they aren’t careful, their cash flow could decrease.   Preventing Cash Flow Problems Because patients are being forced to pay higher costs, it means that more of your cash flow is dependent on your patients than on insurance companies. According to the National Center for Health Statistics, 25% of families have an unpaid healthcare bill, 10% of families have medical bills they can’t pay at all and 20% are on a payment plan to pay off their bills over time. As you can imagine, this could affect your cash flo...