WHITE PAPER: Not Tracking Your HCCs Will Put Your Revenue at Risk
Hierarchical condition categories (HCCs) are used in many value-based healthcare programs and for Medicare Advantage reimbursement. As healthcare delivery organizations prepare to take on more risk, executives must ensure systems are in place for robust HCC capture and management. Read our white paper to learn more.
WHITE PAPER: Performance Improvement
Healthcare organizations undertake performance improvement (PI) initiatives to improve quality and decrease costs. A PI initiative seeks to close a gap between actual performance and desired performance. Read our white paper to learn more.
WHITE PAPER: Managing Population Health
Healthcare reform, specifically the passage of the Patient Protection and Affordable Care Act (ACA), has spurred a shift towards value-based healthcare and population health. Healthcare organizations must now focus on delivering more value and to do so requires better management of patient population health. Read our white paper to learn more.
WHITE PAPER: Is Your Revenue Cycle Value-Based Healthcare Ready?
The shift to value-based healthcare is transforming the healthcare landscape. Executives must understand how value-based healthcare is impacting revenue cycle management (RCM) systems, including the functionality required to support new business models and to provide the flexibility to adapt to changing market conditions. Read our white paper to learn more.
WHITE PAPER: Using the A3 to Problem Solve
A3 is a problem solving approach that is part of lean management and that helps drive continuous improvement. Using A3s to problem solve should allow a healthcare organization to drive improvements in quality outcomes, patient experience and utilization costs – thus delivering more value. Read our white paper to learn more.
WHITE PAPER: Achieving Systemness is the Key to Delivering More Value
The shift to value-based health care requires a greater level of integration than previously achieved by most healthcare delivery organizations. Executives must position their organizations for the future healthcare environment where achieving “systemness” is a fundamental requirement. Read our white paper to learn more.
WHITE PAPER: Analytics and the Need for Information Governance
The push towards value-based purchasing and accountable care organizations as well as initiatives such as meaningful use and physician quality measures have increased the need for better analytics to make faster decisions. To meet these needs, healthcare organizations are looking to analytic toolsets that offer solutions to allow for better analysis and ultimately decision making based on datasets available. To ensure the data is accurate, organizations must have an information governance model in place. Read our white paper to learn more.
WHITE PAPER: Complex Program Management
Organizations today often seek to manage programs, particularly complex programs, to deliver on organizational strategy. Program management is the process of managing several related projects to achieve benefits that cannot be achieved if the projects were managed separately, often with the intention of improving an organization’s performance. Many programs are concerned with delivering a capability to change. Read our white paper to learn more.
WHITE PAPER: Epic Optimization
Epic implementation projects typically follow these phases:
- Phases 0 & 1: Discovery and Initial Analysis
- Phase 2: Validation
- Phase 3: Re-Engineering and System Build
- Phase 4: Testing, Training, and Go-Live
- Phases 5 & 6: Optimization, Stabilization, and Rollout
A mix of strong revenue cycle knowledge plus process workflow expertise and Epic domain knowledge is required to manage through these phases as well as leadership skills to manage the daily and weekly revenue cycle review meetings. Read our white paper to learn more.
WHITE PAPER: Clinical Trials Billing
The clinical trials research billing process is one of the most complex in healthcare. Although the National Coverage Decision (NCD) for Clinical Trial Services established principles for covering certain services provided in connection with qualifying clinical trials, the application of these rules within the healthcare environment can be challenging. Additionally, there can be multiple systems to support clinical trials billing which requires significant integration effort. Read our white paper to learn more.
WHITE PAPER: Computer Assisted Coding
Medical coding remains a very laborious process and the increased use of electronic health records, while providing better and more legible documentation, has increased the volume of information a coder must review when assigning codes. There is also a limited supply of trained coders; staffing coders continues to be challenging, particularly in the inpatient arena. With ICD-10 on the horizon, many organizations are now evaluating computer-assisted coding as a possible solution to improve productivity and provide cost savings. Read our white paper to learn more.
WHITE PAPER: Electronic Payment Posting
As healthcare organizations seek to improve and accelerate their payment cycles, electronic payment posting solutions have become more prevalent. Electronic payment posting solutions convert paper payments to electronic payment files (e.g. 835 EDI). The paper payments can be patient checks or insurance checks associated to explanation of benefit (EOB) statements for facilities, professional services or both. Read our white paper to learn more.
WHITE PAPER: National Drug Code (NDC) Reporting
A3 is a problem solving approach that is part of lean management and that helps drive continuous improvement. Using A3s to problem solve should allow a healthcare organization to drive improvements in quality outcomes, patient experience and utilization costs – thus delivering more value. Read our white paper to learn more.
