At the Margins

Our latest insight into health care margin improvement efforts

Surprise billing is still a problem. Here's how the legislative fixes compare.

by Lauren Robinson and Robin Brand October 9, 2019

Surprise billing continues to garner significant media scrutiny with stories of unexpected medical bills up to tens of thousands of dollars, exacerbating patients' fear and frustration. The attention has spurred debate around potential state and federal government solutions. Providers and insurers (and their respective lobbyists) are now squaring off, each advocating for different solutions, with patients stuck in the middle.

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Preview our 2019 Revenue Cycle Benchmarks

by Sophia Duke-Mosier and Rachel Matthews October 2, 2019

Later this month, we'll refresh our revenue cycle benchmarking tool with the latest data from 2019. In addition to the tool release, we'll detail key insights in a webconference on October 16. Want a sneak peek of our findings? Keep reading.

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Help us help you: Take our 5-minute survey to guide our research on charity care

by Sophia Duke-Mosier August 21, 2019

Struggles with patient collections and uncompensated care have increased, leaving hospitals scrambling for ways to collect on unpaid bills. But hospitals aren't the only ones scrambling—patients are continuously on the hook for more of their bills due to a shift from insurer to patient responsibility and rising out-of-pocket costs.

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Our take: This year's FY 2020 Inpatient Final Rule winners (and 2 other key insights)

Eric Fontana August 5, 2019

Late Friday, CMS continued the flurry of recent regulations by dropping the Inpatient Prospective Payment System Final Rule for Fiscal Year (FY) 2020. Unlike the headline-grabbing HOPPS proposal, this regulation was not expected to make major waves after a relatively tame inpatient proposal back in April. Nevertheless, our team will be scrubbing through the release over the next two weeks to examine the key provisions that will take effect on October 1, 2019.

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Make change a reality: How to gain stakeholder buy-in across the revenue cycle

by Robin Brand and Rachel Matthews July 31, 2019

Today's provider world moves at an impossibly rapid pace. Between mergers, EHR "go-lives," and staffing revamps, your revenue cycle has likely undergone significant change in the past year. In fact, research suggests that the average health care manager juggles five to 15 change initiatives at any one time.

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Medicare wants hospitals to disclose 'secret' prices, plus 2 other key takeaways from the 2020 HOPPS proposed rule

by Eric Fontana, Heather Bell, and Rachel Hollander July 30, 2019

Late yesterday, CMS released its proposed regulations for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) in calendar year (CY) 2020.

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Does your pharmacy know the ins and outs of finance? How a specialist can cut billing errors.

by Robin Brand and Sophia Duke-Mosier July 17, 2019

What if an organization had a pharmacist dedicated to revenue integrity? The pseudonymed Beesly Health has just that—and it's helped the organization considerably reduce its billing errors.

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A new executive order could boost health care sharing ministry enrollment. Here's how to prepare.

by Robin Brand and Rachel Matthews July 10, 2019

The industry is buzzing over President Trump's recent executive order on improving price and quality transparency. However, while pundits devote their attention to the order's main component on price transparency, a smaller provision—with the potential to affect hospital collections—has flown under the radar.

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