At the Margins

The revenue cycle reading list: January 2019

by Anita Mago

Revenue cycle leaders, welcome to your first reading list of 2019! Every month we'll round-up the most interesting and timely revenue cycle content, so you don't have to. Enjoy!

To have the Reading List delivered straight to your inbox, make sure you're subscribed to At the Margins.

What's on your reading list? We want to know! Send your must-reads to rcac@advisory.com.

Tax refund? Schedule that surgery!

Cash flow dynamics and family health care spendingHealth Affairs, December 2018

An analysis of JPMorgan Chase Institute data reveals how short-term changes in household cash flow influence consumer decisions about whether and when to seek medical care. The findings suggest that health care spending is sensitive to a wide range of cash flow events, from tax refunds to natural disasters. Unlike decisions about sports cars and handbags, it seems decisions about health care are largely driven by cash on hand.

Greek to me

As hospitals post sticker prices online, most patients will remain befuddledKaiser Health News, January 2019

As of Jan. 1, CMS required that all hospitals post their list prices online, but what is actually being posted—an alphabet soup of medical abbreviations and dollar signs—may leave consumers more confused than illuminated. That's because a majority of price lists posted were hospital chargemasters—massive compendiums of the prices set by each hospital for every service or drug a patient might encounter. To figure out what a visit might cost, a patient would have to piece together every component of his or her care. So far, the jury is out on the question of the day: Will price transparency lead to clarity?

See you in court

38 hospitals sue HHS over site-neutral payment ruleHealthcare Finance, January 2019

A group of 38 hospitals has sued HHS over a new rule that cuts Medicare payments for some services provided at off-campus hospital sites. The lawsuit claims that HHS Secretary Alex Azar acted beyond his statutory authority when he enacted a site-neutral payment policy that went into effect Jan 1. The policy translates to total payment reductions of $380 million in 2019, leaving many hospitals with ailing balance sheets.

Peaks & valleys

U.S. uninsured rate rises to 4-year high—Gallup, January 2019

The U.S. uninsured rate has risen steadily since 2016, with the greatest increases among women, young adults, and the lower-income. In the fourth quarter of 2018 it stood at 13.8%. While this is well below the high point of 18% in 2014, it is notably higher than the low point of 10.9% reached in 2016 under the Affordable Care Act’s individual mandate. The 2.8% jump translates to another 7 million Americans lacking coverage.

We can work it out

Commentary: Hospital-insurer collaborations can reduce readmissions, cut costsModern Healthcare, January 2019

In a departure from the often-adversarial relationship between hospitals and health insurers, the University of Pennsylvania Health System and Independence Blue Cross joined forces to reduce hospital readmissions. The partners leveraged their collective EHR data to hone in on the most critical time period for readmissions, as well as the highest risk patients. Spoiler alert: It worked.

What patients want along their financial journey

Follow the patient financial journey, from pre-care through billing and collections. Learn a patient's questions and fears that arise at each step, and what tools and support your revenue cycle program must proactively provide.

Download Now