At the Margins

Our latest insight into health care margin improvement efforts

How Cedars-Sinai saved $76M with a simple audit strategy

by Robin Brand and Sophia Duke-Mosier July 3, 2019

Feeling attacked by audits?

Today's revenue cycle leaders often mention feeling attacked by the "regulatory tentacles," of government or non-audit requests at multiple entry points along the revenue cycle. The range of these audit types are seemingly endless, from RACs to MACs, LCDs, NCDs, QIOs, and audits from the Office of Inspector General--with revenue placed at risk from each one. Responding to, and mitigating, these audits can come at a high cost, requiring leaders to divert time and focus from other revenue cycle tasks to ensure compliance.

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The path to revenue cycle systemness starts with a vision. Here's how to build one.

by Anita Mago and Robin Brand June 24, 2019

While hospitals are starting to get a better handle on cost growth, margins still remain slim and much too close for comfort. In 2018, the median operating margin for nonprofit hospitals was just 1.7%. But minimizing cost is only one piece of the puzzle—skillful management of revenue cycle operations is just as critical. As we speak with our members across the country, we consistently get questions such as:

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Robin Brand May 22, 2019

Health care leaders are increasingly focused on revenue capture—and revenue cycle operations—to sustain and bolster margin health. But even as revenue cycle leaders are asked to do more, they face ongoing obstacles to success, such as disengaged staff, inefficient processes for sharing information, and delivery systems that have outgrown existing infrastructure.

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The winners (and losers) in Medicare's 2020 inpatient proposed rule

by Eric Fontana and Kenna Hawes April 24, 2019

Late yesterday, CMS released the Inpatient Prospective Payment System Proposed Rule for Fiscal Year (FY) 2020. Over the next few weeks, our team will be scrubbing through the regulations to examine the key provisions.

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Winter blues, bipartisan agreement, and a novel way to pay less (there's a catch): The rev cycle April reading list

by Anita Mago April 10, 2019

Revenue cycle leaders, it's been a busy few months since we last shared our list, but rest assured, we've got some noteworthy news to share—from how the seasons impact revenue cycle, to … brace yourselves … bipartisan agreement! So without further ado, here's our Spring 2019 reading list!

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Cost to collect, denials, and patient collections: How does your organization stack up?

Eric Fontana March 13, 2019

This month we're opening data collection on our 2019 revenue cycle benchmarks, gathering the latest snapshot of revenue cycle performance from around the nation. This year, we're making some key additions to our metric set as we aim to provide further insight into key aspects of performance for our Revenue Cycle Advancement Center members while helping fuel new revenue cycle research initiatives in the coming year.

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Quick poll: How do you manage physician billing?

by Rachel Matthews March 6, 2019

Do you manage billing for both employed and independent physicians? Are your physician practices on the same billing system as your hospital?

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Wondering if your patients price shop? Ask if they have a health savings account.

by Robin Brand and Rachel Matthews February 20, 2019

When first introduced, high deductible health plans (HDHPs) were viewed by many as a silver bullet. Cost-sharing promotes consumerism, so the story goes, and so once patients bear responsibility for their health spending, they'll price shop their way to low-cost, high-quality providers. But studies show that individuals with HDHPs are actually more likely to decrease care utilization across health services, including utilization of medication, imaging, and preventative care. HDHP consumers aren't savvy—they're scared.

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