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    their options and proceed cautiously in meeting that challenge Shedding Light on Physician Performance Transparency Health systems of all sizes should focus on physician performance transparency to help improve patient experience boost revenue and reduce risk Using this information can help identify systemic problems and improve care Invest in Your Data How Clinical Mobility Solutions Liberate Data and Drive Cost Savings Smart point of care mobile solutions improve data accessibility and safeguard privacy reducing risk improving care and supporting claims for full payment How Streamlining Telecommunications Can Cut IT Expense New requirements driven largely by healthcare reform bring challenges to IT By streamlining telecom systems equipment and practices health systems can maximize efficiency Best Practice in Unbilled Account Management One Medical Center s Story A large academic medical center greatly reduced its unbilled accounts backlog by realigning automatic routing and improving interdisciplinary collaboration and data reporting transparency View the February 2016 Issue Featured Columns Embracing Healthcare Technology and Going Beyond The fact that technology is an essential element in the delivery and financing of health care today presents healthcare finance leaders techies and late adopters alike with numerous opportunities to step out of their comfort zones Healthcare Consumerism It s Not Just About the Revenue Cycle Healthcare finance leaders should consider the impact of consumerism on health care from a strategic perspective EHRs Long Term Vision Short Term Change When it comes to the adoption and use of electronic health records EHRs the long term vision from the Centers for Medicare Medicaid Services CMS hasn t changed but the approach surely will MACRA The Evolution of the Medicare Physician Payment System Continues The Medicare Access and CHIP Reauthorization Act of 2015 MACRA provides incentives for physician group practices to participate in alternative payment models APMs A Progress Check on 7 Aspects of CINs Much of the variation among today s CINs is tied to differences in the overall strategies of health systems that formed them The Continued Proliferation and Evolution of ACA Healthcare Delivery Reforms Changes are on the horizon for five major healthcare delivery reforms established by the Affordable Care Act ACA Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a

    Original URL path: http://www.hfma.org/Templates/Magazine.aspx?id=12598 (2016-02-10)
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  • About HFMA Newsletters
    Growth strategies HFMA newsletters are aimed at healthcare finance leaders with topic specific information needs The more you subscribe to the more knowledge and connections you receive If you have any questions please contact Member Services at 800 252 4362 extension 2 BACK TO PAGINATION How To Strategies for Today s Challenges HFMA s three subscription newsletters provide healthcare finance leaders with expert insight and practical strategies Subscription Benefits Include Tailored articles offering technical how to details and thought provoking insights from healthcare finance leaders and industry experts E blasts delivered to your email linking you to electronic versions html of each issue Archive of past issues Print copies of each issue delivered to your mailing address Healthcare Cost Containment The bimonthly newsletter provides provider tested tactics for strategic cost containment In one past issue subscribers learned how Bon Secours Health System reduced blood use by 65 percent and adverse events by 14 percent while garnering savings of 1 97 million Other topics include Trimming service line costs Reducing labor and supply expenses Working with physicians to reduce clinical costs Transitioning to cost accounting Revenue Cycle Strategist In 10 issues a year this popular newsletter provides finance leaders with needed advice on denials management collections coding and other revenue cycle issues Recently subscribers learned how Mission Hospital reduced denied claims from Blue Shield of California by 65 percent Other topics include Responding to Medicare audits Resolving coding issues Improving insurance eligibility rates Using Lean process improvement to improve KPIs Strategic Financial Planning This quarterly newsletter provides specifics on how to prioritize implement and finance strategic and capital decisions In a recent issue subscribers learned how Adventist Health is gaining a better handle on actual costs by transitioning to a multiple RVU costing system Other topics include Successful financing approaches Strategic reimbursement tactics The latest strategic financial and capital planning approaches Business intelligence approaches Growth strategies HFMA newsletters are aimed at healthcare finance leaders with topic specific information needs The more you subscribe to the more knowledge and connections you receive If you have any questions please contact Member Services at 800 252 4362 extension 2 Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and

    Original URL path: http://www.hfma.org/newsletters/ (2016-02-10)
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  • Peer Review Healthcare Business Solutions
    patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage

    Original URL path: http://www.hfma.org/PeerReviewLanding.aspx?id=12579 (2016-02-10)
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  • McKesson: Leveraging Predictive Analytics to Rein in Operating Costs
    can improve margins Additionally McKesson s solution can help organizations avoid quality risks by ensuring they provide all required care on time What are some of the biggest challenges you see affecting healthcare organizations Hospitals and health systems are facing a huge transformation with the emergence of value based reimbursement Payers are encouraging their members to seek care in lower cost settings which affects a hospital s ability to understand what capacity is going to be next week next month and next year Payers are also tightening reimbursement pushing hospitals to shorten lengths of stay and penalizing them for avoidable readmissions All this change is causing facilities to look for ways to reduce costs Unfortunately healthcare organizations have done just about everything they can to cut back and eliminate expenses Now they have to examine processes that they may not have considered before For example they must evaluate the impact of an overflowing emergency department an underutilized operating room or capacity on MedSurg floors Moreover management has to think about patient flow across the organization to get a better understanding of capacity issues Historically hospitals and health systems have managed capacity to averages If you think about it in terms of maximum and minimum patient census it is easy to see where this approach could cause great problems For example say a specialty care unit in a hospital treats five patients on a typical Monday but on one particular Monday 10 patients need care If the hospital is staffing for average capacity it could be caught short leaving the organization without enough staff to meet regulatory requirements Conversely if there is only one patient on a Monday nursing leadership would tell staff not to come in or send staff home creating schedule chaos for the employees Managing to averages could also leave the hospital without the appropriate staff based on patient acuity For example there could be a situation where the orthopedic unit is full but there are insufficient ortho certified nurses on staff that night Not only could this be a patient safety risk it also puts the organization in a difficult position in terms of compliance with internal or external requirements Rather than staffing to averages hospitals need to accurately forecast capacity so they can allocate resources more precisely How does your product or service offering s help address these needs As mentioned before the McKesson capacity management solution provides predictive analytics that let providers accurately forecast patient demand so they are not managing to averages That means they can staff appropriately based on true capacity and acuity making sure they have the staff with the right credentials and skill mix in the right place at the right time They can also reduce reliance on overtime and travel nurses Our solution also helps manage patient flow allowing organizations to better monitor a patient s specific position in the hospital at any given time Using the solution staff can immediately identify and clear any bottlenecks In doing so organizations can make sure they optimize how they use every single bed and even create virtual capacity The capacity management solution draws data for predictive analytics via HL7 from historical ADT data which can come from human resource and or health information systems The solution automatically converts demand forecasts into suggested staffing needs in McKesson s workforce management solution removing much of the effort to optimize schedules from unit managers What are some key considerations for healthcare leaders when choosing this type of product or service Are there key product service features that people should know about When seeking capacity management solutions hospitals and health systems should look for healthcare expertise especially with managing capacity and patient flow In addition companies should be able to supply proven customer success stories and clearly demonstrate something that differentiates their product from the competition For example many demand forecasting solutions produce only a static short term demand projection for the next 7 days without converting the projection to a staffing plan Our solution produces long term budgetary and near term forecasts and even predicts patient arrival and discharge times It also allows for OR schedule optimization including the downstream impact on units If your goal is to sustainably reduce operating expenses by transforming how you allocate staff and resources you need a holistic system The fact that McKesson offers a bundle of solutions related to capacity management predictive analytics workforce management and patient flow management uniquely positions us among competitors to ensure that hospitals and health systems fully optimize their resources Our company also scores highly with KLAS Research which rates products for healthcare organizations As healthcare organizations implement use of your product or service into their day to day operations what advice would you offer so they can best set themselves up for success A hospital or health system must be committed to making changes and that is not easy Technology by itself is not going to be enough These entities must seek a vendor that is willing to work through all the necessary nuances to improve capacity management To navigate change organizations should embrace the concept of change management Looking at your capacity and patient flow in a different way can be nerve wracking for people who have been doing things the same way forever Embracing change management will help hospitals and health systems be successful as new payment models take shape Are there any educational materials you would like to share to help healthcare providers in these efforts For more information about McKesson s capacity management solution visit the website To learn more about how to improve forecast accuracy download our most recent white paper HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by McKesson This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Friday January 01 2016 BACK TO PAGINATION Advertisement In this business profile a leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow Tell me a little bit about your organization McKesson the oldest and largest healthcare services company in the nation provides innovative distribution and technology solutions for healthcare organizations An especially timely offering is our dynamic capacity management solution which helps health systems improve operating margins by reducing labor costs optimizing patient flow and avoiding quality risks The solution includes predictive analytics that help hospitals and health systems accurately forecast patient demand far enough in advance so they can align resources and schedule the right staff without incurring last minute expenses Not only does this allow for more precise resource allocation it can improve margins Additionally McKesson s solution can help organizations avoid quality risks by ensuring they provide all required care on time What are some of the biggest challenges you see affecting healthcare organizations Hospitals and health systems are facing a huge transformation with the emergence of value based reimbursement Payers are encouraging their members to seek care in lower cost settings which affects a hospital s ability to understand what capacity is going to be next week next month and next year Payers are also tightening reimbursement pushing hospitals to shorten lengths of stay and penalizing them for avoidable readmissions All this change is causing facilities to look for ways to reduce costs Unfortunately healthcare organizations have done just about everything they can to cut back and eliminate expenses Now they have to examine processes that they may not have considered before For example they must evaluate the impact of an overflowing emergency department an underutilized operating room or capacity on MedSurg floors Moreover management has to think about patient flow across the organization to get a better understanding of capacity issues Historically hospitals and health systems have managed capacity to averages If you think about it in terms of maximum and minimum patient census it is easy to see where this approach could cause great problems For example say a specialty care unit in a hospital treats five patients on a typical Monday but on one particular Monday 10 patients need care If the hospital is staffing for average capacity it could be caught short leaving the organization without enough staff to meet regulatory requirements Conversely if there is only one patient on a Monday nursing leadership would tell staff not to come in or send staff home creating schedule chaos for the employees Managing to averages could also leave the hospital without the appropriate staff based on patient acuity For example there could be a situation where the orthopedic unit is full but there are insufficient ortho certified nurses on staff that night Not only could this be a patient safety risk it also puts the organization in a difficult position in terms of compliance with internal or external requirements Rather than staffing to averages hospitals need to accurately forecast capacity so they can allocate resources more precisely How does your product or service offering s help address these needs As mentioned before the McKesson capacity management solution provides predictive analytics that let providers accurately forecast patient demand so they are not managing to averages That means they can staff appropriately based on true capacity and acuity making sure they have the staff with the right credentials and skill mix in the right place at the right time They can also reduce reliance on overtime and travel nurses Our solution also helps manage patient flow allowing organizations to better monitor a patient s specific position in the hospital at any given time Using the solution staff can immediately identify and clear any bottlenecks In doing so organizations can make sure they optimize how they use every single bed and even create virtual capacity The capacity management solution draws data for predictive analytics via HL7 from historical ADT data which can come from human resource and or health information systems The solution automatically converts demand forecasts into suggested staffing needs in McKesson s workforce management solution removing much of the effort to optimize schedules from unit managers What are some key considerations for healthcare leaders when choosing this type of product or service Are there key product service features that people should know about When seeking capacity management solutions hospitals and health systems should look for healthcare expertise especially with managing capacity and patient flow In addition companies should be able to supply proven customer success stories and clearly demonstrate something that differentiates their product from the competition For example many demand forecasting solutions produce only a static short term demand projection for the next 7 days without converting the projection to a staffing plan Our solution produces long term budgetary and near term forecasts and even predicts patient arrival and discharge times It also allows for OR schedule optimization including the downstream impact on units If your goal is to sustainably reduce operating expenses by transforming how you allocate staff and resources you need a holistic system The fact that McKesson offers a bundle of solutions related to capacity management predictive analytics workforce management and patient flow management uniquely positions us among competitors to ensure that hospitals and health systems fully optimize their resources Our company also scores highly with KLAS Research which rates products for healthcare organizations As healthcare organizations implement use of your product or service into their day to day operations what advice would you offer so they can best set themselves up for success A hospital or health system must be committed to making changes and that is not easy Technology by itself is not going to be enough These entities must seek a vendor that is willing to work through all the necessary nuances to improve capacity management To navigate change organizations should embrace the concept of change management Looking at your capacity and patient flow in a different way can be nerve wracking for people who have been doing things the same way forever Embracing change management will help hospitals and health systems be successful as new payment models take shape Are there any educational materials you would like to share to help healthcare providers in these efforts For more information about McKesson s capacity management solution visit the website To learn more about how to improve forecast accuracy download our most recent white paper HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by McKesson This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Friday January 01 2016 Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes HFMA RESOURCE LIBRARY Large Health System Drives 10 UP Patient Payments and 10 DOWN Billing related Costs Faced with a rising tide of bad debt a large Southeastern healthcare system was seeing a sharp decline in net patient revenues The need to improve collections was dire By integrating critical tools and processes the health system was able to increase online payments and improve its financial position Taking a holistic approach increased overall collection yield by 10 while

    Original URL path: http://www.hfma.org/Content.aspx?id=45027 (2016-02-10)
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  • Accretive Health: Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment
    Many of our customers are faith based non profit hospitals or teaching institutions including a number of the top rated healthcare systems What are some of the biggest challenges you see affecting healthcare organizations Hospitals have always experienced rules and regulations changes which affect the way in which they are reimbursed However current industry changes are unlike any others and have put increased pressure on hospital leaders to control care quality and be accountable for costs These are not subtle changes but seismic shifts creating new and tremendous challenges The traditional role of the hospital is also changing More services are being conducted in pre and post acute care centers the length of stay has been reduced outpatient surgical centers have expanded capabilities and we continue to see the emergence of large health systems and super systems The small independent hospital or physician practice is quickly becoming obsolete These new changes may cause providers to struggle when deploying health information systems building front and back end financial infrastructure and reengineering claims submission As a result merger and acquisition activity will keep growing and physicians and health systems will continue to integrate and align For the most part providers understand the need for change in order to combat rising healthcare costs and improve quality Those that are quick to adapt and assimilate will survive and prosper and those that remain stagnant run the risk of margin contraction at the very least How do Accretive Health s products or services address these issues Accretive Health is a leader in the field and well positioned to help customers through the current transition offering flexible resources that fit evolving provider needs We help our partners significantly reduce the administrative costs associated with revenue cycle management We also maximize a hospital s current revenue by constantly monitoring and optimizing all front middle and back end processes Our end to end offering is comprehensive and it rests on a foundation of operational excellence We have always been on the cutting edge of revenue cycle technology development Our technology allows us to automate processes such as intelligence gathering and metrics management as well as monitor changing conditions in real time and remain nimble to our clients needs For example we are developing tools that will immediately inform us if a certain procedure is denied why it is denied and where in the process it is denied This will allow us to better align clinical and financial outcomes What is the key to successfully transitioning from fee for service to value based reimbursement More than a decade of experience integrating revenue cycle functions throughout a variety of hospitals and health systems has taught us valuable lessons on how to move seamlessly from fee for service to value based reimbursement There are three key aspects to successfully making the transition First and foremost payers and providers must form a strong partnership It is imperative they work together to ensure contract terms are clear and financial incentives are aligned Second as patients begin to think more like consumers patient engagement is becoming increasingly important It is essential that providers manage patient care by encouraging wellness visits and preventive screenings especially in patients with chronic conditions These efforts will improve HEDIS and PQRS scores which are so important in emerging value based models Additionally engaged patients tend to have better health outcomes and are more inclined to seek in network care Last but certainly not least analytics are a high priority because without actionable data providers will have a difficult time succeeding with new payment models When assessing metrics organizations should make sure they have quality measure assurance population analytics and contract modeling capabilities How is Accretive Health preparing providers for the transition Accretive Health has been getting ready for this transition for quite some time by developing proprietary technology and shifting our attention to services that better align with value based reimbursement Over the last 18 months we have changed our focus from back end payer reimbursement processes to front end patient and provider activities Our coding emphasis has also moved from CPT and EM levels and medical necessity to health conditions quality measures and risk scores Under value based reimbursement our approach integrates clinical and financial functions which is more strategic from a provider perspective and more beneficial for the patient What are your recommendations to leaders considering revenue cycle management vendors First I suggest completing an internal assessment and pinpointing specific functions with which you need assistance It is crucial for providers to weigh what is best for their particular organizations Healthcare CEOs and CFOs are ultimately responsible for ensuring their organizations deliver outstanding care to patients while maintaining financial viability A revenue cycle vendor must understand a healthcare provider s mission and have the ability to adapt quickly to changes which will further unfold in years to come Second technology prowess should be a top priority when searching for the proper partner At the heart of any good revenue cycle management vender is its technological capabilities because automation drives all business functions We believe that our model is unique in the industry and produces the best results for providers Our integrated approach allows us to stand side by side with clients to best serve their missions and strengthen their financial foundations Where can readers learn more about Accretive Health s solutions I encourage readers to take a look at our newly redesigned website where they can find more information about our innovative solutions and proprietary technology I also recommend reading our whitepaper The Provider Crossroad to Value Based Reimbursement which provides further detail about overcoming the industry challenges associated with evolving payment models HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by Accretive Health This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Tuesday December 01 2015 BACK TO PAGINATION Advertisement In this Business Profile Emad Rizk MD president and CEO at Accretive Health discusses the uncertainty facing hospitals today and the transitions affecting revenue cycle management With more than two decades of experience in both payer and provider organizations he offers a blended perspective on revenue cycle management solutions Tell me a little bit about your organization Accretive Health partners with provider organizations to help them navigate the changing healthcare revenue cycle management landscape Our company supports the mission and business objectives of hospitals and health systems and their affiliated ambulatory clinics and physician practices by effectively managing their revenue cycle processes and strengthening their financial stability Our core business model is unlike any other company we offer comprehensive end to end revenue cycle management Our company motto Operating together stresses the value we place on operational excellence and the partnership we strive for with our clients Accretive Health s goal is to deliver unrivaled revenue cycle management results as we integrate with our partners front middle and back end revenue cycle processes We don t give advice from afar we are at our clients elbows with our sleeves rolled up ready to work alongside them to improve performance Accretive Health s customer base has expanded to nearly 100 hospitals and health systems across the country Many of our customers are faith based non profit hospitals or teaching institutions including a number of the top rated healthcare systems What are some of the biggest challenges you see affecting healthcare organizations Hospitals have always experienced rules and regulations changes which affect the way in which they are reimbursed However current industry changes are unlike any others and have put increased pressure on hospital leaders to control care quality and be accountable for costs These are not subtle changes but seismic shifts creating new and tremendous challenges The traditional role of the hospital is also changing More services are being conducted in pre and post acute care centers the length of stay has been reduced outpatient surgical centers have expanded capabilities and we continue to see the emergence of large health systems and super systems The small independent hospital or physician practice is quickly becoming obsolete These new changes may cause providers to struggle when deploying health information systems building front and back end financial infrastructure and reengineering claims submission As a result merger and acquisition activity will keep growing and physicians and health systems will continue to integrate and align For the most part providers understand the need for change in order to combat rising healthcare costs and improve quality Those that are quick to adapt and assimilate will survive and prosper and those that remain stagnant run the risk of margin contraction at the very least How do Accretive Health s products or services address these issues Accretive Health is a leader in the field and well positioned to help customers through the current transition offering flexible resources that fit evolving provider needs We help our partners significantly reduce the administrative costs associated with revenue cycle management We also maximize a hospital s current revenue by constantly monitoring and optimizing all front middle and back end processes Our end to end offering is comprehensive and it rests on a foundation of operational excellence We have always been on the cutting edge of revenue cycle technology development Our technology allows us to automate processes such as intelligence gathering and metrics management as well as monitor changing conditions in real time and remain nimble to our clients needs For example we are developing tools that will immediately inform us if a certain procedure is denied why it is denied and where in the process it is denied This will allow us to better align clinical and financial outcomes What is the key to successfully transitioning from fee for service to value based reimbursement More than a decade of experience integrating revenue cycle functions throughout a variety of hospitals and health systems has taught us valuable lessons on how to move seamlessly from fee for service to value based reimbursement There are three key aspects to successfully making the transition First and foremost payers and providers must form a strong partnership It is imperative they work together to ensure contract terms are clear and financial incentives are aligned Second as patients begin to think more like consumers patient engagement is becoming increasingly important It is essential that providers manage patient care by encouraging wellness visits and preventive screenings especially in patients with chronic conditions These efforts will improve HEDIS and PQRS scores which are so important in emerging value based models Additionally engaged patients tend to have better health outcomes and are more inclined to seek in network care Last but certainly not least analytics are a high priority because without actionable data providers will have a difficult time succeeding with new payment models When assessing metrics organizations should make sure they have quality measure assurance population analytics and contract modeling capabilities How is Accretive Health preparing providers for the transition Accretive Health has been getting ready for this transition for quite some time by developing proprietary technology and shifting our attention to services that better align with value based reimbursement Over the last 18 months we have changed our focus from back end payer reimbursement processes to front end patient and provider activities Our coding emphasis has also moved from CPT and EM levels and medical necessity to health conditions quality measures and risk scores Under value based reimbursement our approach integrates clinical and financial functions which is more strategic from a provider perspective and more beneficial for the patient What are your recommendations to leaders considering revenue cycle management vendors First I suggest completing an internal assessment and pinpointing specific functions with which you need assistance It is crucial for providers to weigh what is best for their particular organizations Healthcare CEOs and CFOs are ultimately responsible for ensuring their organizations deliver outstanding care to patients while maintaining financial viability A revenue cycle vendor must understand a healthcare provider s mission and have the ability to adapt quickly to changes which will further unfold in years to come Second technology prowess should be a top priority when searching for the proper partner At the heart of any good revenue cycle management vender is its technological capabilities because automation drives all business functions We believe that our model is unique in the industry and produces the best results for providers Our integrated approach allows us to stand side by side with clients to best serve their missions and strengthen their financial foundations Where can readers learn more about Accretive Health s solutions I encourage readers to take a look at our newly redesigned website where they can find more information about our innovative solutions and proprietary technology I also recommend reading our whitepaper The Provider Crossroad to Value Based Reimbursement which provides further detail about overcoming the industry challenges associated with evolving payment models HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by Accretive Health This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Tuesday December 01 2015 Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how

    Original URL path: http://www.hfma.org/Content.aspx?id=43730 (2016-02-10)
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  • Conifer Health Solutions: Helping Providers and Employers Build a Foundation for Better Health
    more Content for this Business Profile is supplied by Conifer Health Solutions This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Comments Please login to add your comments Add Comment Text Only 2000 character limit ADVERTISEMENTS HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied

    Original URL path: http://www.hfma.org/Leadership/Archives/2015/Fall/Conifer_Health_Solutions__Helping_Providers_and_Employers_Build_a_Foundation_for_Better_Health/ (2016-02-10)
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  • Ontario Systems: Optimizing Accounts Receivable in a Rapidly Changing Environment | HFMA
    to make reasonable efforts to determine if a patient is eligible for financial assistance before the institution takes certain collection actions Another regulation that affects patient collections is the Telephone Consumer Protection Act TCPA which applies to phone calls made to mobile devices In the context of this regulation providers must be intentional when they connect with patients to communicate financial responsibilities Regarding payer reimbursement the launch of ICD 10 in October will increase claim denials expand days in AR slow cash flow and perhaps even restrict revenue in the near term How does Ontario Systems help address these challenges The Artiva HC product includes a number of feature sets that improve a healthcare provider s revenue cycle operations in response to the abovementioned issues One of the product s key benefits is high yield aggregation meaning it manages accounts receivable from the health system s various facilities and practices within one system that standardizes workflow for every account and reinforces repeatable processes thereby driving the best outcomes This is especially important when an organization has legacy systems or when it has recently gone through a merger or acquisition and is blending disparate systems With an aggregation strategy differing hosts feed into Artiva HC enabling it to deliver comprehensive and consistent reports that highlight actionable data We also focus on the front end as a feeder into the patient and payer reimbursement process The Artiva HC product orchestrates specific steps in pre registration that help providers standardize patient access verify insurance set patient payment expectations and thus gain the financially cleared patient Another area of focus is claim denial management The Artiva HC product will assess the claim remittance advice for a root cause and respond with automated workflow that alerts the appropriate team or skill set to appeal the denial for example alerting the right personnel to respond to the need for additional medical information By automating the denial management process and moving claims seamlessly through the workflow a provider will manage today s denial volume and be poised to respond to any uptick in denials from ICD 10 To enable a highly effective patient collection process Ontario Systems leverages communication methods that are very familiar to patients the phone and the Internet The Artiva HC product allows our clients to execute calling campaigns with patients while also intelligently routing any calls the patient makes in response We also offer options that turn the business office into a 24 7 operation by empowering the patient to self serve via our inbound IVR and our online automated portal Your patient connectedness strategy should provide the patient options that fit their communication preferences while also complying with important regulations such as TCPA Ontario Systems also leverages data analytics to identify process improvement opportunities through trended real time data that highlights staff productivity payer activity payment trends and other important KPIs With this data in hand the provider can undertake process improvements and monitor the results We employ a disciplined closed loop change management strategy setting up potential improvements testing them training them and then rolling them out to production What are some key considerations for healthcare leaders when choosing an accounts receivable product A vital consideration is how the system responds to the real challenges faced by today s healthcare finance leaders Artiva HC augments a hospital s patient accounting and practice management systems with an accounts receivable competence that reduces costs increases efficiency and thus improves the bottom line By offering solutions in the areas of pre registration payer follow up and denials management and patient liabilities we deploy a comprehensive approach that moves key financial indicators in the right direction and most importantly brings cash in the door Another consideration is how the system interacts with patients as consumers We feel it s important to embrace a customer service mindset and consequently empower hospital staff with information regarding the patient bill With this in hand the customer service representative can knowledgeably discuss the bill including how it rolls to the patient balance what the co pay is and how much the payer has already paid The representative can also quickly see whether the patient needs financial assistance or a payment plan or whether the individual is ready to make a full payment via credit card As healthcare providers implement your products what advice do you offer so they can best set themselves up for success When providers implement our products a key strategic asset is the existence or formation of a steering committee that provides guidance to the mutual implementation teams Our consultants will indeed recommend practices and standards but at the end of the day we want to make sure we align with the vision and strategy of the steering committee The steering committee should have clear decision rights regarding system goals and the implementation timeline With this alignment our consultants can better keep the project on track and ensure that the benefits of the initiative are realized Are there any educational materials you would like to share to help healthcare providers in these efforts On our website we have two areas that are especially worth visiting The InfoHub is where we post eBooks success stories data sheets replays of our webinars and more We hold approximately 10 to 12 webinars a year on various compliance accounts receivable and healthcare topics Alongside our InfoHub is a robust blog community where subject matter experts from accounts receivable IT security compliance and other aspects of the healthcare industry share valuable information Finally if you d like to learn more about any of the topics mentioned above please contact me and we can dig deeper HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by Ontario Systems This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Sunday November 01 2015 BACK TO PAGINATION Advertisement In this Business Profile Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables Tell me a little bit about your organization Ontario Systems is an experienced receivables management company which delivers a combination of software and expert services that empower organizations to secure more cash and decrease their cost to collect Through our strategic revenue cycle management product Artiva HC healthcare providers can seize revenue opportunities speed cash flow reduce days in AR and optimize patient payment While three of the top 6 largest U S health systems use the Artiva HC product our solutions scale to the regional health system level as well What are some of the biggest challenges you see affecting healthcare organizations Today s healthcare finance leaders are facing an increasingly challenging reimbursement environment as patient responsibility grows and payer requirements intensify resulting in climbing accounts receivable volumes High deductible health plans HDHPs for example require patients to pay more out of pocket When individuals have HDHPs they are more likely to carry a balance which requires organizational intervention to resolve Depending on the patient this may involve setting payment expectations establishing payment plans providing charity care and so on The risk within a provider s self pay portfolio has increased as volume has grown Amidst increasing patient payment last December the IRS introduced the final regulations that non profit hospitals need to meet in order to maintain their 501 r status Three of the rules pertain to patient billing and collections and specify the options available to these consumers One area in particular requires hospitals to make reasonable efforts to determine if a patient is eligible for financial assistance before the institution takes certain collection actions Another regulation that affects patient collections is the Telephone Consumer Protection Act TCPA which applies to phone calls made to mobile devices In the context of this regulation providers must be intentional when they connect with patients to communicate financial responsibilities Regarding payer reimbursement the launch of ICD 10 in October will increase claim denials expand days in AR slow cash flow and perhaps even restrict revenue in the near term How does Ontario Systems help address these challenges The Artiva HC product includes a number of feature sets that improve a healthcare provider s revenue cycle operations in response to the abovementioned issues One of the product s key benefits is high yield aggregation meaning it manages accounts receivable from the health system s various facilities and practices within one system that standardizes workflow for every account and reinforces repeatable processes thereby driving the best outcomes This is especially important when an organization has legacy systems or when it has recently gone through a merger or acquisition and is blending disparate systems With an aggregation strategy differing hosts feed into Artiva HC enabling it to deliver comprehensive and consistent reports that highlight actionable data We also focus on the front end as a feeder into the patient and payer reimbursement process The Artiva HC product orchestrates specific steps in pre registration that help providers standardize patient access verify insurance set patient payment expectations and thus gain the financially cleared patient Another area of focus is claim denial management The Artiva HC product will assess the claim remittance advice for a root cause and respond with automated workflow that alerts the appropriate team or skill set to appeal the denial for example alerting the right personnel to respond to the need for additional medical information By automating the denial management process and moving claims seamlessly through the workflow a provider will manage today s denial volume and be poised to respond to any uptick in denials from ICD 10 To enable a highly effective patient collection process Ontario Systems leverages communication methods that are very familiar to patients the phone and the Internet The Artiva HC product allows our clients to execute calling campaigns with patients while also intelligently routing any calls the patient makes in response We also offer options that turn the business office into a 24 7 operation by empowering the patient to self serve via our inbound IVR and our online automated portal Your patient connectedness strategy should provide the patient options that fit their communication preferences while also complying with important regulations such as TCPA Ontario Systems also leverages data analytics to identify process improvement opportunities through trended real time data that highlights staff productivity payer activity payment trends and other important KPIs With this data in hand the provider can undertake process improvements and monitor the results We employ a disciplined closed loop change management strategy setting up potential improvements testing them training them and then rolling them out to production What are some key considerations for healthcare leaders when choosing an accounts receivable product A vital consideration is how the system responds to the real challenges faced by today s healthcare finance leaders Artiva HC augments a hospital s patient accounting and practice management systems with an accounts receivable competence that reduces costs increases efficiency and thus improves the bottom line By offering solutions in the areas of pre registration payer follow up and denials management and patient liabilities we deploy a comprehensive approach that moves key financial indicators in the right direction and most importantly brings cash in the door Another consideration is how the system interacts with patients as consumers We feel it s important to embrace a customer service mindset and consequently empower hospital staff with information regarding the patient bill With this in hand the customer service representative can knowledgeably discuss the bill including how it rolls to the patient balance what the co pay is and how much the payer has already paid The representative can also quickly see whether the patient needs financial assistance or a payment plan or whether the individual is ready to make a full payment via credit card As healthcare providers implement your products what advice do you offer so they can best set themselves up for success When providers implement our products a key strategic asset is the existence or formation of a steering committee that provides guidance to the mutual implementation teams Our consultants will indeed recommend practices and standards but at the end of the day we want to make sure we align with the vision and strategy of the steering committee The steering committee should have clear decision rights regarding system goals and the implementation timeline With this alignment our consultants can better keep the project on track and ensure that the benefits of the initiative are realized Are there any educational materials you would like to share to help healthcare providers in these efforts On our website we have two areas that are especially worth visiting The InfoHub is where we post eBooks success stories data sheets replays of our webinars and more We hold approximately 10 to 12 webinars a year on various compliance accounts receivable and healthcare topics Alongside our InfoHub is a robust blog community where subject matter experts from accounts receivable IT security compliance and other aspects of the healthcare industry share valuable information Finally if you d like to learn more about any of the topics mentioned above please contact me and we can dig deeper HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by Ontario Systems This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Sunday November 01 2015 Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient

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  • Optum: Enabling Transformative Change | HFMA
    than 76 million individuals What are some of the biggest challenges you see affecting healthcare organizations In today s environment one of the biggest challenges is the ongoing and fast accelerating shift from fee for service FFS to value based payments While some in health care particularly providers may be primarily operating FFS models recent activity and announcements by the Centers for Medicare Medicaid Services CMS and commercial health plans are spurring the transition to value based care As spelled out earlier this year by HHS Secretary Sylvia M Burwell CMS intends to tie 85 percent of all traditional Medicare payments to quality by 2016 and push that to 90 percent of all payments by 2018 Private payers too are increasingly looking to create alternative payment model contracts that emphasize value while sharing risk with the health provider At the same time healthcare consumers who are taking greater ownership of their healthcare decisions are faced with their own set of challenges as they try to navigate the shifting landscape and search for health networks or plans that will deliver the most value for their increasing out of pocket investments They are more engaged and empowered than ever before as their mindset changes from my health your money to my health my money How do your solution and service offerings help address these challenges Optum partners with provider organizations and hospitals making the transition from volume to value to identify organizational strengths shore up weaknesses and find the best opportunities to realize positive change For example many new payment models require healthcare providers to think and behave more like health plans as the providers assume greater risk Optum can analyze and align both the local market landscape and a provider s strengths to map out the best payer contracting and provider network strategy In house experts provide added knowledge such as actuarial guidance to ensure providers are set up for success in their risk sharing arrangements Similarly we can deliver outcomes data and analytics to develop an appropriate care delivery and management strategy Consulting operational and IT resources are available for providers for all areas of risk operation which includes performance acceleration network and referral management integrated clinical models including risk contract and care coordination solutions and comprehensive analytics technology and services Optum has a track record of working with payers using internal claims data to better understand healthcare providers performance This experience benefits our provider clients because we guide them through strategies for engaging in value based contracting and point to methods on how to work more closely and effectively with payer partners to better ensure success in risk based contracts What are some key considerations for healthcare leaders when choosing this type of solution or service Today s healthcare marketplace is complex and it can be challenging to find experienced vendor partners that have the breadth and depth of resources needed to enable risk When looking for a partner provider organizations are better served if they don t simply evaluate companies based on the products and or services needed right now but anticipate additional needs that might be required down the road Single focus solutions can address an immediate problem but providers are wise to closely examine their goals and anticipate future needs Seeking a collaborative partnership is essential Providers can also benefit from a vendor relationship that offers a comprehensive suite of solutions and services that support organization objectives both today and as the organization evolves A strong full service vendor will typically offer a wide range of services including an experienced team that provides strategic consulting quality and depth in data resources and analytics operating resources that bring scale and flexibility and technology platforms built to meet the changing demands and opportunities of clients Organization leaders should also check prospective vendors industry track records to ensure they are selecting a partner that delivers measurable results Finally looking for broad expertise in the areas of risk based payer contracting network management care management and operations is extremely important As healthcare providers implement use of your solutions and services into their day to day operations what advice would you offer so they can best set themselves up for success Aligning your people with processes and technologies powered by analytic insights is key to successfully managing financial risk Starting with strong payer and provider network strategies is essential and should guide your investments in solutions and services to deliver and manage care under risk contracts Strategic operation and governance by an experienced leadership team when transitioning an organization is also critical At the top of the operational list is taking time to identify which key staff resources will use the tools and solutions and engage these individuals in the implementation process as early as possible These stakeholders can provide critical insight and ensure the resulting changes deliver operational efficiency and value Organizations can also develop protocols and processes in advance of deploying risk enablement solutions to hone the business case and make sure employees are fully leveraging any new tools or solutions Finally maintaining open communication is imperative because it is the trigger that allows leadership and a partner like Optum to more readily adapt processes and services to meet your organization s needs as the industry and local environment change Are there any educational materials you would like to share to help healthcare providers in these efforts For more information on the suite of services and solutions Optum offers to providers making the transition to value based models visit www optum com risk Also we recommend viewing our publication developed specifically for providers taking on financial risk and improving quality RISKMATTERS HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by Optum This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Sunday November 01 2015 BACK TO PAGINATION Advertisement In this business profile Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization Tell us a little bit about your organization Optum is a health services and innovation company on a mission to help make the health system work better for everyone When we say everyone we mean everyone with a stake in creating a better future those who provide care those who pay for care and most importantly those who need care The company combines data and analytics with technology and expertise to power modern health care and in collaboration with our partners focuses on three key drivers of transformative change modernizing the health system infrastructure advancing care and empowering consumers Optum actively serves and partners with care providers and health systems including four out of five hospitals supporting their focus on driving quality care creating better patient experiences and achieving operational efficiency and cost savings The company also works across the industry providing services to 300 health plans approximately 150 global life sciences companies 67 000 pharmacies half of the Fortune 500 companies and 40 state and government agencies Through these important relationships across the health system we touch and make a positive impact on more than 76 million individuals What are some of the biggest challenges you see affecting healthcare organizations In today s environment one of the biggest challenges is the ongoing and fast accelerating shift from fee for service FFS to value based payments While some in health care particularly providers may be primarily operating FFS models recent activity and announcements by the Centers for Medicare Medicaid Services CMS and commercial health plans are spurring the transition to value based care As spelled out earlier this year by HHS Secretary Sylvia M Burwell CMS intends to tie 85 percent of all traditional Medicare payments to quality by 2016 and push that to 90 percent of all payments by 2018 Private payers too are increasingly looking to create alternative payment model contracts that emphasize value while sharing risk with the health provider At the same time healthcare consumers who are taking greater ownership of their healthcare decisions are faced with their own set of challenges as they try to navigate the shifting landscape and search for health networks or plans that will deliver the most value for their increasing out of pocket investments They are more engaged and empowered than ever before as their mindset changes from my health your money to my health my money How do your solution and service offerings help address these challenges Optum partners with provider organizations and hospitals making the transition from volume to value to identify organizational strengths shore up weaknesses and find the best opportunities to realize positive change For example many new payment models require healthcare providers to think and behave more like health plans as the providers assume greater risk Optum can analyze and align both the local market landscape and a provider s strengths to map out the best payer contracting and provider network strategy In house experts provide added knowledge such as actuarial guidance to ensure providers are set up for success in their risk sharing arrangements Similarly we can deliver outcomes data and analytics to develop an appropriate care delivery and management strategy Consulting operational and IT resources are available for providers for all areas of risk operation which includes performance acceleration network and referral management integrated clinical models including risk contract and care coordination solutions and comprehensive analytics technology and services Optum has a track record of working with payers using internal claims data to better understand healthcare providers performance This experience benefits our provider clients because we guide them through strategies for engaging in value based contracting and point to methods on how to work more closely and effectively with payer partners to better ensure success in risk based contracts What are some key considerations for healthcare leaders when choosing this type of solution or service Today s healthcare marketplace is complex and it can be challenging to find experienced vendor partners that have the breadth and depth of resources needed to enable risk When looking for a partner provider organizations are better served if they don t simply evaluate companies based on the products and or services needed right now but anticipate additional needs that might be required down the road Single focus solutions can address an immediate problem but providers are wise to closely examine their goals and anticipate future needs Seeking a collaborative partnership is essential Providers can also benefit from a vendor relationship that offers a comprehensive suite of solutions and services that support organization objectives both today and as the organization evolves A strong full service vendor will typically offer a wide range of services including an experienced team that provides strategic consulting quality and depth in data resources and analytics operating resources that bring scale and flexibility and technology platforms built to meet the changing demands and opportunities of clients Organization leaders should also check prospective vendors industry track records to ensure they are selecting a partner that delivers measurable results Finally looking for broad expertise in the areas of risk based payer contracting network management care management and operations is extremely important As healthcare providers implement use of your solutions and services into their day to day operations what advice would you offer so they can best set themselves up for success Aligning your people with processes and technologies powered by analytic insights is key to successfully managing financial risk Starting with strong payer and provider network strategies is essential and should guide your investments in solutions and services to deliver and manage care under risk contracts Strategic operation and governance by an experienced leadership team when transitioning an organization is also critical At the top of the operational list is taking time to identify which key staff resources will use the tools and solutions and engage these individuals in the implementation process as early as possible These stakeholders can provide critical insight and ensure the resulting changes deliver operational efficiency and value Organizations can also develop protocols and processes in advance of deploying risk enablement solutions to hone the business case and make sure employees are fully leveraging any new tools or solutions Finally maintaining open communication is imperative because it is the trigger that allows leadership and a partner like Optum to more readily adapt processes and services to meet your organization s needs as the industry and local environment change Are there any educational materials you would like to share to help healthcare providers in these efforts For more information on the suite of services and solutions Optum offers to providers making the transition to value based models visit www optum com risk Also we recommend viewing our publication developed specifically for providers taking on financial risk and improving quality RISKMATTERS HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by Optum This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Sunday November 01 2015 Please login to add your comments HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for

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