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PMMC Healthcare Revenue Cycle Blog
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Shaping the Future of Healthcare Consumerism
Consumerism is shaking up the healthcare industry, and it's an exciting opportunity for CFOs, CEOs, and financial teams in hospitals to embrace change and plan ahead. In a recent conversation with Ryan Donohue, consumerism author and expert, we explored the evolving landscape of healthcare consumerism and its impact on hospital operations.
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Co-sourcing as a Hybrid Approach to Financial Management
In the evolving landscape of healthcare finance, hospitals continuously face the dilemma of choosing between insourcing and outsourcing their financial administration tasks. This decision carries significant implications for operational efficiency, cost management, and overall patient care quality. In assessing these options, it's crucial to understand the advantages and challenges associated with each strategy.
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Consumerism in Healthcare: A Look to the Future
In the near future, hospitals will compete for business just like other service industries, i.e., restaurants and retailers, to name a few. For example, consider how someone finds the best speaker to buy on the market. They go online and compare prices, specs and quality. Knowing this information, they can then decide whether they will choose a certain speaker or not. For years, healthcare was immune to this level of consumerism, but since the push for stricter price transparency laws in healthcare, the consumer now has all the information they need to choose your hospital or not. The truth this change brings is that consumerism isn’t going anywhere. In fact, it is only going to get ramped up. As it will affect their bottom line, hospitals should take this seriously and plan to align with consumer demands and expectations.
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Why Denial Management For State Medicaid Is So Frustrating
It's estimated that nearly 7% of healthcare providers claims are denied by payers. The good news is that nearly 75% of these items can be successfully appealed and collected. However, this process is tedious and, more importantly, extremely time consuming for staff. Some payers are notorious for denying claims more frequently and are slower to pay than others. State Medicaid programs are known to be one of them. Medicaid state programs are among the slowest paying and least transparent payers, with an overall average denial rate of 18.5 percent (compared with 6.8 percent for all payers) and an average of 44 days spent in Accounts Receivable (compared to 26 days for all payers).
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Price Transparency: Why Knowing and Defending Your Price Matters
There is a lot of discussion about Price Transparency in Healthcare across our country. Many state legislatures are getting involved, including Florida. Recently, Florida Governor Rick Scott announced he will encourage (some might say push) state legislation to require hospitals to post their prices for procedures and services as well as their average reimbursement on the hospitals' websites in early 2016.
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Florida Governor Not Backing Down on Price Transparency
Florida Governor Rick Scott is not backing down on his push for price transparency for health services.
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Are Florida Hospitals Price Gouging?
Florida Governor Rick Scott thinks so and he wants to add legislation to put an end to it.
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