Revenue Cycle Management Case Studies & White Papers

  1. Four Steps To Develop, Implement, And Operationalize A Bundled Payment Strategy

    In the continuing effort to increase quality and decrease costs, health plans and providers are shifting from volume-based care (fee for service) to a value-based reimbursement structure (fee for value). Value-based reimbursement promises benefits to patients, providers, and health plans, as it encourages delivery of high quality care at the lowest cost, largely by improving clinical and administrative efficiency.

  2. Bundled Payments For Care Improvement (BPCI) Benchmark Survey

    Caradigm recently conducted a survey of healthcare organizations in order to better understand how providers are approaching bundled episodes of care. Although some providers have been piloting bundled episodes for several years, most are still in the early stages of refining their strategies and increasing their participation in The Centers for Medicare and Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) program.

  3. Unified Reimbursement Strategy: Implementing Common Ground Among Next-Generation Reimbursement And Quality Systems

    We may look back on the 25-year span following the change of the millennium as one of the most densely populated periods of healthcare regulation ever seen in the history of the United States. Every year, individual clinicians, private practices, and health systems are bombarded with new coding, compliance, quality, and reimbursement models, making staying ahead of the curve in terms of overall strategy nearly impossible. Executives, physicians, and healthcare experts would probably agree that it is impossible to maintain a status quo level of performance if your strategy is one of pure reaction to each new deadline from the Department of Health and Human Services.

  4. Revenue Cycle Management: Is Your Process Under Control?

    When it comes to the revenue cycle, do you have it covered, or could it be time to consider turning over certain processes to a trusted partner?

  5. Steps To Effectively Manage Payer Contracts

    Simple steps to effectively manage revolving payer contracts at your facility.

  6. Navigating The Road To RAC Survival

    In late August 2014, the Centers for Medicare and Medicaid Services (CMS) announced plans to reinstate the Recovery Audit program on a limited basis. CMS reports the delay in restarting the Recovery Audit program was to enable the various RAC regions to restructure, allowing time for the appeals to catch up. Soon, however, the hiatus will end and RACs in all regions will resume automated reviews; these will be in addition to select complex reviews based on topics chosen by CMS.

  7. Adventist Health Streamlines Claims Management

    Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.

  8. Financial, Supply Chain Software Improves Book-Closing Times 80%

    Parkland Health and Hospital System is one of the largest public hospital systems in the country, with 861 beds, 101 neonatal patient beds, more than 10,000 employees, and more than $1.2 billion in revenue. The hospital averages more than 1 million patient visits annually. Services include a Level 1 trauma center, the second-largest civilian burn center in the U.S., and a Level III neonatal intensive-care unit. Parkland serves as a teaching hospital for UT Southwestern Medical School, and operates 20 community-based and 12 school-based clinics.

  9. Best Practices For Boosting Patient Payments

    Healthcare reimbursement is facing some of the biggest changes – and challenges – of the past 50 years.

  10. Healthcare Systems Saves $1.1 Million Annually On Invoice Processing

    Ranked among the nation's top five large healthcare systems, Memorial Hermann Healthcare System is the largest not-for-profit healthcare system in Texas. More than 20,000 employees serve the greater Houston community through 12 hospitals, a vast network of affiliated physicians and numerous specialty programs and services.