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Quality Manager formerly known as abaqis®

Mitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.

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10 Trends for 2024: Absorbing New Technology, Facing New Realities, and Solving Old Problems

< HealthStream Resources

tentrends2021

Ten Top Trends: Organizations Should Seek Solutions to Optimize their Revenue Cycle

April 8, 2021
April 8, 2021

This blog post is part of our Ten Healthcare Trends Series, presented annually since 2012 by Robin Rose, VP, Healthcare Resources Group.

Trend Two: Many hospitals will be challenged by financial difficulties

Just five months after the first confirmed case of COVID-19, the American Hospital Association put it plainly. “Hospitals and health systems face catastrophic financial challenges in light of the COVID-19 pandemic.”

As the novel coronavirus swept across China in the first quarter of 2020, manufacturing ground to a halt, disrupting supply chains, and leading to punishing cost increases for medical supplies and equipment. In some cases, DME shortages limited the care that hospitals could deliver. In hospitals around the world, the healthcare workforce was quickly pushed to its limits as mass casualty response plans stretched from weeks to months.

Meanwhile, rising unemployment and numbers of uninsured patients, paired with elective care and procedures being deferred by insured patients, delivered a one-two punch to healthcare system revenues.

By June, the picture was bleaker still. Non-COVID-related inpatient volume was down by nearly 20 percent, while outpatient care was off by almost 35 percent. Through the end of 2020, the AHA was projecting total losses to hospitals and health systems at $323.1 billion. Care Acts and PPP dollars totaling $54.6 billion will offset just 16.7% of those losses.

Find Help from Within Through Better Revenue Cycle Management

Health systems and hospitals will be hard-pressed to simply save their way back to financial stability. Instead, they’ll need to look for new ways to optimize operating efficiencies and revenue capture in every department. And far from being within sole purview of Finance, every department can contribute to making 2021 a better revenue year.

Like most aspects of healthcare, education and training are at the heart of incorporating revenue cycle best practices into the organization.  HealthStream’s Revenue Cycle solutions are built to cultivate competence in the business side of delivering top-quality care.

TRAINING SOLUTION: Patient Access

GOAL: Grow staff competency in accurately and completely collecting benefits and medical necessity information, ABNS, insurance and demographics.

OUTCOME: Increased payment collections and reduced AR days.

TRAINING SOLUTION: Case Management

GOAL: Learn to effectively address care coordination issues to better plan, communicate and manage quality patient care while lessening readmissions and lowering discharge barriers.

OUTCOME: Reduced financial and compliance risks.

TRAINING SOLUTION: Clinical Documentation and Medical Coding

GOAL: Master the accurate, timely capture of services provided and coding in compliance with current industry recordkeeping and reimbursement models, Fraud and Abuse Compliance programs, EHR requirements, and more.

OUTCOME:  Accurate reimbursement for the care provided, and avoidance of government sanctions and penalties

TRAINING SOLUTION: Charges and Reimbursement

GOAL: Increase clinical staff competency in the capture and coding of charges from a patient’s intake to discharge.

OUTCOME: Reduced lost and late charges, increased billing accuracy and reimbursement .

TRAINING SOLUTION: Claims Management

GOAL: Decrease time and resource-draining issues that arise from record duplication, failed claims, incorrect patient status, and mastering new reimbursement methods 

OUTCOME: Smoother overall revenue cycle  through increased efficiency of operations, and less re-work by staff

Healthcare leaders know that sustained improvement of patient outcomes is only possible when revenues are in balance with the costs. But healthcare’s service and reimbursement environments are constantly changing. Combined with the once-in-a-generation challenges created by the worldwide pandemic, the revenue challenges can be daunting. That’s why healthcare organizations have partnered with HealthStream for more than 30 years for comprehensive, proven online revenue cycle training.

It’s easy to get started. To rise to the challenges of 2021 and lay the foundation to a brighter, healthier 2022 and beyond, contact HealthStream today