New & Notable
Breaking down claim denial rates by healthcare payer
Rising claim denial rates challenge healthcare providers, increasing revenue losses, staff burden and patient dissatisfaction, with private payers denying more claims.
What's driving $4.9T in U.S. healthcare spending?
U.S. healthcare spending hit $4.9 trillion in 2023, growing 7.5%, driven by increased service use, federal aid expirations and rising private insurance costs.
Hospital finances remain stable amid rising supply costs
Hospital finances remained stable in October, according to Kaufman Hall, with increased outpatient revenue and daily discharges helping to offset rising supply costs.
High-acuity inpatient stays up 41%, likely result of upcoding
The upward trend in high-acuity hospital stays and upcoding in medical billing have yielded billions in hospital reimbursements.
Insights
Insights is the research division of Xtelligent Healthcare Media. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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How do FQHCs affect accountable care organizations?
FQHCs help accountable care organizations reach a more diverse patient population and potentially enable better patient access to preventive care.
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For-profit hospices linked to poor care quality
Researchers discovered that hospices owned by private equity firms and publicly traded companies were linked to poorer care quality.
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Back surgeries: Low-value care swells Medicare spending
According to new research from the Lown Institute, unnecessary back surgeries led to an estimated $2 billion in Medicare spending over a three-year period.
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Physician compensation totals 84% of medical group expenses
Medical groups might rethink operations in light of new Kaufman Hall data about physician compensation and overall employee investment/subsidy.
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CMS highlights maternal care in CY 2025 OPPS, ASC final rule
The CMS CY 2025 OPPS, ASC final rule aims to reduce maternal mortality, remove barriers to care for formerly incarcerated individuals and enhance health equity.
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CMS finalizes CY 2025 Medicare physician fee schedule rule
CMS issued the CY 2025 Medicare physician fee schedule final rule, which included updates to payment policies and average payment rate reductions.
Features
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Exploring the role of medical claim clearinghouses
Medical claim clearinghouses manage claim submissions for providers, increasing efficiency, reducing costs and improving payment accuracy.
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Unpacking the mid-revenue cycle, strategies for success
The mid-revenue cycle includes coding, CDI, and compliance, making its processes vital to a provider organization’s success.
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How Robotic Process Automation Optimizes Revenue Cycle Management
Robotic process automation (RPA) saves practices money and time by automating manual, repetitive tasks within revenue cycle management.
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Breaking Down the Back-End Revenue Cycle, Key Best Practices
When a patient encounter ends, the back end of the revenue cycle gets busy creating claims and managing A/R to optimize revenue collection and integrity.