The Rundown | Week of 4.3.2017

Est. Reading Time: 3 Minutes

Healthcare is a rapidly evolving industry – it’s difficult to read up on everything that matters to you. But the success of your practice can depend on how knowledgeable you are about changes in the healthcare landscape. Privia has compiled a weekly list of important articles we are reading on healthcare industry trends, clinical best practices and legislative updates for your convenience. Here are some of the important articles and blogs on health care that stood out this week:

Interesting clip: “Validate patient information every time the patient comes to the office and be sure the specific insurance plan is covered under your contract with a payer. Dig to find out the reason for the denials and make sure to correct inaccurate patient information to prevent the same denial issue, Maureen Clancy, senior vice president of revenue cycle management and credentialing at Privia Health, told Medical Economics.”

Interesting clip: “In all, 31 states and the District of Columbia have expanded Medicaid after the Affordable Care Act passed in 2010. The majority acted so that the expansion went into effect in 2014. A handful of states, including Louisiana and Montana, that first rejected the expansion have since embraced it. But those efforts face the same political and ideological fights that have plagued health care policy in Washington.

Interesting clip: “3M Health Information Systems, in fact, conducted two research studies shortly after Donald Trump won the presidency to better understand what leaders at medium-sized and large integrated delivery networks and provider-run health plans expect under the new administration. Forty-four percent said they still support of value-based care, according to 3M Health Information Systems Director of Commercialization for Data Informatics Scott Monroe. ‘In spite of the all the uncertainty, there are a lot of good things going on with value-based care and population health management,’ Monroe said.”

Interesting clip: “Following implementation of clinical interventions and community-based partnerships in recent years, Humana’s “Bold Goal” initiative uses measures established by the U.S. Centers for Disease Control and Prevention to track an individual’s physical and mental “unhealthy days” over a 30-day period. Humana said health plan members in participating “Bold Goal” communities decreased their number of unhealthy days by a “margin of 3%” from 2015 to 2016.”

Interesting clip: “Patients who owed less than $1,200 for inpatient services had a payment rate of 40.1 percent. But once patients incurred a balance between $1,201 and $1,450, the payment rate dropped by 17.6 percent. The lower patient collection rate may spell financial trouble for hospitals because the $1,201 and $1,450 balance was near the inpatient Medicare deductible amount, researchers noted.”

Interesting clip: “‘Billing patients in ways they prefer cannot be understated. Changes in healthcare have made patients the third largest payer behind Medicare and Medicaid. Unlike the other two, the patient is much harder to collect from and takes more time and money to secure payment. Electronic bills and payment capabilities will improve collection rates, especially when they are readily understood. A survey conducted for Citibank found 71 percent of respondents would promptly pay their bills if they were understandable and, more importantly, matched a payer’s explanation of benefits.’”

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