Despite significant challenges, there’s value in hospital mergers
Hospitals are facing severe economic pressures, and the Biden administration's Federal Trade Commission and Department of Justice have intensified enforcement of antitrust laws for hospital mergers, causing many hospitals to abandon their merger plans.
How nonprofit health systems can benefit from post-acute care partnerships
Nonprofit health systems are increasingly partnering with for-profit operators to deliver post-acute care, which is necessary due to margin compression, difficulty in delivering cost-effective care, and lack of core competencies.
How healthcare providers can streamline A/R through partnerships
The efficient management of accounts receivable (A/R) is essential for maintaining the fiscal health and operational effectiveness of any healthcare organization. Finance leaders are increasingly recognizing the benefits of leveraging strategic A/R partnerships to improve revenue cycle operations, decrease costs and boost liquidity. It is imperative, however, that they take a systematic approach to understand…
How one health system focused on revenue cycle staff education to improve its denial rate
Many longtime revenue cycle leaders can recall a simpler time when insurance companies sold plans that were broadly accepted by providers in their service areas. Back then, hospitals provided services to patients, billed their health insurance plans and expected relatively prompt payment. This is no longer true. Today’s revenue cycle team members must be knowledgeable…
What health systems need to know about partnering to develop an ASC strategy
Health systems must contend with conflicting imperatives. While remaining intensely focused on day-to-day operations and financial viability, they cannot ignore longer-term strategic imperatives, which may include building out a full continuum of care to succeed under value-based payment while maintaining market relevance. Yet many health systems face significant impediments to broadening the continuum of care,…
Not-for-profit health systems need a new enterprise strategy
Based on findings of recent original research, the current financial performance of not-for-profit (NFP) health systems raises concerns over their long-term financial viability. The research findings underscore the need for NFP health system leaders to reconceptualize their organization as comprising six strategic business units (SBUs) and then manage each in terms of competitiveness. Research findings…
How to promote patient loyalty by improving network integrity
To achieve enduring financial stability, health systems must pursue initiatives to improve margins. And a particular priority for them is to focus on improving the integrity of their provider networks, with the goal of building patient loyalty to the larger healthcare organization. The first step in such an effort should be to perform a network…
How providers can optimize payer contract negotiations
Negotiating payer contracts can be both challenging and frustrating. Payers have significant leverage at the bargaining table, enhanced by payer consolidations and the emergence of dominant local, regional and national plans. But by adopting a transparent data-driven strategy in negotiations with a payer, a provider organization can create an opportunity for building a strong partnership…
8 healthcare trends for 2024: A guide for health system leaders and their boards
As health systems progress through 2024, they will require effective governance to successfully navigate the rising headwinds. As they plan and execute initiatives, their leaders and boards should remain informed about eight key trends that will have a growing impact on the industry and the future success of their organizations. 1 Continued big technology M&A…
How a payer-provider collaboration around quality reporting can reduce costs and improve outcomes
Too often today, relations between provider and payer organizations can become contentious around issues related to payment and quality of care. Yet such conflict does not serve patients well, because it deflects these organizations’ attention from their underlying shared purpose: To work together to deliver well-coordinated, cost-effective healthcare to patients. With this purpose in mind,…