Expert Reviewed

Articles vetted and approved by hfm magazine editors and industry experts.

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.

Max Reynolds, JD July 26, 2024

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…

Ryan Downs, CHFP, CRCR, CPA July 26, 2024

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…

Kristen Shoup, CHFP, MBA, RHIA June 3, 2024

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,…

Daniel M. Grauman, MBA, CPA/ABV June 2, 2024

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…

Jim Price April 30, 2024

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…

Shawn Williams, FHFMA, CPA April 29, 2024

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…

Scott G. Ellsworth, MBA March 29, 2024

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…

Daniel J. Marino March 23, 2024

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,…

Brian Wheeler January 24, 2024

How CFOs can bring the rigor of finance to the call center

Health system call centers are universally acknowledged as significant cost centers. Too often, however, they are viewed as non-revenue-generating cost centers. In fact, a call center’s performance also affects revenue growth factors such as clinician utilization and patient loyalty. Despite the multiple ways that call centers affect both the bottom and top lines, there is…

Yuriy Kotlyar October 31, 2023
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