Insights: Article

Revenue Cycle in a Value-Based World

January 06, 2017

The revenue cycle has long been recognized as the backbone of a health care organization. Patients enter to receive services through contact with patient access. Coding provides validation of the care the patients receive, and billing and reimbursement are dedicated to recouping payment for the services rendered. The dynamic health care environment is transitioning to a value-based world filled with confusing acronyms and a multitude of different payment programs. Is your revenue cycle prepared?

Engage Your Revenue Cycle Team
Health care organizations are balancing high-deductible plans and an increased demand on services while refocusing care to chronic disease management rather than acute services. Engaging your revenue cycle team allows your organization the ability to maintain focus while implementing the necessary changes to be successful in value-based reimbursement. This may include increased emphasis on timely and effective denials management, consistent communication with patients regarding financial responsibility, and utilizing your resources within patient access to engage patients in chronic disease management from the first point of contact. 

Educate to Engage
Education becomes key in engaging your revenue cycle team in the changes necessary to support your health care organization. Hierarchical Condition Category (HCC) scoring is utilized in many value-based reimbursement programs to communicate cost and effectiveness of care. Understanding the effect that concise, compliant documentation and accurate coding can have on HCC scoring allows your organization to effectively communicate cost of care to Medicare.

As your health care organization makes decisions to move from volume-based to value-based payment models such as Medicare Shared Savings Programs, CPC+, Medicare-Medicaid ACO model, and MACRA, the readiness of your revenue cycle team will be amplified. Prepare your revenue cycle team today to enable them to move to the forefront of change in supporting organization-wide initiatives. 

Latest Insights

September 21, 2018
Article
In the wake of hurricanes, devastating results have been experienced by communities and businesses throughout the Texas Gulf Coast, Caribbean, Florida and southeastern United States. As a result of these catastrophes, businesses will turn to…
September 20, 2018
Firm News
Eide Bailly LLP announced the winners of its 2018 Nonprofit Resourcefullness Awards, recognizing creative and sustainable revenue ideas from nonprofits in Arizona, Colorado, Minnesota, North Dakota and Utah.
September 19, 2018
Article
The IRS has started sending out Letter 5699 asking businesses to verify if they should have filed Forms 1094/1095-C. These forms are required for all ALEs.
September 19, 2018
Recorded Webinar
Are you considering doing business or having employees in Pennsylvania? Have you had issues with your state tax filing? Join our state and local tax team for some helpful insights into Pennsylvania tax filings.
September 19, 2018
Recorded Webinar
Are you considering doing business or having employees in Nevada? Have you had issues with your state tax filing? Join our state and local tax team for some helpful insights into North Dakota tax filings. This webinar will cover registration,…
September 19, 2018
Recorded Webinar
Are you considering doing business or having employees in North Dakota? Have you had issues with your state tax filing? Join our state and local tax team for some helpful insights into North Dakota tax filings. This webinar will cover registration,…
September 18, 2018
Article
As the largest tax reform legislation in the past 30 years becomes reality, it is important to stay up-to-date on planning opportunities and how reform may impact you and your business. Our Tax Reform: Practical Insights examples aim to break down…
September 18, 2018
Tool
Get ahead of tax season with the Eide Bailly Tax Planning Guide. A supplemental strategy guide to help guide year-end and make the tax laws work for you.
September 18, 2018
Article
The SCOTUS Wayfair decision has prompted a new focus on state and local tax compliance. The decision to register, report, and comply is important.