GeBBS Healthcare Blog

A new year presents a fresh opportunity to set annual goals and create a plan to achieve them.  Many people make New Year’s resolutions where they strive to do better than they have in the past.  Often the most successfully attained resolutions are the ones that are documented and backed-up with a plan to achieve them. 

With the growing number of high deductible insurance plans and the Affordable Care Act (ACA), patients are now responsible for up to 35 percent of their healthcare delivery costs. Here are some staggering facts from MGMA and McKinsey & Company:

The amounts for insurance deductibles continue to grow each year and there is no end in sight to these increases. With more and more patients opting for high deductible, low premium commercial health insurance policies, and the growing usage from the Affordable Care Act (ACA), providers must seek ways to collect these large deductible amounts at the point of care, using an integrated approach that includes call centers and comprehensive end-to-end revenue cycle management, coupled with compassionate collection training.

By Nitin Thakor, GeBBS President & CEO

The way patients want to receive their medical treatment is creating significant growth in two types of healthcare delivery facilities: Urgent Care Centers and Free Standing Emergency Departments.

By Nitin Thakor, GeBBS President & CEO

So far small hospitals and small health systems are not faring as well as large hospitals and health systems during the ICD-10 transition. The press is full of reports about how well the transition is going for large hospitals, but that is not the case for smaller community hospitals.

By Nitin Thakor, GeBBS President & CEO

According to a recent survey reported in Healthcare Finance, 83 percent of hospitals now outsource some accounts receivable and collections, 58 percent of hospitals outsource some contract management, 55 percent of hospitals outsource some denials management and 68 percent of physician groups with more than 10 practitioners now outsource some combination of collections and claims management.

There are many benefits of outsourcing the chronic care management (CCM) activities for physicians who want to take advantage of the new Centers for Medicare & Medicaid Services (CMS) initiative that pays doctors for delivering non-face-to-face care to their Medicare patients who have two or more chronic conditions.

Primary, of course, is the ability to create a new, significant revenue stream for the practice. This is entirely possible, even for smaller practices, when the chronic care management coordination is outsourced to a healthcare organization that specializes in this type of activity.

In an article entitled: “Boeing negotiates directly with more health systems” in this morning’s Modern Healthcare e-newsletter, it was reported that airplane manufacturer Boeing Co. will soon offer more employees the option of health benefits negotiated directly with local health systems. The employer, being skilled in the art of negotiations, is bypassing the big insurance companies and negotiating directly with providers. The company first used the strategy last year in Seattle to better control healthcare costs.

Although employee negligence and lost/stolen devices continue to be major causes of data breaches, criminal attacks are now the leading cause of breaches in healthcare.

What are these cyber criminals doing to get access to the data, and what is causing the breaches in our healthcare organizations? Ponemon’s report says that 88 percent of these breaches came from phishing to get a foothold into a network. The attackers try to compromise employees who have elevated privileges that will give them access to sensitive systems and critical data.

Stronger technical controls like encryption and bio-access security devices will prevent damages from most of these attacks. These criminal are not looking for gall bladder surgery data; they are looking for financial information they can use to rob unsuspecting patients.

By Nitin Thakor, President & CEO

I read with interest this week an article In Modern Healthcare’s e-newsletter titled, “Uninsured rate dips below 10%.” The statistic comes from The Centers for Disease Control and Prevention.

In my opinion the most important sentence in the article follows: “The survey also found that 36% of people younger than 65 were enrolled in a high-deductible health plan in the beginning of 2015.”

The growing number of people – not only the young -- who are opting into these high deductible plans is forcing healthcare financial managers to re-evaluate their present revenue cycle management solutions, and look to the next generation of solutions for answers to their financial woes. Shifting payment models, new regulations and healthcare reform are forcing healthcare leaders to redirect previously launched budgets, priorities and strategic plans to assess if new solutions can rescue them from imminent financial catastrophes.