Knowledge Center2018-10-22T16:14:40+00:00

Knowledge Center

Providing insider perspectives to help health leaders rethink the business of healthcare.

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Driving Quality & Accurate Reimbursement Through a Best-Practice Clinical Documentation Improvement Program

Without a well-established clinical documentation improvement program in place, healthcare organizations' risk rankings falling short of achieving clinical documentation integrity which underscores how critical accurately delivered and documented care reflects the well-being of individual patients and an organization's financial health. Here are three reasons why implementing a CDI program can prove beneficial to your healthcare organization.

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6 Steps to a Better Patient Experience

Timing is key when it comes to a positive patient experience - meaning, patients don't want to be hung up at registration. But providers need data from their patients, and that can take time. Your patient access team shouldn't have to sacrifice speed for accuracy, let us help with these actionable insights.

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Better Manage the Health Plan Generation Gap

New research indicates that generational groups have widely varying preferences when it comes to utilizing aspects of their health plans. The differences among Millennials, Generation X and Baby Boomers when accessing benefit features argue the point that a one-size fits-all approach to employee engagement may miss opportunities to achieve savings in healthcare spend.

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Dartmouth-Hitchcock Heath Realizes 12.6% Increase in Cash Collected Over Baseline Through Improved Revenue Cycle Operations

To achieve the Triple Aim of healthier populations, improved patient experience and lower costs of care, AHC sought an innovative approach to population health management through a partnership with Conifer Health. AHC also wanted to create and continuously develop an overall culture of well-being and good health that started with health plan members and their families.

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The 15 Minute Milestone: Are you Maximizing Your Registration Opportunity?

It’s said that you have only one chance to make a good first impression. In today’s healthcare environment, those words couldn’t ring truer. Providers need information to appropriately bill for services, and patients don't want long wait times. Make your registration process work for you and your patients, increasing efficiency without sacrificing accuracy with our 15 Minute Milestones.

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4 Components of Effective Population Health Management

It’s more imperative than ever that providers have population health capabilities. As health plans look to improve the health of populations and contain costs, they are partnering with organizations that help them differentiate their offering to employers or consumers. Developing strong population health capabilities can appear daunting, as it requires careful planning on the part of the organization.

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How Much Is Your Unmanaged Population Costing You?

To achieve more effective results, organizations are establishing population health management programs to improve health outcomes and lower healthcare costs. In this infographic, follow the journey of two members to see the cost and quality impact of implementing a successful population health management strategy.

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Adventist HealthCare Achieves Sustainable Results through Focus on Care Management and Employee Health

To achieve the Triple Aim of healthier populations, improved patient experience and lower costs of care, AHC sought an innovative approach to population health management through a partnership with Conifer Health. AHC also wanted to create and continuously develop an overall culture of well-being and good health that started with health plan members and their families.

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Pursuing Risk: Hospital Takes Proactive Approach to Manage Risk, Improves Quality and Financial Performance

To manage the process for taking on risk, one community hospital contracted with Conifer Health to manage the risk pool and operate the utilization management and claims adjudication functions for the risk-bearing organization. Through Conifer Health’s ongoing management, the hospital has improved cash flow, significantly reduced outstanding accounts receivable (A/R), and increased opportunities to get paid upfront for services.

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Navigating the Transition to Value-Based Care: Physician Alignment Is Critical to Your Success

Physician engagement and alignment are critical components for healthcare organizations navigating the transition to value-based care. An engaged and aligned physician network is a major determinant for enhanced patient care, lower costs, greater efficiency, and improved quality and patient safety. Successful physician alignment, however, remains a challenge for many hospitals and health systems.

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10 Questions to Answer Before Entering into Value-Based Contracts

In many value-based payment program engagements, hospital executives jump right into questions about the mechanics of implementing specific payment models. But that's a common mistake - without first assessing the organization's cultural, operational and technical capabilities in managing risk. For that reason, we've identified the top 10 questions providers should ask themselves as they evaluate value-based contracting strategies.

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5 Considerations for Success with Risk-Based Contracting

The saying is true: proper preparation prevents poor performance. It's no different when it comes to the effective negotiation of value-based contracts, which requires unique skills and capabilities in order to tie reimbursement to performance. Learn about the five key areas to help position your organization for success in negotiating risk-based contracts.

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Stop Denials Where They Start: 5 Key Steps for Success

Many healthcare organizations work the back-end denials management process without ever taking time to understand the root cause. Countless hours are spent appealing denials, but little attention is focused on fixing and preventing the issue. Often, the cause of denials can be achieved through process improvements - and sometimes the solution can be a relatively simple fix.

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Rx for Healthcare Revenue Success

Are your revenue cycle operations achieving your performance objectives? A variety of treatment options exist to help. Learn about four essential components that can help your hospital or health system achieve a healthy, more modernized revenue cycle.

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How Hospitals and Physician Groups Benefit from a Strong CDI Program

Without a well-established clinical documentation improvement program in place, healthcare organizations' risk rankings falling short of achieving clinical documentation integrity which underscores how critical accurately delivered and documented care reflects the well-being of individual patients and an organization's financial health. Here are three reasons why implementing a CDI program can prove beneficial to your healthcare organization.

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Top Revenue Cycle Challenges Facing Providers

With value-based care penetrating deeper into the industry and uncertainty looming about the future of the ACA, the near-term future will continue to test revenue cycle professionals as well as bring new opportunities. We've compiled the five most impactful revenue cycle challenges and their implications to help position you for success.

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Negotiating Downside Risk with Your Payers

As your organization assumes downside risk, you must reevaluate the respective value you and your payer partners bring to the table. In such agreements, payers effectively transfer risk to the provider organizations. In turn, providers should negotiate to retain a larger share of the premium dollar.

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Executive Buy-In Key to Addressing Opioid Epidemic

Executive decision-makers have a big say in how aggressive workplace health plans are in addressing the opioid issue. Although corporate leaders are not expected to be experts in combating opioid addiction, C-suite awareness and engagement on this issue can drive treatments toward a more effective holistic approach that acknowledges addiction is a chronic and complex medical diagnosis.

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Downside Risk: The Endgame for ACOs

ACO programs and other value-based initiatives are not themselves the endgame for CMS, but the vehicles for its ultimate goal: the assumption of substantial quality-driven financial downside risk by providers.

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KentuckyOne Health Partners Thrives in the CMS Medicare Shared Savings Program

To achieve its top priorities of better health, better care, better quality and lower cost for managed lives, KentuckyOne Health Partners needed improved data integrity to transition its fast-growing provider network to a fee-for-value model. Learn how one of Kentucky's first Medicare ACOs generated $18.1 million in shared savings by optimizing its care management technology.

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ACOs Can Be Stepping Stone to Greater Risk & Reward

While it is almost certain that parts of the Affordable Care Act (ACA) may be altered during the new administration, many experts agree that the complete repeal and replacement would be very difficult and ill-advised, especially as it relates to the future of Accountable Care Organizations (ACOs) and other value-based care initiatives under Republican control.

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Data Is Key to Recouping Care Delivery Control from Payers

As the healthcare landscape shifts toward population health and value-based care, including alternative payment models, the payers in our country hold much of the data needed to be successful in the new world of healthcare - including care management. But are they the best source of truth to drive the collaborative, preventative strategies needed to succeed?

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MACRA Final Rule: What No One Has Yet Told You about MIPS

You may have already read about the concessions CMS has made to ease providers onto one of the two MACRA tracks: the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs). However, when one looks at the complicated details of how MIPS will unfold, it can leave your head spinning.

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Partnering to Achieve Improved Care Coordination, Reduced Costs

In a dynamic healthcare world, staying ahead of changes and evolving to meet the challenges of new care models and consumer-oriented care delivery - all while managing costs - is the new reality. For physician hospital organizations, this means not only meeting these challenges for their own organizations, but also helping their stakeholders succeed in this ever-changing healthcare climate.

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eBook: 7 Steps to a Clinically Integrated Network

The transformation towards more integrated and accountable healthcare delivery systems is aligning physicians, outpatient care, hospitals and ultimately payers in unprecedented numbers. Yet creating a successful clinically integrated network can be a daunting and complicated undertaking. Download the 7 Steps e-book and discover how to successfully navigate the many components of a clinically integrated network.

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MACRA: Physicians’ Choice Puts Hospitals on the Hook Too

MACRA lays out two paths for adjusting providers' Medicare fee-for-service payments: MIPS and advanced APMs. Regardless of which track physicians choose to be reimbursed, hospitals and health systems have a vested interest in helping their clinicians succeed under MACRA - because hospitals are directly on the hook when it comes to the proposed rule.

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Benefits Administrators Have Important Role in Fight against Opioid Epidemic

The nation's opioid epidemic continues to dominate news coverage, and with good reason. More than four in 10 Americans know someone who has been addicted to prescription painkillers. Large and small employers are grappling with this crisis. Front and center to the financial impacts of opioid abuse are benefits administrators in an environment where controlling costs is paramount.

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A Year into ICD-10: 5 Strategic Reminders

A year into the ICD-10 transition, many organizations have experienced only a few minor disruptions. As the industry continues to embrace the new coding routine, providers must now focus on processes and best practices to promote optimal revenue cycle performance for the long haul. These five strategic reminders can help your organization avoid impacts to cash flow.

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Healthcare Trends from an HFMA Board Director

Healthcare financial management professionals across the country are tackling head-on some of the industry's most pressing challenges. Tammie L. Galindez, HFMA National Board Director and Conifer Health Regional Vice President of Value-Based Care, shares her perspective and identifies key trends that are impacting leaders' decision-making.

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Value-Based Care – Adaptability is Key

Preparing for value-based care involves examining and prioritizing various IT and population health management approaches and models. For Robert Wood Johnson Health System, embracing uncertainty and moving forward with plan to adapt was a better approach.

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The Evolution of the Hospital CFO

The role of the hospital chief financial officer has been undergoing a serious remodel. While all of the financial responsibilities remain, the new roles required of CFOs by healthcare's steady shift to value-based reimbursement necessitate the use and mastery of a whole new set of skills and approaches.

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