Rev Up Your Revenue Cycle with AI

July 18th, 2019 / Judi Cahill / Posted in Gebbs Healthcare

With profit margins shrinking and the cost of health care going nowhere but up, operational leaders and consultants throughout the healthcare industry are looking in every nook and cranny to either find ways to cut costs or generate more revenue. With the ongoing need for costly equipment, an expert workforce and the state-of-the-art facilities needed …

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Risk Adjustment Meets Artificial Intelligence – A Perfect Match

July 15th, 2019 / Judi Cahill / Posted in Gebbs Healthcare

Big data is all the rage – transforming industries from tech to retail and much more. Healthcare – an industry slow to adopt technology in many ways now has access to more data than ever before with the widespread adoption of electronic health records (EHRs). But, what do we do with all this data in …

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It’s Working – CMS Report Concludes the Effectiveness of Risk Adjustment

July 10th, 2019 / Judi Cahill / Posted in Gebbs Healthcare

In late June, the Centers for Medicare & Medicaid Services released data demonstrating that its Risk Adjustment Program – developed as part of the Affordable Care Act just five years ago – is working just as planned. What was the plan? To prevent payers from developing plans intended to attract healthier patients and to incentivize …

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The #1 Most Critical Driver in the Successful Adoption of Shared Risk Programs

June 27th, 2019 / Judi Cahill / Posted in Gebbs Healthcare

The unavoidable shift toward value-based and two-sided risk payment models is here to stay – and while the benefits are countless, the journey thus far has been slow and somewhat painful for payers, providers and healthcare organizations alike. Healthcare is one of the slowest industries to effectively adopt technology and the reasons for this are …

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Strategies for Mastering Two-Sided Risk

June 26th, 2019 / Judi Cahill / Posted in Gebbs Healthcare

Population health and the transition to two-sided risk is no easy feat – it’s a monumental shift in the way providers, payers and hospitals think about the delivery of health care. And, while, we all know it’s coming – knowing how to get there and doing it successfully is the real challenge. While most accountable …

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Accurate RAF Scores Could Mean Billions in Savings for Medicare

June 20th, 2019 / Judi Cahill / Posted in GeBBS Healthcare Solutions, Medicaid, Medicare

A recent study published by the Kaiser Family Foundation sheds light on a complex issue – how to determine the real or predicted cost of care for Medicare Advantage plan members when establishing RAF scores is based on the inexact science of provider documentation. The study released this spring indicated that those who were enrolled …

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Five-Year Growth Explosion Anticipated for Medical Billing Outsourcing

June 6th, 2019 / Judi Cahill / Posted in Coding Outsourcing, GeBBS Healthcare Solutions, Medical Coding, Medical Coding Outsourcing, Offshore Medical Billing, Outsource Coding, Value-Based Care

The administrative costs associated with medical billing within a physician practice are becoming unmanageable for independent and major health-system affiliated practices alike. A 2018 research study was conducted by experts at Duke University and Harvard designed to examine the administrative costs specific to large academic medical centers using electronic health record (EHR) technology – and …

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Keeping an Eye on Value-Based Care – 3 Things to Watch

May 15th, 2019 / Tyler Cowart / Posted in Technology, Value-Based Care

“Work smarter, not harder.” This age-old philosophy is the mantra behind value-based health care. After all, more health care doesn’t necessarily mean better outcomes – this much has been proven by evidence-based medicine time and again. As the fee-for-service model of health care slowly fades away, true value-based care (and all the benefits that come …

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With Telehealth on the Rise, Policy & Payers Are Catching Up

May 10th, 2019 / Tyler Cowart / Posted in Accountable Care Organizations (ACOs), Medicare, Telehealth

Telehealth is a key element of our country’s health care transformation – and health care providers, payers and patients are getting on board today more quickly than ever. After all, getting timely and convenient medical diagnosis and treatment using your computer, phone or tablet – anywhere, anytime, is of incredible value in our busy, technology-driven …

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Shedding Light on Alternate Payment Models

May 2nd, 2019 / Tyler Cowart / Posted in Accountable Care Organizations (ACOs), CMS, Coding Accuracy, Medicaid, Medicare

The shift to value in healthcare is no easy feat. While the Centers for Medicare and Medicaid Services (CMS), accountable care organizations (ACOs) and healthcare systems are all working towards it, true success requires a commitment to collaboration, communication and transparency.