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Although collaboration between payers and providers will be critical if they are to succeed in transitioning to value-based payment models, they continue to struggle with information exchange in the current fee-for-service environment. That’s the finding of a new survey of 40 health plans and more than 400 practice- and facility-based providers, which found significant communication gaps between the stakeholder groups.

Online and multi-payer portals are viewed as promising solutions to improve communications between payers and providers while also mitigating costs, yet these tools are underutilized. While 60 percent of payers prefer the use of online portals as the primary means of communication with providers, it seems providers are less enthusiastic, as only 39 percent of practice-based providers and 40 percent of facility-based providers strongly support online portals as a primary source, according to a survey by Availity.

Healthcare industry trends such as growth in data analytics and high-deductible health plans are causing payer and provider relationships to evolve. With this evolution comes the need for greater communication and collaboration between the two sides. A recent Availity survey of 40 health plans and 400 practice- and facility-based providers found 53 percent of payers "strongly agree" providers and health plans need to collaborate to be profitable.

In an era of shrinking reimbursements, it's more important to capture every dollar owed to your practice as far forward in the process as possible. It's a matter of time and money. According to a 2016 Kaiser Family Foundation study, average deductible and co-insurance costs have seen the biggest increases between 2004 and 2014, and continue to grow while copays are continuing to decline. The shift toward high deductible health plans has fueled that rise.

Availity, the nation’s largest real-time health information network, announced the launch of its automated prior authorization platform, which eliminates the cost, time, and administrative burdens associated with manual authorization processes.

A myriad of factors stand in the way of health care organizations using data analytics to boost reimbursement. As hospitals transition to a value-based reimbursement model, data analytics may play a leading role. However, with an overwhelming wealth of information being generated each day, key decisions must be made to ensure the captured data are truly of benefit.

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their payments walk right out the door with their patients.

Health plans have long supplied their members with provider directories to assist in finding in-network physicians who are accepting new patients. But what should be a helpful aid often isn't, due to outdated or just plain wrong data. Not only is this frustrating for patients trying to find an available provider, it can cost them more than they anticipated if they end up incurring out-of-network fees for a physician they thought was in-network.

A tiny change to how a small hospital uses technology is resulting in big savings of between $3,000 and $10,000 a month. Iroquois Memorial Hospital, a 25-bed facility in the eastern Illinois town of Watseka faced a problem.

As patient financial responsibility continues to increase in a more consumer-focused healthcare environment, more hospitals are shifting healthcare revenue cycle management strategies to improve patient collections. Iroquois Memorial Hospital in Illinois is one of these healthcare organizations.