Accounts Receivable Management Strategies to Ensure Timely Payments in Rural Clinics

Healthcare business leaders in a rural clinic setting can enhance profitability by implementing strategies to ensure timely payments. The purpose of this multiple case study was to examine strategies applied by healthcare leaders in rural clinics to improve profitability. The population included 10 rural clinic managers and billing staff from 5 rural clinics in the southwestern region of the United States. The conceptual framework for this study was Wernerfelt\u27s resource-based value theory. Implementing Yin\u27s multiple-step data analysis process, data from semistructured interviews were transcribed, coded, and analyzed to identify strategies used by rural clinic managers and billing staff to enhance profitability. Four primary themes emerged regarding revenue cycle management that could increase profitability, including developing effective communication between medical providers and billing staff, implementing payment plan strategies, ensuring accuracy of billing claims, and consistently reviewing open receivable accounts. The implications of this study for positive social change include insights for clinic managers in the development of strategies to increase cash from accounts receivables, which may contribute to the financial stability of the clinic and improve the provision of healthcare for citizens of the southwestern region of the United States

Strategies for Hospitals After Implementation of Reimbursement Cuts to the Outpatient Prospective Payment System

Healthcare costs have continued to increase in the United States. The Centers for Medicare and Medicaid Services (CMS) have proposed policy changes to reduce inequities between hospital outpatient centers and independent freestanding facilities when reimbursing for the same service. The purpose of this quantitative study was to explore if there was a difference in the payments to the Outpatient Prospective Payment System between the years 2017 and 2018 to assist hospital administrators in preparing for Medicare reimbursement cuts. The study was grounded in the agency theory and aimed to determine the relationship among the provider, payer, and patient. The research questions were designed to determine a statistically significant relationship between the reimbursement of monies for outpatient and inpatient billing between 2017 and 2018. The descriptive quantitative study utilized publicly available secondary data published by CMS to see if there was a change in outpatient and inpatient payments and procedures billed to Medicare between 2017 and 2018. The sample size for this quantitative study was 64 and was limited to New Jersey hospitals. The statistical analysis used for this study was the paired-samples Wilcoxon test to determine whether there was a statistically significant difference between the three variables chosen. The results from this study showed a statistically significant difference in outpatient payments, services, and inpatient hospital volume from 2017 to 2018. There was an increase in outpatient spending and volume and a decrease in inpatient volume. The findings of this study will help hospital administrators create positive social change by closing the healthcare equity gap, increasing transparency in healthcare costs, and promoting patient-centered care

Leadership Strategies to Maintain Hospital Business Office Productivity During a Merger

In 2017, healthcare system mergers in the United States set a record with 115 deals made and 11 involved sellers with net revenue of at least $1 billion; however, it is common for hospital business office productivity to suffer during a merger. Grounded in the theory of business process re-engineering, the purpose of this qualitative single case study was to explore strategies hospital leaders in the southeastern United States used to maintain business office productivity as they completed a merger. A review of documentation from archival records supplemented in-depth interviews with 7 purposively selected hospital leaders. Yin’s 5-step analysis guided the coding process of participants’ responses, and member checking was used to validate the transcribed data. The major themes of the study revealed that strategies for hospital leadership maintaining business office productivity require (a) presenting unified and consistent messaging, (b) openly sharing outsourcing advantages, (c) making a concerted effort to alleviate the fear of the unknown, and (d) proactively addressing potential challenges. A recommendation for hospital leaders is to preemptively confront the potential obstacles and elucidate opportunities presented by the merger. The implications for positive social change include the potential for hospital leadership to increase productivity, enhance patient quality of care, and improve surrounding communities’ economic stability