Overview

We help our clients see that higher quality care, enhanced operational efficiency, and improved financial sustainability are possible as they adapt to the rapidly changing healthcare environment.

Given the rapid transformation of the healthcare industry, Accretive Health is deliberately evolving its service offerings to align with the present needs of provider organizations—and to help prepare them for the healthcare landscape of the future. Accretive Health supports the mission and business objectives of hospitals and health systems through three primary service areas:

  • Revenue Cycle Management (RCM), which encompasses the entire end-to-end revenue cycle of our provider clients including preparing them for value-based reimbursement
  • Physician Advisory Services (AccretivePAS®), which works to strengthen compliance, limit denials, and improve revenue integrity
  • Population Health Solutions (PHS), which helps providers assess their risk-readiness for capitation, reconfigure delivery systems accordingly and enter into risk-bearing arrangements with payors in order to manage the health of defined populations.

Revenue Cycle Management

Our holistic approach—anchored by an infused operating system—aspires to the highest level of innovation that can be applied to revenue cycle operations in today’s healthcare marketplace

U.S. hospitals and physician groups today face numerous obstacles in their efforts to control operating costs while providing high quality care to the patient populations they serve. Those challenges simultaneously impact healthcare providers on a variety of fronts—their revenue, their cost, their risk exposure, and their outcomes. Specific examples include:

  • Declining patient volumes
  • Decreasing reimbursements
  • Deteriorating payor mix
  • Increased patient responsibility
  • Fixed cost structures
  • Capital investments/Sunk costs
  • High compliance hurdles
  • Increasing legislative and regulatory complexity
  • Shift to value-based reimbursements
  • Patient engagement and satisfaction requirements
  • Consumer-driven healthcare

In light of these challenges to balancing quality patient care with the cost of providing it, Accretive Health has developed a proven, end-to-end revenue cycle solution based on the measured value we deliver to healthcare providers that includes:

  • A distinctive operating partnership model
  • An aligned financial relationship
  • Leading-edge, proprietary technology and data science
  • Multi-site, shared service centers

To learn more about Accretive Health’s revenue cycle management services contact Julie Nauman, Director of Business Development, at 312-519-1339 or jnauman@accretivehealth.com.

AccretivePAS® (Physician Advisory Services)

A comprehensive physician advisory medical necessity solution that helps hospitals and medical facilities confirm their navigation of the regulatory environment so that compliance improves

Hospitals and physician groups operate in an environment inundated with rules and regulations and multiple federal, state, and commercial entities auditing compliance. These factors drive the need for precise and timely case classification and a demand for formalized processes related to admissions and billing.

The decision to classify a patient as inpatient versus observation is based on complex medical judgment, made all the more complicated in light of The Centers for Medicare and Medicaid Services’ release of the FY 2014 Hospital Inpatient Prospective Payment System (IPPS) Final Rule. AccretivePAS® focuses on concurrent recommendations to increase compliance and success on retrospective appeals and maximizes total utilization review (UR) compliance through a full suite of IPPS “two midnight” standards and services performed only by licensed physicians:

  • A comprehensive line of best-in-class services tailored to the precise requirements of the new IPPS Final Rule
  • Easy-to-follow UR guide to help hospital case managers bridge between Medicare and commercial payor, and between pre-IPPS denials and post-IPPS status decisions
  • Status confirmation and assurance of all concurrent Medicare reviews
  • Utilization of a proprietary model for the prediction, substantiation, and documentation of the two midnight expectation
  • Thorough documentation reviews of all submitted cases to minimize the risk of audit findings and inappropriate denials

To learn more about Accretive Health’s physician advisory services (AccretivePAS®) contact Joe Evans, Senior Marketing Associate, at 312-931-3007 or jevans1@accretivehealth.com.

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