It’s no secret that negotiating payer contracts has always been a challenge for healthcare providers. With the recent shift toward consumerism, changing patient behavior, and the revenue fallout from the COVID-19 pandemic, uncertainty is at an all-time high. To address this uncertainty, PMMC brought together three Managed Care experts. And we do mean experts – every panelist has had at least 25 years of experience. The panelists didn’t hold back from addressing the real challenges our hospitals face today in terms of revenue and reimbursement. It was shocking to learn that from March 1 to April 15, hospitals were losing $1 Billion per day due to the drop in elective procedures during the height of the COVID-19 outbreak. In just one hour, we covered everything including how to handle this revenue loss with payers, the impact of the rise in telehealth, and how to use predictive analytics and scorecards to manage and predict all these shifting dynamics in reimbursement.
Every profession has its set of experts. In the health industry’s managed care field, one of those experts is Susan Mego.
Key Metrics for Contract Management
The proper use of healthcare contract management software can make a difference of 2-3 percent net revenue. Thus, the proper use of a contract management system should be considered “mission critical,” from a financial perspective, but it often does not receive the attention it deserves. This whitepaper explains how applying metrics to healthcare contract management helps assure all accounts receive appropriate attention, thus ensuring revenue integrity.
Due to complications with timing, the Centers for Medicare and Medicaid Services (CMS) has delayed implementation of the three new episodic payment models (EPM) and Cardiac Rehabilitation (CR) incentive program until January 1, 2018.
We're pleased to announce that PMMC has been selected by JFK Health, based in Edison, NJ, for bundled payment analytics to manage the costs for the Comprehensive Care for Joint Replacement (CJR) Model.
Be sure to join PMMC next Tuesday, October 18th for a webinar featuring The MetroHealth System, to learn how they are navigating price transparency requirements by offering online, self-service patient estimates.
We know revenue cycle teams are very busy and often managing competing priorities. So what are their top initiatives today? A recent survey of 93 senior healthcare finance executives provides some insight. According to the survey from Connance and Porter Research, senior healthcare finance executives are more likely to implement updated IT and hire additional staff than contract with outside consulting services in order to optimize revenue cycle workflows.
We're pleased to announce that PMMC has been selected by Cabell Huntington Hospital (CHH) for contract management and denial management.
One of our most forward thinking clients, The MetroHealth System (based in Cleveland, Ohio), will share its experiences with consumerism, price transparency, and patient financial communications during an HFMA webinar next Tuesday, August 30th.
Despite efforts to improve price transparency, 43 states received an "F" grade according to the Health Care Incentives Improvement Institute (HCI3 ) – Catalyst for Payment Reform (CPR) Report Card on State Price Transparency Laws.
Las Vegas is the place to be next week (June 26-29) for healthcare finance and the revenue cycle at the annual HFMA National Institute (ANI). PMMC will be front and center in the exhibit hall, so be sure to visit us at Booth 123.