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PMMC Healthcare Revenue Cycle Blog

Stay up to date on best practices for healthcare revenue cycle management with PMMC's blog.

Palmer Hamilton

Palmer Hamilton has over 25 years of healthcare experience with hospitals and insurers. He has a BA in English from VMI as well as an MBA from Wake Forest University, and he served as a Captain in the US Army. He has spoken at several HFMA events and has been published as well. His experience includes most aspects of the Revenue Cycle, and he is currently product manager for Online Analytics, a web-based solution for healthcare finance benchmarking.

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Revenue Cycle Consolidation Causes Heartburn For Hospitals

For hospitals contemplating revenue cycle solutions, it’s important to make sure your revenue cycle solutions aren’t half-baked. Have you ever bought a bunch of ingredients and gadgets to duplicate what the pros make on a cooking show?  They make it look easy…but it’s not.  There are nuanced skills with timing, technique, temperature, and other subtle variables related to sequence and presentation. Cooking shows are similar to industry consolidation; be it energy, automotive, or even healthcare. So, what do we get with consolidation? 

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Why Mandatory CMS Bundles Could be the Best Thing to Happen to Your System

Much of the rhetoric surrounding mandatory bundles has been negative and defensive – i.e. how do healthcare organizations deal with these programs to prevent risk and avoid financial penalties to CMS?

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Key Metrics for Contract Management

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.

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No Joke: CJR Ruling Starts Today

No April Fools joke here.  Medicare's Comprehensive Care for Joint Replacement (CJR) ruling officially goes into effect TODAY in 67 markets leaving many hospitals accountable for the total cost of services across the entire episode of care for hip and knee replacements. The financial risk for hospitals is between $500,000 and $3 Million in payback penalties over the next five years. That's a lot of money.

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CJR Is Here: How To Prepare for The Financial Impact [Webinar]

This is not an early April Fools joke.  Medicare's Comprehensive Care for Joint Replacement (CJR) officially goes into effect on April 1st in 67 markets (the specific MSA's can be found at the bottom of this post), leaving many hospitals accountable for the total cost of services across the entire episode of care for hip and knee replacements. That's why we're partnering with Healthcare Business Insights (HBI) on March 15th for a webinar to help hospitals prepare for the financial impact of the CJR model.

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Hospitals Face Up to $3 Million Financial Loss from CJR Ruling

We now have a better understanding of the financial implications of the Comprehensive Care for Joint Replacement (CJR) model, the new CMS rule that requires bundled payments for hip and knee replacements.

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CJR Model  |  CMS  |  bundled episodes

A New Era for Hospital Finance: Being Accountable for Things Beyond Your Control

Significant Changes Coming - Get Ready Now On November 16, 2015, The Department of Health and Human Services (HHS) announced that CMS has approval for the final rule for the Comprehensive Care for Joint Replacement (CJR) Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services .  It will be applicable in April 2016. CJR is the first mandatory bundle model, and it represents the prototype for massive change in healthcare finance that will take place in the next two years. 

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Blog Feature

CMS  |  bundled episodes

It's Official: CMS Finalizes Mandatory Bundled Episodes Initiative

As expected, the Centers for Medicare & Medicaid Services (CMS) finalized the Comprehensive Care for Joint Replacement (CJR) model, which will hold hospitals accountable for the total quality of care they deliver to Medicare beneficiaries for hip and knee replacements from surgery through recovery. The announcement came in a news release on Monday.

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Blog Feature

CMS  |  bundled episodes

The Alphabet Soup of the New CMS Bundled Episode Model

The Centers for Medicare and Medicaid Services (CMS) loves to use acronyms and there’s quite a few related to its new CCJR bundled episode payment model. For healthcare finance professionals, it’s easy to lose sight of some of these, so we’ll recap and break them down with definitions:

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Blog Feature

CMS  |  Comprehensive Care for Joint Replacement Model  |  bundled episodes

Ready or Not, CMS says Go: Hospitals to Manage Episodes of Care

By now, most healthcare finance leaders are at least familiar with the recent CMS Comprehensive Care for Joint Replacement (CCJR) Model. This is a really big deal for healthcare providers. Let’s start with the basics:

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