PMMC Healthcare Revenue Cycle Blog
Stay up to date on best practices for healthcare revenue cycle management with PMMC's blog.
Healthcare Price Transparency Tested In 6 Cities - How Did They Do?
From New York to Los Angeles and in between, researchers found it difficult, frustrating, and sometimes impossible to obtain patient estimates for routine medical procedures, according to a new study from the Pioneer Institute Policy Brief. Here's the scenario: Researchers called into 54 hospitals in six metropolitan areas (Des Moines, IA, Raleigh-Durham, NC, Orlando, FL, Dallas-Ft. Worth, TX, New York, NY and Los Angeles, CA) asking for the price of an MRI of the left knee. Generally speaking, this is a pulse check of how far healthcare providers have advanced in adapting price transparency.
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CMS & Transparency | Strategic Pricing & Chargemaster
Why Hospitals Should Stop Automatic Chargemaster Increases
Hopefully your hospital's pricing strategy doesn't sound like this: “Prices were set in cement a long time ago and just keep going up almost automatically.” This was one Chief Financial Officer’s explanation of Chargemaster prices from the controversial 2013 Time Magazine article “Bitter Pill: Why Medical Bills Are Killing Us.” The article highlighted the extreme cases of high prices at hospitals and even called several hospitals (by name) into question. Although some of the findings in the report were later disputed, the article placed hospital pricing under a microscope and reinforced the need for defensible pricing. Automatic price increases might be the traditional route, but the strategy opens itself up to scrutiny, inefficiencies, and a potential loss in net revenue. Because of these factors and the recent emphasis on increased price transparency and defensible pricing, hospitals are moving away from the "across the board" annual gross price increase and towards a modeling approach to predict how charge adjustments impact net revenue. Not only does this give finance a clearer picture of future net revenue, it creates a defensible pricing strategy if prices ever come into question.
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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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Electronic Data To Save Healthcare $8 Billion, Help Price Transparency
“The health care system suffers from an overabundance of paper work” is how the American Hospital Association (AHA) begins its January 2016 Trendwatch report.
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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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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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Price Transparency: Why Knowing and Defending Your Price Matters
There is a lot of discussion about Price Transparency in Healthcare across our country. Many state legislatures are getting involved, including Florida. Recently, Florida Governor Rick Scott announced he will encourage (some might say push) state legislation to require hospitals to post their prices for procedures and services as well as their average reimbursement on the hospitals' websites in early 2016.
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Florida Governor Not Backing Down on Price Transparency
Florida Governor Rick Scott is not backing down on his push for price transparency for health services.
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Are Florida Hospitals Price Gouging?
Florida Governor Rick Scott thinks so and he wants to add legislation to put an end to it.
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No More Surprises: Maximize Estimates to Educate Patients and Increase Collections
As patient responsibility continues to grow, point-of-service collections become increasingly important. According to a recent HFMA article, two-thirds of patients are consistently surprised by their bills and only 25 percent are proactively counseled about their cost of care. In response, hospital revenue cycle processes need to account for the shift in payment responsibility.
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