PMMC Healthcare Revenue Cycle Blog
Stay up to date on best practices for healthcare revenue cycle management with PMMC's blog.
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:
Share
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:
Share
Why Can’t Patient Registration Be More Like the Airport?
Remember the days of waiting in line at the airport to actually have someone check you in at the counter? Those days are long gone in the airline industry, as airlines have adapted self-service kiosks, and more recently, mobile check-in to expedite the process even further. But this self-service model is still in the infancy stages in other industries, like healthcare.
Share
Strategic Pricing & Chargemaster
Steps for Planning a Chargemaster Review
Hospital pricing has come under intense scrutiny over the past several years, from both government legislation and media attention. The pinnacle of the media coverage came in 2013 when Time Magazine released “Bitter Pill: Why Medical Bills Are Killing Us.” The article highlighted the extreme cases of high prices at hospitals (i.e. patients getting charged $1.50 for single aspirin or $74 for a roll of gauze). Because of the recent pressure towards increased priced transparency and defensible pricing, hospitals are moving away from the traditional annual gross price increase.
Share
7 Tips to Maximize Reimbursement with Hospital Contract Management
The hospital contract management system is the key to maximizing financial performance, minimizing risk, and ultimately managing all aspects of payer contracts to get reimbursed accurately. However, it’s becoming more and more difficult to predict reimbursement. As third-party payers shift from a “fee-for-service” or “percent-of-charge” reimbursement model to value-based reimbursement, contract terms, coding, and their interpretations inevitably become more complex.
Share
8 Implementation Best Practices for Revenue Cycle Contract Management
Here’s a frightening statistic: Only 2.5% of companies successfully complete 100% of their projects. The reasons why, you ask? Requirements – Unclear, lack of agreement, lack of priority, contradictory, ambiguous, imprecise Resources – Lack of resources, resource conflicts, turnover of key resources, poor planning Schedules – Too tight, unrealistic, overly optimistic Planning – Based on insufficient data, missing items, insufficient details, poor estimates Risk – Unidentified or assumed, not managed
Share