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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.

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The 4 Components of Payer Negotiations

Laying the Foundation

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How to Negotiate with Payers – Tips from a Managed Care Expert

Every profession has its set of experts. In the health industry’s managed care field, one of those experts is Susan Mego.

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Revenue, Cost, Productivity and Quality: The Four Modern Day Healthcare Directives Heard in Today’s Boardroom

All across the modern day healthcare landscape in hospital and healthcare system boardrooms, the four main topics discussed on a regular basis by executive leadership are focused on these business issues:

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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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What We Learned (Part 2): 8 Points on Narrow Networking That Every Hospital Needs to be Aware Of

This webinar has taught us a lot about a program in the healthcare industry commonly referred to as narrow networks. We learned about the pros and cons for adopting this type of system, the growing trend of employers offering this to their employees, and most importantly, the value of knowing the contracted terms before entering into these agreements. So, with that being said, what’s the biggest piece of advice we can take away from this presentation?:

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What We Learned (Part 1): How Narrow Networks Impact Healthcare Providers

During our recent webinar session “Intro to Narrow Networks: What’s the Impact on Healthcare Providers?” we polled healthcare providers on several topics around narrow networks.

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Stats on Narrow Networks

Narrow Networks have become increasingly popular among providers looking to provide patients with a comparable quality of care at lower premiums. Here's a look at some stats showing its current success rate:

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What We Learned (Part 1): What Hospitals Need to Know About Narrow Networks Before Joining

The path toward financial stability for healthcare organizations can be a bumpy road. Due to a surplus of big data, providers can utilize this information to search for any areas (aka. opportunities) where they can lower their costs by working together to create a solution that all parties can agree on. This process usually requires some give-and-take from both sides but the goal is to find new innovative means of lowering their costs, without sacrificing the quality of patient care.

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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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Webinar recap: Intro to Narrow Networks

Click here for a 20 minute intro session to Narrow Networks.

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