healthcare revenue cycle, revenue cycle blog, revenue cycle tips, revenue cycle information
PMMC Healthcare Revenue Cycle Blog
Stay up to date on best practices for healthcare revenue cycle management with PMMC's blog.
Business Insights | Contract Modeling
Leveraging Medicare Benchmarks in Contract Negotiations
When it comes to hospital reimbursement, one statistic often dominates the conversation—on average, hospital commercial reimbursement is coming in at approximately two to three times Medicare reimbursement. It’s critical to understand how your organization stacks up against industry benchmarks since this can significantly affect preparations for contract negotiations and your bottom line. Through analysis, we've found reimbursements to be approximately 200%-215% of Medicare. But here's the big question—how do you use this data strategically to enhance contract negotiations, improve financial planning and analysis (FP&A), and maximize net revenue?
Share
Transforming Data into Actionable Insights for Informed Decisions
Efficient contract management is increasingly becoming a linchpin for organizations aiming to leverage data for strategic advantage. Understanding how to turn raw data into actionable insights is crucial for maintaining business continuity in a dynamic environment. Explore how mature organizations can harness data for effective contract management, ensuring they remain competitive in the fast-paced world of healthcare finance.
Share
Ensuring Payer Contracts Are Being Maximized with Contract Modeling
Contract modeling software can help healthcare decision-makers look beyond their revenue cycles and adapt to industry trends to maximize profitability. Partnering with an experienced contract modeling system provider like PMMC is also helpful for evaluating payer contracts and ensuring that they’re being fully maximized. Let’s further examine contract modeling software, including why hospitals need them and the benefits they provide.
Share
Modeling Payer Proposals to Maximize Return and Cash Flow
Over the last several years, hospitals and healthcare groups have been ravaged by pandemic-related revenue losses. According to the American Hospital Association, in 2021 alone, U.S. hospitals lost approximately $54B in net income. Despite that, hospital leaders strive to achieve an economic resurgence by reducing operating expenses, streamlining operations, and perhaps most importantly, restructuring payer proposals to maximize their returns.
Share
3 Reasons Why Hospitals Should Use Analytics to Drive Payer Contracts
Insurers are swimming in data that gives them a steady stream of insights into their markets and the healthcare providers with whom they contract. Unfortunately, most providers don’t have access to the same level of business intelligence. That lack of reliable information on payer performance puts healthcare organizations at a disadvantage.
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