6 revenue cycle objectives for the transition to value-based payment models
To maximize revenue, medical practices are focusing on value — delivering high-quality care while managing total costs — and managing risks associated with two-sided payment models.
Analysis: Local purchasing alliance reduces hospital prices by 20%
As more data on price variability in healthcare becomes available, there will be an increase in activist employers and employer coalitions getting local health systems to lower prices.
Analysis: Employers are not a monolithic block on Medicare for All
If struggles to control healthcare costs continue, more U.S. employers may change their positions in favor of Medicare for All.
Providers push arbitration approaches used in some state surprise-bill laws
What should Congress learn from states’ experiences with laws attempting to curtail surprise healthcare bills?
Medicare Advantage plans accelerating their move into SDOH, advocate says
Medicare health plans have increasing authority to grapple with the social determinants of health, and more are pursuing such initiatives.
Get creative with technology to drive your managed care programs
Technological innovations can help healthcare organizations improve their managed care programs.
Ask the Experts: SSI percentage and eligibility
Rolling averages are one way to benchmark patient SSI eligibility percentages.
Ask the Experts: Contract performance
My organization recently transitioned to its first Ambulatory Payment Classifications (APC)/DRG-based contract with a commercial plan. We are struggling with determining how to monitor the contract’s performance and, in particular, with the primary focus on the APC payment. Are there recommended key performance indicators (KPIs) used to track this performance? Answer: It is likely that your organization…
Earning a 4-start patient-experience rating takes dedication
Main article: Why optimizing the patient experience should be on every C-suite leader’s radar Under Maryland’s hospital rate-setting system, 1% of hospital payment from all payers is based on an organization’s performance on the HCAHPS inpatient survey. “It can be millions of dollars for organizations that can be lost or gained,” says Lisa Allen, PhD,…
Why optimizing the patient experience should be on every C-suite leader’s radar
Jason Wolf, president and CEO of The Beryl Institute, knows from personal experience how easily a healthcare organization can lose a customer. A few years ago, his wife was mistakenly billed for a $25 copay that she already paid, and then the account was fast-tracked into collections. Despite receiving excellent clinical care, his wife vowed…