Financial Analysis Archives - Page 7 of 9 - BHM Healthcare Solutions

5 Aspects of CMS’ 2015 Proposed IPPS Regulations

2017-04-02T13:28:39-04:00By BHM Marketing|Clinical Analysis, Compliance, Financial Analysis, Health Care Reform, Medicare and Medicaid, Physician Compensation, Readmissions, Services|

On April 30, 2014, CMS announced proposed IPPS regulations to become effective January 1, 2015. The ruling covers: Hospital Value-Based Purchasing Program, Hospital Readmissions Reduction Program, Hospital-Acquired Condition Reduction Program, Quality Reporting Programs, and Wage Index – Updated Labor Market Areas. CMS just announced proposed regulations to become effective January 1, 2015. These regulations further the goals of the Affordable Care Act: increasing patient outcomes and reducing healthcare spending. These proposed regulations are Medicare specific and, if approved, will be applicable to general acute care and long-term care hospitals.

New ACA Provision Calls For Cost Transparency in Hospitals

2017-04-02T13:28:39-04:00By BHM Marketing|Financial Analysis, Health Care Reform, Medicare and Medicaid|

New rules put forth by the ACA will require hospitals to be transparent about the costs of care at their facility. They can do this in one of two ways: either by releasing a list of procedures and their costs, or, releasing the information after an inquiry by a patient.

Telemedicine is Expanding but Faces Obstacles

2017-04-02T13:28:39-04:00By BHM Marketing|Financial Analysis, Physician Compensation, Services|

Summary: As a result of the ACA and the increase in patients while the physician shortage is magnified, efforts are under way to address the lopsidedness of supply and demand. One of those efforts is telemedicine. The influx in individuals who are recently eligible for insurance coverage has added fuel to the fire in terms of the number of physicians who can provide care. Telemedicine is expanding in popularity and use as a means to address this issue, while also reducing healthcare costs and increasing both accessibility and affordability.

Factors Influencing ACO Expansion

2017-04-02T13:28:39-04:00By BHM Marketing|Accountable Care Organizations, Financial Analysis, Physician Compensation, Services|

Summary: What is contributing to the rapid expansion of ACOs? What programs are currently being piloted? What are the initial results of current ACOs? What is an ACO? An ACO is a group of healthcare providers who work together and accept accountability for reducing costs and increasing quality of care.

Benefits of ACOs to Both Patients and Providers

2024-06-26T10:44:51-04:00By BHM Marketing|Care Coordination, Financial Analysis, Health Care Reform, Health Insurance, PCHCH Accreditation, Physician Compensation, Quality Improvement Programs, Services|

Summary: Accountable Care Organizations (ACOs) are gaining in popularity as a result of the Affordable Care Act. Have you considered the benefits of ACOs from both the patient and provider perspectives? One of the goals of the Affordable Care Act (ACA) is to provide coordinated care which, in turn, increases quality and efficiency within the healthcare field, and reduces costs. ACOs – What is an ACO? ACOs are groups of providers which form an organization based upon the Medical Home (or PCMH) concept. The Medical Home places responsibility for the coordination of care with the primary physician. The primary care physician coordinates with other physicians and providers such as specialty physicians, laboratories and diagnostic imaging, providing a central point for the patient’s medical information.

How Are You Using Physician Data Mining?

2024-06-26T10:46:45-04:00By BHM Marketing|Big Data, Financial Analysis, Physician Compensation, Services|

The pay for performance model of payment has been the preference of health insurance companies for several decades. Previous models made it too easy for money to be paid for services that were not truly needed, were poorly documented or in some cases, were entirely fabricated for the purpose of payment. Pay for performance measures are meant to validate payments to physicians in accordance with The Affordable Care Act by using data mining techniques to keep tabs on physician costs.

Do Patient Satisfaction Surveys Help or Hurt Reimbursement?

2017-04-02T13:28:40-04:00By BHM Marketing|Financial Analysis, Healthcare Preventitive Care, Medicare and Medicaid, Physician Compensation, Services|

The “patient is always right” model has been the primary driving force behind healthcare for the last several decades. But is this the right approach? Classifying patients as “customers” is a slippery slope. While you might be able to barter with a customer at a shop about the price of a necklace, should doctors ever barter with a patient about their treatment? What about when their patient satisfaction scores are drooping low?

The Cost of Resistance | Clinical Coding Optimization

2023-07-28T14:53:42-04:00By BHM Marketing|Financial, Financial Analysis, Medicare and Medicaid, Physician Compensation, Services|

Physician practices may be lagging behind hospitals when it comes to implementing coding software. The hesitation to do so is costing them not only efficiency in coding, but reimbursements withheld due to avoidable errors.

Bundled Payments | Rewarding Quality and Value

2017-04-02T13:28:40-04:00By BHM Marketing|Care Coordination, Financial Analysis, Health Care Reform, Services|

Summary: The healthcare industry is transforming from fee-for-service to value-based payment systems. One of the fairly new forms of reimbursement to hit the streets is bundled payments. Overview of Bundled Payments The Medicare reimbursement system is in the process of transforming healthcare as we know it from a traditional fee-for-service model to a system that rewards based on quality, care coordination, accountability, and healthcare cost savings.

Understanding RVUs | Medicare Reimbursement

2017-04-02T13:28:40-04:00By BHM Marketing|Financial, Financial Analysis, Physician Compensation, Services|

Summary: Do you understand Relative Value Units (RVUs) as they relate to Medicare reimbursement? Is your physician compensation model based upon RVUs or a derivative thereof? What is an RVU? RVU stands for Relative Value Unit and is currently used by Medicare to determine the amount of reimbursement to providers. RVUs are basically a way of standardizing and comparing service volumes across all continuums.

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