Financial Archives - Page 7 of 23 - BHM Healthcare Solutions - Experts in Healthcare Financial Management

All-Payer Model Maryland Update: Care Redesign Program

2017-08-21T18:03:30-04:00By Eric Duchinsky|Financial, Medicare and Medicaid|

In July of 2017, CMS and Maryland continued their partnership and announced the Care Redesign Program (CRP). The CRP is a new voluntary program within the Maryland All-Payer Model that advances efforts to redesign and better coordinate care in Maryland. The CRP provides hospitals participating in the Maryland All-Payer Model the opportunity to partner with and provide incentives and resources to certain providers and suppliers in exchange for their performance of activities and processes that aim to improve quality of care and reduce the growth in total cost of care for Maryland Medicare beneficiaries.

Medicare Advantage Projected Market Growth Creates Untapped Opportunities for Insurers

2017-08-15T21:28:11-04:00By Eric Duchinsky|Financial, Medicare and Medicaid|

Despite rapid-fire growth that has resulted in upwards of 33% of all Medicare beneficiaries now being enrolled in Medicare Advantage plans, few health plans are proactively marketing their offerings to consumers and all but a select few plans are falling short when it comes to successfully addressing provider integration and access to care for their members. Those are the key findings of the J.D. Power 2017 Medicare Advantage Study.

Key Payer Competitive Differentiator: Analytics

2017-08-24T18:37:35-04:00By Eric Duchinsky|Big Data, Financial, Financial Analysis, Physician Advisor/Peer Review, Trends|

Many health plans are facing uncertainties: the changing health insurance landscape, the speed at which value–based care is approaching, and growing demands from customers, to name a few. But one investment may help executives meet each of these challenges—an investment in analytics. Health plans are data rich, yet those data are not always leveraged to understand what happened and why, or predict what is likely to happen. Health plans that don't take advantage of their data may risk being disrupted and left behind. Analytics can be a key payer competitive differentiator setting your organization ahead of the pack.

5 Medical Cost Pressures Shaping 2018

2017-07-11T18:11:23-04:00By Eric Duchinsky|Financial, Financial Analysis, Health Insurance, Revenue Cycle Improvement, Trends, Uncategorized|

The era of volatile swings and double-digit growth in employer medical costs appears to be ending. With medical cost trend hovering in the single digits for several years, the industry has been waiting for the inflection point when spending will take off. But that spike appears unlikely to happen. The New Health Economy is settling into a “new normal,” typically characterized by more attenuated fluctuations and a single-digit trend.For four years, medical cost trend has hung between 6 and 7 percent, seeming to settle into a “new normal.” PwC’s Health Research Institute (HRI) anticipates a 6.5 percent growth rate for calendar year 2018, half a percentage point higher than in 2017.

Significant Risks Beyond Recruitment: Medical Directors and CMOs

2017-06-20T20:12:11-04:00By Eric Duchinsky|Clinical Operations Improvement, Compliance, Financial|

Recruiting and retaining qualified Medical Directors and Chief Medical Officers challenge healthcare organizations of all types. Whether you employ or contract these medical professionals, consider two recent cases as reminders of potential issues far different than recruitment and retention and considerably more financially damaging. Significant risks beyond recruitment exist and staying informed about new Stark Law rulings pays.

Not Waiting For Capitol Hill: Health System Leaders Move Ahead

2017-05-23T19:29:16-04:00By Eric Duchinsky|Clinical Operations Improvement, Compliance, Financial, Financial Analysis, Health Care Reform|

Despite industry uncertainty about the fate of healthcare under the new administration and Republican Congress, health system leaders move ahead and are preparing for the future. A recent Premier Inc. survey show the target areas for improvements within their systems. The results signal growth concerns and why the leaders will not wait for Capitol Hill results.

Removing Value-Based Care Barriers

2017-05-22T20:57:20-04:00By Eric Duchinsky|Financial, Physician Advisor/Peer Review, Services|

The promises of value-based payment models came to life within the last 12+ months with results of real world tests. They quickly move to the implementation of useful models and processes. With ramped-up implementations overcoming value-based care barriers step out as real things.

CMO-CFO Collaboration Marks Success

2017-05-17T13:47:19-04:00By Eric Duchinsky|Financial, Quality Improvement Programs|

It is important to acknowledge that CMOs and CFOs speak different languages, have different perspectives and focus on different goals. It is absolutely critical for clinical and financial leaders to recognize and understand the pain points of their colleagues on the other side of the C-suite. The need for CMO-CFO collaboration is just as evident in the financial realm of health care organizations.

Medical Loss Ratio: Updates and Impact

2017-04-18T20:46:47-04:00By Eric Duchinsky|Financial, Financial Analysis, IRO, Physician Advisor/Peer Review, Uncategorized|

Healthcare spending is on the rise. The federal government has begun several initiatives to control costs, increase efficiency, and increase quality. Revisiting one of the ACA, Medical Loss Ratio.

Most Bang: Impactful Metrics For RCM

2017-04-02T13:27:55-04:00By Eric Duchinsky|Financial, Financial Analysis, Services, Uncategorized|

Analyzing your revenue cycle from start to finish can lead to recouping significant revenue dollars for your organization. Knowing what are the most impactful metrics sets revenue cycle experts apart.

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