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Eeny Meeny Miney Money | Understanding Fee for Service Alternatives

November 3, 2014

When we look at the fee-for-service model from only one perspective, it’s easy to condemn it as “the reason” healthcare spending has spiraled out of control. When it comes to how providers bill for services, having the ability to bill for anything and everything could, and certainly did, encourage the ordering of too many tests and procedures, even unnecessary ones. The idea of value-based payment models not only encourages providers to make more mindful choices, but cost-effective ones too. It also challenges healthcare systems, pharmaceutical companies and patients to be even more vigilant about healthcare costs. Fees are relative to each party involved.

Boo! BHM Wishes You a Spooky Halloween!

October 31, 2014

Here’s an oldie but goodie:

Trick or Treat! Smell my feet! Give me something good to eat!

BHM wishes you a Happy and Safe Halloween!

Don’t let the goblins get you!

7 Steps to Avoid Another Ebola – Like Pandemic

October 30, 2014

For all the conversations happening about Ebola right now, startlingly few of them are practical. One question that all healthcare systems ought to be asking themselves right now is not only are they equipped to treat an Ebola patient, but can they afford it?
After the first patient with Ebola in the U.S., Thomas Duncan, passed away Texas Health Presbyterian Hospital reportedly faced as much as a half a million dollars in healthcare expenses for his treatment. Since the stakes are so incredibly high with a confirmed Ebola diagnosis, it might seem insensitive to attempt to put a price tag on the treatment. As we’ve seen with the other Ebola patients in the U.S., Amber Vinson, Nina Pham and Craig Spencer, early intervention and aggressive treatment are the difference between life and death.

The Basics of ACOs in Less Than 6 Minutes Video

October 29, 2014

Are you confused about ACOs – what they are, how they function, what their purpose is? We have all heard the term ACO and most of us know that stands for Accountable Care Organization. Stretching past these basics, the waters become a bit more muddied. So what is an ACO and how does it work? Do you have 6 minutes? Following is a great video created by OSF Healthcare. The video gives a great overview of what an ACO is as well as the goals. Some of the highlights include:

New CMS Report Shows Continued ACO Success

October 13, 2014

The Centers for Medicare & Medicaid Services (CMS) released a new set of quality and financial performance findings on September 16, 2014. These findings showed Medicare Accountable Care Organizations had elevated the quality of care for recipients through preventative health initiatives and collaborative efforts between doctors, hospitals, and care providers.

Can You Afford Not to Appeal Denied Claims?

October 10, 2014

The Medical Group Management Association actually put a price tag on the cost of managing each denial in your organization’s denial queue: $25-$30 a piece. That cost adds up when you consider that up to as many as a quarter of all claims get denied – meaning that for some hospitals, that $25 per claim price tag could become overwhelming pretty quickly. The first step in the case of any denied claim is determining why it was denied.

Peer Review Demystified

October 9, 2014

Peer review and quality.

Healthcare is an industry that perhaps has even surpassed car manufacturing in concern with quality measures. And it should be. After all, we’re dealing with human beings, not cars. Peer review often concerns itself with peering closely at quality measures, compliance and safety. Patients are already vulnerable when they enter the hospital, due to illness or injury, so it is everyone’s concern in healthcare to be mindful of what areas of weakness within an organization could be influencing patient outcomes in a negative way.

ACO Prescription: Cure or Disease? Infographic

October 8, 2014

We would love to hear your opinions on ACOs – the good, the bad, and the ugly. What successes have you achieved? What issues have arisen? How are ACOs seen from a patient perspective?

3 Pronged Approach to Organizational Analysis

A Three Pronged Approach to Organizational Analysis

October 7, 2014

When was the last time your organization performed a SWOT analysis? If you aren’t familiar with SWOT (strengths, weaknesses, opportunities and threats) it’s a widely used strategy in many industries, not just healthcare, for identifying areas for improvement. You can break SWOT down even further:
Strengths: What sets your hospital apart from all the rest? What can you offer that makes you competitive?
Weaknesses: What puts your hospital and employees at a disadvantage compared to other hospitals? What of these factors can you change?
Opportunities: How can you show your strengths to others?
Threats: What could cause big trouble for your hospital or employees?

ACOs vs Bundled Payments – Can Either Save Healthcare?

October 6, 2014

Everyone in healthcare knows that something’s got to give – it’s not a matter of “if” but “when” – and to some extent, how? In the arena of change, two major payment players, ACOs and Bundled Payments, are fighting to become the savior of American healthcare. Chances are you’ve already heard plenty about the former; accountable care is the hot topic of the year. Not only has it made headlines, but it’s been the topic of industry wide webinars and education.

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