We analyze hospital prices at the procedure code level and present an analysis of suggested rate changes designed to enhance the defensibility of proposed pricing with sensitivity to financial impact.
Web-based software that creates custom analyses of financial/operating strengths, weaknesses, and opportunities. Utilizes client-submitted claims data as well as national public-use data.
Exploring the Relationship Between Quality and Cost in Hospital Data
CMS has recently released its 5-star hospital compare ratings with the distribution shown in Table 1. The ratings are based upon metrics in five areas: Mortality (22%), Safety (22%), Readmission (22%), Patient Experience (22%), and Timely and Effective Care (12%).
These quality metrics are important because Medicare does pay hospitals based on quality through several programs. These programs are part of an effort to improve ...
Patient Rights Advocate Dramatically Overstates Hospital Non-compliance
Last month, PatientRightsAdvocate.org (PRA) released its Sixth Semi-Annual Hospital Price Transparency Compliance Report (https://www.patientrightsadvocate.org/semi-annual-report-feb2024). The report shows that 34.5% of the 2,000 US hospitals it reviewed comply with federal price transparency requirements. Unfortunately, PRA’s findings continue to be horribly flawed. HFMA, AHA, and even CMS have countered the findings in ...
Cleverley + Associates Looks at the Link Between Value and Hospital Price Transparency
On January 18th of this year Money Magazine released its list of Best US hospitals. They provided 5 overall metrics for each of the top US hospitals: Overall Grade (A+ to B), Top Specialty, Price Transparency (A+ to D-), Top Service, and Federal rating. They explained their methodology for determining the overall rank as follows:
“Our first step to whittling down 6,000-plus hospitals across the country was ...
Are Health Insurance Firms Putting Profits Over Patient Care?
There have been some advertisements on various media platforms suggesting that major health insurance firms are prioritizing profits over the health of patients. The website that contains more information is www.healthcomesfirst.org and is an initiative of Trinity Health. The primary focus of the commercials and the website is that hospitals are not being fairly reimbursed by major health insurance firms and are realizing inadequa...