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What Hospitals Need To Know About Price Transparency
The CY20 Final Rule expanded the transparency requirements described in the FY19 Final Rule. What does that mean for hospitals and systems?
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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.
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We utilize extensive proprietary and public data sources to create fact-based, actionable plans to address specific client objectives.
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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.
Check Out The Latest Hospital Finance News!
Wednesday, November 18, 2020
How To Prepare for An Insurance Audit
Insurance audits can be an intimidating prospect, but they’re necessary and, unfortunately, inevitable. Even if an insurer didn’t single your facility out for an audit, you may be part of a random selection. Whether you’re preparing for a pre-payment review or a post-payment review, the general purpose of an audit, from the insurer’s perspective, is to check for fraud abuse, and waste. There’s no such thing as a routine audit. They’re all a little bit...
Thursday, October 29, 2020
Beckers recently published an article on how to gauge your hospital’s financial health, and they make excellent points. You can read the full article here.
They cover many of the basics, including Aggregate Volume, Operating Ratios, Labor Costs Relative to Patient Volume, and Liquidity Ratios, but we believe there is another measurement that can shed light on your facility’s health and financial stability – Equivalent Discharges.
Equivalent Discharges is an alternative to Adjusted Pati...
Thursday, September 17, 2020
The FY21 IPPS Final Rule solidified a new requirement for hospitals to post the median payment (called the median “payer specific negotiated charge”) by MSDRG for Medicare Advantage (MA) plans. The plan is to use this information to establish weights for MSDRGs using hospital payments, as opposed to hospital costs via the current cost-to-charge ratio methodology. Per the rule, this transition to payment-based weights would likely begin in FY24. There are several key points to consider ...
Tuesday, July 28, 2020
On July 16, 2020 Cleverley + Associates presented a webinar on the final rule on hospital price transparency and the requirements for individual hospitals and systems.
Content included a description of the price transparency guidelines effective 1/1/21, a list of important action items hospitals must implement, and a discussion of the two different ways prices must be published.
A recording of the webinar can be viewed here!
Thanks to great attendance and participation in this eve...