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The CY20 OPPS Proposed Rule: A Response

The CY20 OPPS Proposed Rule contains additional information and requirements regarding hospital price transparency. Read our summary here!
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Our Latest Research

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Rate Advisor

Rate Advisor

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.
Contract Concierge

Contract Concierge

Coming soon! Contract benchmarking, modeling, and measurement through personal consulting with industry experts.
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Strategic Advisor

We utilize extensive proprietary and public data sources to create fact-based, actionable plans to address specific client objectives.
HospitalDx®

HospitalDx®

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!
Friday, September 20, 2019
Recently, NASA verified that they are investigating what might be the first crime in space. The short version is that Anne McClain accessed her ex-wife’s bank account while stationed aboard the International Space Station. It should be noted that Ms. McClain denies any wrongdoing, but the incident has raised some interesting questions about crime in space. Specifically, what do we do about crimes in space? In case you’re curious, the short answer here is that the offender would be subj...
Friday, September 20, 2019
The No-Surprises Act, currently under consideration, would prohibit providers from balance-billing. It would also establish rates for payments from commercial health plans, based on the local market. There is a process (added on July 17) that includes a third-party arbitration process for resolving certain disagreements.  The main focus of the bill, as with other recent surprise billing legislation attempts, the goal is to protect patients from large, surprise bills, especially from ...
Wednesday, September 18, 2019
As many hospitals are nearing the start of their next fiscal year, we thought it would be interesting to look at pricing strategies selected by a significant national sample during the first half of 2019. Hospitals may take one of two approaches when setting prices by following either an across-the-board (ATB) price change or a strategic approach. The ATB method assumes all prices in the chargemaster change by a constant percentage. For example, targeting a 5% overall price increase would...
Thursday, September 19, 2019
COLUMBUS OH, SEPTEMBER 6 2019 – The CY20 OPPS Proposed Rule contains additional information and requirements regarding hospital price transparency. There are nine areas pertaining to the proposed requirements for hospitals to make public a list of their standard charges. Some of the areas represent further clarifications or definitions of terms outlined in the FY19 IPPS Final Rule and others are entirely new components. Among the most critical proposals are: 1.  Expan...

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