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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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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
Coming soon! Contract benchmarking, modeling, and measurement through personal consulting with industry experts.
Strategic Advisor
We utilize extensive proprietary and public data sources to create fact-based, actionable plans to address specific client objectives.
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!
Wednesday, February 12, 2020
Two areas that affect the impact of contract changes include how payers define categories and services and hierarchies of payment.
A substantial provider-payer contract is nearing the renewal period. The payer initiates proposed changes to current payment terms, but the provider already has in mind specific outcomes desired for the upcoming contract year. The provider is faced with two choices; accept and move forward with the proposed changes or engage in the negotiation process. What sh...
Tuesday, February 11, 2020
Healthcare figures to be a primary issue in the 2020 elections, with much of the focus on costs — especially hospital costs. A common concern among users of hospital services is the apparent lack of correlation between hospital charges and payment. Although some hospital managed care executives have suggested replacing percent-of-charge (POC) contract provisions with fixed-fee payment as a solution, these proposals are based on three myths regarding the POC payment methodology relative to fi...
Friday, September 20, 2019
“Big Data” is a buzz word in a lot of industries right now, so what do we mean when we talk about big data in healthcare? We know that big data is, well, big – usually very, very big. When we talk about big data in any context we’re usually discussing something that is more than a single person can analyze and parse. In fact, it might need a team or specialized equipment,and is assembled from multiple data sources.
Of course, those of us in healthcare, and especially healthcare finance, k...
Monday, September 30, 2019
Every year, as the winter holiday season rolls around, the greatest debate of our time resurfaces – is Die Hard a Christmas movie?
We at Cleverley + Associates believe that the answer to this question may be beside the point. What’s important are the traditions we make for ourselves, especially around the holidays, that bring us together and make us feel happy and fulfilled.
But also, yes. Yes, it’s a Christmas movie.
It’s also a totally awesome action movie, which means injuri...