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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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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 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!
Tuesday, December 08, 2020
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 create for ourselves, especially around the holidays. What really matters is what brings us together and make us feel happy and fulfilled.
But also, yes. It’s a Christmas movie.
Plus, it’s a totally awesome acti...
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...
Tuesday, December 08, 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 ...