Tuesday, October 02, 2018 Cleverley Uncategorized No comments
Equivalent discharges™, our replacement measure for “adjusted discharges,” continues to gain acceptance as the new standard for volume measurement as it isn’t influenced by pricing changes and calculates a volume value specific to inpatient and outpatient areas.  The latest research shows that positive growth occurred in all but three states/territories (HI, MD, PR).  The national average has c...
Friday, September 07, 2018 Cleverley Uncategorized No comments
CMS reports an estimated increase by 2.4 percent for FY 2019 in overall payments to hospitals paid under the IPPS. This increase is due to the applicable percentage increase and changes to policies related to MSDRGs, geographic adjustments, and outliers. National standardized amount increases by 1.85 percent. Hospitals paid under the hospital-specific rate will receive a 1.35 percent hospital u...
Thursday, September 06, 2018 Cleverley Uncategorized No comments
To what extent is Wage Index based on payment CBSA changing from FY 2018 to FY 2019? *Data Source: CMS, FY 2018 & 2019 IPPS Final Rule Impact Files, FY 2019 URSPA variable *Data Source: CMS, FY 2018 & 2019 IPPS Final Rule Impact Files, FY 2019 URSPA variable Based on the data above, the clear majority of hospitals are experiencing an increase or decrease less than 5% or no change at a...
Thursday, September 06, 2018 Cleverley Uncategorized No comments
Version 36 incorporates changes to our MSDRG list as well as associated relative weights.  From FY 2018 to FY 2019, 742MSDRGs are present in both versions. Does FY 2019 (MSDRG V36) involve any new or deleted MSDRG? It sure does! Eleven (11) MSDRGs are removed for FY 2019 and eighteen (18) MSDRGs have been created. To what extent is Relative Weight changing from FY 2018 to FY 2019?   *Data Sou...
Thursday, September 06, 2018 Cleverley Uncategorized No comments
Remove – Remove – Remove! CMS’s strategy for a holistic quality payment program, the FY 2019 IPPS Final Rule, involves several removed measures to prevent duplication across programs in which is stated as considered causing unnecessary complexity or unnecessary costs. This focus on removal is ultimately positive and will help reduce administrative burden on providers. “Regulatory re...
Thursday, October 18, 2018 Cleverley Uncategorized No comments
A Compliance Continuum for the FY19 IPPS Final Rule (CMS-1694-F) for Requirements for Hospitals to Make Public a List of Their Standard Charges via the Internet **Updated October 2018 to reflect CMS responses to frequently asked questions Provided by: Cleverley + Associates BACKGROUND The FY19 IPPS Final Rule contains a section for requirements for hospitals to make public a list of their st...
Wednesday, August 22, 2018 Cleverley Uncategorized No comments
Pricing transparency has been the topic and trend in healthcare for the past few years.  The industry has responded with numerous research articles, solutions and products.  Hospitals have made prices more publicly available, reduced charges and restructured pricing methodology.  However, with pricing transparency being all the buzz, where has that left the focus on costs in healthcare? Recentl...
Tuesday, August 07, 2018 Cleverley Uncategorized No comments
The state of Nevada has continued its ascent to the leading cost position in the nation as it was ranked 6th lowest three years ago, 2nd two years ago, and first in the current national study.  Not surprisingly, the Las Vegas metro area was among the five lowest cost metro areas.  Some might be surprised, though, that two California metro areas lead the way for cost position.  It’s important t...
Wednesday, July 11, 2018 Cleverley Uncategorized No comments
  The chargemaster, or CDM (charge description master), is an integral component of hospital financial strategy, reimbursement, and the revenue cycle. It is important to understand the complexities of the CDM as well as the consequences of even seemingly simple changes. Throughout the year, this “menu” of hospital service prices changes to reflect minor adjustments. Larger modifications a...
Wednesday, June 06, 2018 Cleverley Uncategorized No comments
The effects of Maryland’s all-payer rate regulation, the only of its kind in the nation, are clearly seen in the HCI results where Maryland hospital charges are approximately one-third of the US average.  As rate changes have been heavily limited for the past thirty-plus years, it’s no surprise to see Maryland and the Baltimore metro area as the lowest charge regions in the country.  As we kno...

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