Tuesday, February 12, 2019 Cleverley Uncategorized No comments
A clear sense of current market trends, cost of care, and demonstrated efficiencies that reduce cost are essential elements of contract negotiation preparations. Negotiation leverage, in terms of hospital control, comes from several sources. The most recognized driver is market power based on geographical area or demographic factors. However, hospital/payer relationships, service offerings ...
Friday, January 25, 2019 Cleverley Uncategorized No comments
Obtaining an accurate perspective on the meaning and relative impacts of cost and payment increases in the healthcare industry depends on the specific metrics that provide the basis for the analysis. To no one’s surprise, health care was a primary political issue in the Fall midterm elections. Everyone knows that our country spends more on health care as a percentage of GDP than other dev...
Monday, January 07, 2019 Cleverley Uncategorized No comments
Earlier this month, the CMS issued another responses to frequently asked questions on its website.  Knowledge of – and access to – this latest posting have been limited, however, there is important information administrators have been learning from this latest update.  The information in this latest update were largely not part of the original final rule language, nor part of the first response...
Wednesday, November 28, 2018 Cleverley Uncategorized No comments
We had several questions following our webinar on the FY 2019 IPPS Final Rule regarding drugs and supplies. We created a matrix to help you understand the options based on billing methodology. If you’d like to watch the full webinar, you can see it here! Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Google+ (Op...
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...

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