Downloadable Versions of all White Papers
CY24 OPPS Final Rule (CMS-1786-FC) Updates
Cleverley CY24 OPPS Final Rule – Updates to Hospital Price Transparency Requirements – Summary of Key Updates The CY24 OPPS Final Rule contains additional requirements for hospital Price Transparency. We cover the changes here as well as requirements previously established by the rule.
A Response To The CY24 OPPS Proposed Rule (CMS-1786-P)
The CY24 OPPS Proposed Rule contains additional information and requirements regarding hospital price transparency. Here we provide a summary of all the elements contained in the CY24 OPPS Proposed Rule as it relates to hospital pricing transparency and include our proposed comments to CMS to assist others as they consider comments for their organizations.
Hospital Finance Research White Papers
Our response to the CY22 Proposed rule. The CY22 OPPS Proposed Rule contains additional information and requirements regarding hospital price transparency. The proposed changes relate to current requirements found in CY 2020 OPPS Final Rule on Transparency (CMS-1717-F2).
How To Use Contract Testing And Analysis To Prepare For Payment Changes
Why Removing Percent-of-Charge Provisions in Managed Care Contracts Won’t Address Concerns About High Hospital Charges
A Response To The CY20 OPPS Proposed Rule (CMS-1717-P) For Increased Price & Payment Disclosures
How Hospitals Can Create Cost Advantage Where Product Differentiation
National Hospital Survey Shares Insight into CMS’s Price Transparency Requirement
Negotiation Skills Have an Impact on Health Plan Terms
Understanding Why Hospital Costs are Increasing – It Depends on the Metrics
Webinar: The FY19 IPPS Final Rule
A response to the FY19 IPPS Proposed Rule (CMS-1694-P) for Requirements for Hospitals to Make Public a List of Their Standard Charges via the Internet
11 Metrics Reveal the Best Strategies For Cutting Outpatient Prices
Health systems must decide which hospitals should be targeted and how quickly price reductions can be implemented.
Mystery Markups: Medical Supply and Drug Pricing Policies Vary Across Hospitals
In general, medical supplies and pharmaceuticals represent 20 percent of gross charges. Even the slightest change in markup policies could have enormous financial impact.
Mystery Markups: Medical Supply and Drug Pricing Policies Vary Across Hospitals
Closing the Price Gap for Commodity Services
The competitive pricing ordered by freestanding clinics has many hospitals looking to lower their own prices.
Essential Elements of Charge Protection Language
Health plan contracts include charge limit provisions to ensure chargemaster increases above a predetermined amount will not lead to higher payments than were negotiated.
Identifying the Gap Between Hospital and Free-Standing Prices
Commodity services such as imaging and lab work are often considered for reduced pricing.
Identifying the Gap Between Hospital and Free-Standing Prices
In Light of Transparency, How Are Hospitals Changing Their Prices?
Analysis reveals that hospital prices are spreading further from the average.
In Light of Transparency, How Are Hospitals Changing Their Prices?
Analyzing Medicare Margins
Data reveal hospital characteristics that affect margins.
Pricing Commodity Outpatient Procedures: Assessing the Impact
Hospital executives are facing unrelenting pressure to reduce prices and payments for outpatient services, which have begun to be viewed as commodities. Here are ve components of a thoughtful strategy.
Pricing Commodity Outpatient Procedures: Assessing the Impact
The ‘Lesser of’ Conundrum: Solving the Puzzle Through Payment Terms and the Chargemaster
Evaluating the nancial impact of ‘lesser of’ provisions requires a thorough review of contract language and how that language is applied.
Pricing Commodity Outpatient Procedures: Assessing the Impact
Hospital executives are facing unrelenting pressure to reduce prices and payments for outpatient services, which have begun to be viewed as commodities. Here are ve steps to a thoughtful analysis.
Insights into Hospital Retail Pricing Strategies
An analysis of the retail pricing strategies of 156 hospitals and health systems points to the need for a thoughtful approach to balancing prices, costs,
and operating margins.
Insights into Hospital Retail Pricing Strategies
Bundled Payments and Big Data
Big data can help healthcare providers determine what factors drive total episodic cost and whether those cost drivers can be controlled.
How Hospitals Approach Price Transparency
The issue of price transparency has become more prevalent in health care recently, but hospitals may have different views of the concept depending
on their relative charge levels.
How Hospitals Approach Price Transparency
Time to Replace Adjusted Discharges
A new metric for measuring total hospital volume correlates significantly better with cost than do adjusted discharges—without the same inherent flaws.