Transitioning to a New Medicare Benchmarking Paradigm
As commercial health plans adopt a case-rate approach to payment based on Medicare’s MS-DRGs, modifications are needed to account for how health plans’ populations differ from the Medicare population.
Time to Reassess: Keeping Up with Changes to CJR Target Pricing
Performance improvement targets have shifted again in the Comprehensive Care for Joint Replacement (CJR) program. Darcie Hurteau explains why participants should reassess their program strategies in light of this change.
Using Business Intelligence to Succeed in Value-Based Care
Gain buy in for value-based care by picking a few key areas to cost and monitor. A few easy wins builds momentum and confidence across a healthcare organization.
7 Considerations in the Financial Modeling of Value-Based Payment Arrangements
In preparing for the impact of changing to value-based payment, hospitals must be able to predict the gain or loss from related incentives, penalties, volume changes, and other factors. Seven considerations provide a guide to successfully managing the shift.
4 KPIs to Increase Profitability Under Value-Based Payment Models
Revenue cycle KPIs are evolving to assist healthcare finance leaders determine net profit rather than revenue.
5 DRGs Are Primary Contributors to Rising Average Loss per Medicare Hospital Admission
Among Medicare admissions in 2015 to 2017, costs per admission rose more rapidly than did payments, and the impact of this trend on hospitals’ financials strongest with admissions associated with 5 DRGs.
Why Fee-For-Service Remains Prominent
Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.
How to Really Know Your Payment Rates
A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.
Trends in Building and Fixture Costs, 2007-16
An analysis looked at Medicare cost reports to compared trends in capital costs for buildings and fixtures among different types of acute care hospitals.
Acute Care and Critical Access Hospital Occupancy Rate Variability by Location
An analysis of Medicare cost reports from 2016 shows that urban U.S. hospitals typically had higher occupancy rates than their rural counterparts, with notable exceptions in the Northeast and Arizona.