A good read from a bright person on medical reimbursement. Check it out.
Financials
Article – Value-based payment models expected to reach tipping point by 2018, study finds
Here’s an article on a study on the adoption rate of value-based payment models.
Note that the original study is provided by a vendor (Availity™) of a revenue cycle management solution—to read the study you need to register on the vendor’s Web site.
Article – Hospital Billing Varies Wildly, Government Data Shows
One of the thorns in the side of payers is the wide disparity of money charged for the seemingly same procedure among different hospitals—even among those in the same city.
This New York Times article explores some U.S. government data that was recently released, showing procedures at one facility costing multiple times more than the same procedures at another.
If you go through the multimedia widget (the little map on the left), you can explore what specific hospital’s charge for a given procedure, how many cases were in the sample size, and the variance to the norm. The authors did a good job designing this tool.
Article – MRI Payment Cuts Having Dramatic Effect on Radiology Groups
Last month, I posted about reimbursement cuts to two popular MRI exams.
In this article, the impact of these changes to Radiology groups are explained fairly clearly. Worth a read if you make your living (directly or indirectly) from Radiology services reimbursement.
Article – Outpatient services will dominate 2013, survey says
Healthcare providers are shifting their focus from providing inpatient services to providing outpatient services—and their investment priorities reflect this, according to a survey.
Some key stats from this article…
- 69% of survey respondents projected an increase in outpatient volume for 2013, while only 35% predicted an increase in inpatient volume
- 43% of respondents plan to make health IT their biggest capital investment in 2013, up from 21% two years ago
- 22% of respondents were part of an Accountable Care Organization, and 55% planned to be part of one by 2014
Article – EHR part of MaineHealth’s financial woes
This article describes a “perfect storm” of factors that lead to the health system’s financial loss…
…”the operating loss is due to declines in inpatient and outpatient volumes because of the hospital’s efforts to reduce readmissions and infections; “unintended financial consequences” due to the roll out of the health system’s Epic electronic health record and problems associated with being unable to accurately charge for services provided; an increase in free care and bad debt cases; and continued declining reimbursement from Medicare and MaineCare, the state’s Medicaid program”
Don K Dennison 