Over the last decade, health systems have faced heightened demand to increase financial support in hospital-based physician services. While many hospital executives view the support as a sunk cost, if services are structured properly, they can act as a major catalyst for driving performance improvement.
Hospitals and health systems need to understand Total Performance Score (TPS), how TPS is calculated, and how it can be used to optimize strategic decisions and increase total revenue.
Price transparency is not a new concept for the healthcare provider market. There has been a year-over-year increase in consumer out-of-pocket cost and recent legislation requiring online access to provider charge master pricing.
In the closing days of 2018, CMS released its 2019 final rule for the Medicare Shared Savings Program (MSSP), thereby finalizing several significant program changes that CMS had previously proposed in August 2018.
To be successful under value-based payment, a health system requires collaborative and binding relationships with affiliated physicians; the professional service agreements the organizations enters with the physicians should be designed to firmly establish such relationships.
On December 27, 2018, the United States District Court for the District of Columbia granted a permanent injunction on the 2018 Medicare reimbursement cuts related to 340B drugs. What does this mean for the hospitals affected by these changes?
Although clinical standards are constantly evolving as medical evidence and treatments emerge, the diagnosis of sepsis has been an area of active debate over the past decade for payers, providers, and researchers.
CMS is expected to announce the final payment rules for ASCs in the next few weeks. Here are four key changes to look for when the final rules are published in November:
A forward-thinking financial model can help hospital leaders better predict and balance potential gains and losses from incentives, penalties, volume changes, and other factors related to value-based payment.
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