By Aaron Brandwein Up until this point, our discussion about analytics in healthcare has revolved heavily around clinical analytics—and understandably so. The potential promises it brings to the table are huge, especially when you look at things like predicting clinical outcomes, identifying the risks for diseases and ailments, and helping practitioners choose better treatment … [Read more...] about Not ready for clinical analytics? Try operational analytics
Increasing profits
How to choose a healthcare analytics provider: A checklist
By Kevin Keenahan An effective analytics provider promises to bring novel data sets and insights to the table, optimize workflows, build efficient processes, and deliver superior financial returns in evolving value-based payment models. The challenge for buyers The “analytics” is a complex, nebulous family of functionality and the marketing noise surrounding many … [Read more...] about How to choose a healthcare analytics provider: A checklist
Denial management: the missing ingredient in revenue cycle management
By John McDaniel The blueprint for effective Revenue Cycle Management (RCM) is complex in today’s healthcare environment. When we map out the RCM process, it includes the following steps: Patient scheduling and registration Insurance eligibility and benefit verification Collection of copayments and deductibles at time of service Claims submission Remittance processing … [Read more...] about Denial management: the missing ingredient in revenue cycle management
5 tech resources improving medical practice efficiency this year
By Alison Foster bio There was a notable increase in the adoption of healthcare technology by practices and providers in 2020. This continues in 2021, especially as the COVID-19 pandemic shows no signs of letting up. Many practices are short on both human and financial resources and need to increase efficiency to the maximum. Here are some forms of healthcare technology you … [Read more...] about 5 tech resources improving medical practice efficiency this year
Medicare payment upped for COVID-19 vaccine
The Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting … [Read more...] about Medicare payment upped for COVID-19 vaccine
The physician enterprise model: a non-employment alternative
By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a … [Read more...] about The physician enterprise model: a non-employment alternative
The new paradigm for physician compensation: payment for value/quality v. volume
By John McDaniel bio How will physician compensation arrangements be impacted by quality incentive payments with respect to determining Fair Market Value and commercial reasonability? The enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) in November 2016 set forth future options for payment from Medicare, those being participation in the Merit‐Based … [Read more...] about The new paradigm for physician compensation: payment for value/quality v. volume
New deadline of Dec. 13 to update APM Incentive billing info
Is your office among the clinicians that need to verify Medicare billing information by Dec. 13 in order to receive payments? The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program website includes 2020 Alternative Payment Model (APM) Incentive Payment details. To access information on the incentive amount and organization paid, clinicians and surrogates … [Read more...] about New deadline of Dec. 13 to update APM Incentive billing info
Impact of 2021 evaluation and management coding changes to WRVU based physician compensation
By John McDaniel bio As you may know, all physician contracts which include any form of WRVU based compensation will need to be reviewed and probably amended due to the increase in WRVUs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. We recently conducted an assessment for one of our hospital clients which showed the ʺunintended … [Read more...] about Impact of 2021 evaluation and management coding changes to WRVU based physician compensation
Deadline Oct. 5 to ask for MIPS targeted review
If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website. This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment … [Read more...] about Deadline Oct. 5 to ask for MIPS targeted review