HEALTHCARE

Key Factors that Drive Reimbursement in the PDPM Model

PDPM or Patient-Driven Payment Model is the new Medicare reimbursement system. It introduces a number of changes compared to the historical RUG-IV model. It is designed to address each patient’s unique needs independently and encourages more specialized, patient-driven care.   Under PDPM, each patient is classified into a group of each of the five case-mix [...]

2019-12-06T13:20:57-05:00December 6th, 2019|HEALTHCARE|

Healthcare Data Breach: You Could Be Ripe for the Picking

Hospitals and health systems across the country have increasingly reported sophisticated malware attacks, many of which seem to originate from groups in Russia, China, and eastern Europe. These attacks generally fall into one of two broad categories. The first is an intent by the criminals to obtain names, addresses, and social security numbers of patients, [...]

2019-11-18T21:43:14-05:00November 18th, 2019|HEALTHCARE|

Helpful Tips for Completing Medicare Cost Reports

If you have ever looked at a Medicare Cost Report (MCR), you likely cringe at the thought of having to fill out copious amounts of forms and data. If the sheer volume doesn’t faze you, the pressure to produce a comprehensive and entirely accurate report is enough to make most healthcare providers a little uneasy. [...]

2019-11-15T10:15:56-05:00October 29th, 2019|HEALTHCARE|

Impact of the New Revenue Recognition Standard on the Healthcare Industry

The Financial Accounting Standards Board (FASB) issued ASC 606, Revenues from Contracts with Customers, which replaced all previously-existing guidance and created a new model for recognizing revenues from transactions with customers (or patients). Healthcare providers are unique in the accounting world in many ways, most notably for the complexities surrounding the revenue cycle (billing and [...]

2019-10-01T10:25:26-05:00September 11th, 2019|HEALTHCARE|

Improve Patient Accounts Receivable and Keep Cash Flowing into Your Medical Practice

As healthcare reimbursements continue to decrease and the responsibility of healthcare costs shift to patients, medical practices must properly manage and improve patient accounts receivable to keep cash flowing. Many employers are moving away from traditional health insurance plans as employer insurance costs continue to rise. High deductible health plans (HDHP) offer lower premiums to [...]

2019-09-04T14:02:09-05:00September 4th, 2019|HEALTHCARE|

New Opportunities Arise if Hospitals Embrace Pricing Transparency

In a sweeping effort aimed at empowering consumers (patients), hospitals are now required by the federal government to post their standard service costs online. This new transparency rule seeks to provide the public with a more traditional consumer experience, unveiling more information for patients to consider when making critical healthcare decisions.  But, the question is, [...]

2019-08-30T11:48:23-05:00August 30th, 2019|HEALTHCARE|

Four Steps to Facilitate Medical Practice Strategic Planning

With today's rapidly changing healthcare environment, physicians must spend time working on, not just in, their practices. Medical practice strategic planning can be a challenge, but analyzing the practice’s current standing and deliberately forecasting for future endeavors can be the equivalent of a hole-in-one for a medical practice. Step 1: Evaluate the current competitive market.  [...]

2019-09-03T12:12:20-05:00August 12th, 2019|HEALTHCARE|

Medicare Wage Index

The CMS “wage index” remains a vital (and controversial) component of how hospitals receive payment for services to Medicare beneficiaries. CMS recognizes that labor costs vary from one area to the next. So, as a part of the methodology for determining IPPS (inpatient prospective payment) reimbursement, standardized amounts are adjusted for area differences in facilities’ [...]

2019-08-14T11:53:56-05:00July 26th, 2019|HEALTHCARE|

Five Steps to Lift Self Pay Patient Collections in Medical Practices

Self pay patients were once a small percentage of a medical practice’s patient mix. However, in today’s market, the number of self pay patients is rising due to increases in health plan costs and the number of high-deductible healthcare plans. Medical practices can elevate self pay patient collections by implementing the below five steps. 1. [...]

2019-09-03T15:01:28-05:00July 9th, 2019|HEALTHCARE|

How to Arrange a Medical Practice Buy-Sell Agreement that Minimizes Disputes

Many medical practices are seeing an influx of new patients in the wake of healthcare reform. Some practices may respond to this influx by adding more physicians to their staffs. Recruiting and retaining physicians requires the skill of a conductor to keep all areas of the practice playing in unison. Just as a musician needs [...]

2019-09-03T12:01:04-05:00March 18th, 2019|HEALTHCARE|

Build Medical Practice Productivity with Non-Physician Providers

Every healthcare practitioner should work at the top of his or her license. That’s why non-physician providers - or NPPs - are essential to medical practice productivity. NPPs include nurse practitioners, nurse midwives, physician assistants, and physical therapists. These providers possess a skill set along the clinical continuum between registered nurses and doctors. Create a [...]

2019-09-03T16:11:24-05:00March 15th, 2019|HEALTHCARE|

Captive Insurance Overview: Healthcare Provider Industry Highlights

Healthcare provider captive insurance arrangements represent approximately 15% of the global captive insurance market and are currently one of the largest growing sectors within the captive industry due to the changing risk landscape that healthcare organizations are facing. Approximately 75% of hospitals now have some form of alternative risk management in place for their professional [...]

2019-08-14T11:52:08-05:00March 15th, 2019|CAPTIVE INSURANCE, HEALTHCARE|

Medical Practice Profitability

How can you create medical practice profitability? They can begin targeting sound financial management practices and patient growth strategies that improve overall practice efficiencies. Pinpoint Financial Management Create a budget by checking the previous 12-month financial statement and then setting revenue and expense goals. The budget should include physician compensation and every line item. Scrutinize [...]

2019-09-03T13:46:05-05:00March 9th, 2019|HEALTHCARE|

Seven Keys to Improving Medical Practice Cash Flow

No matter what specialties their physicians may have, healthcare practices must focus on collecting payments to remain profitable. Here are seven ways that practices can more accurately track patient collections. 1. Educate Personnel Personnel plays a significant role in the collection process. Delegating collection responsibilities to different staff members can improve a practice’s collection performance. [...]

2019-03-14T15:11:44-05:00February 23rd, 2019|HEALTHCARE|

Physicians: Remember to Add Quickbooks Accountant’s Copy to Toolbox

Medical practices often look for ways to maximize operational efficiencies, and they often need professional assistance with their accounting records – monthly, quarterly, or annual. How can a practice that uses QuickBooks® accounting software save time and money? The answer is by using an often overlooked feature known as the QuickBooks Accountant’s Copy (QAC). It allows [...]

2019-04-05T10:07:00-05:00February 12th, 2019|HEALTHCARE|

Keeping a Close Eye on Medicare Fraud

Medical practices face many dilemmas in today’s healthcare landscape–from decreased reimbursements to increased patient demands—while fighting extinction in the current competitive environment. Overlooking certain operational efficiencies can lead to revenue loss, but not keeping those binoculars focused on changes to Medicare regulations can also lead to compliance issues–and even fraud. Observe Common Medicare Fraud Red [...]

2019-09-03T16:16:31-05:00January 5th, 2019|HEALTHCARE|

Medical Practice Consolidation

Medical practices must balance the impacts of healthcare reform, decreased reimbursements, payer negotiations, and other issues to remain profitable. While some physicians have decided to leave the private practice circus and work at a hospital, others are considering merging with or acquiring medical practices. Combining practices can create a greater revenue-generating entity with potential cost-saving [...]

2019-09-03T13:27:09-05:00December 13th, 2018|HEALTHCARE|

Medical Practice Fee Schedule Annual Review

In the wake of healthcare reform and delayed or reduced reimbursements, many medical practices may feel like pressure surrounding fee schedules. One way they can ease into this new reality is by examining fee schedules on an annual basis and adjusting accordingly for maximum benefit. Determine Top CPT Codes and Costs The first step of [...]

2019-09-03T16:00:12-05:00December 8th, 2018|HEALTHCARE|

Achieving a Five-Star Quality Rating for Your Nursing Home

Long-term care facilities are also in constant pursuit of a much-desired five-star rating. The Centers for Medicare & Medicaid Services (CMS) developed the Five-Star Quality Rating System as a tool for consumers to compare nursing homes and make better-informed decisions. Consumers can visit the Medicare Nursing Home Compare website to research the ratings for different [...]

2019-02-13T11:18:31-05:00September 12th, 2016|HEALTHCARE|

How CMS’ New Arrival Will Affect Medicare DSH

The Centers for Medicare & Medicaid Services (CMS) recently published their 2,434-page fiscal year 2017 Hospital Inpatient Prospective Payment System (IPPS) Final Rule. The hospital community eagerly anticipated this new arrival, especially its expected changes to Medicare disproportionate share hospital (DSH) payments. To illustrate the potential impact of the 2017 IPPS rule, we’ve highlighted three [...]

2018-11-12T15:47:29-05:00August 26th, 2016|HEALTHCARE|