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At the Margins

Our latest insight into health care margin improvement efforts

Focus on quality to protect your revenue: The evolving role of CDI

Samantha Hauger August 26, 2014

It’s a common theme in my discussions with CFOs and CEOs across the country: health care is moving from fee-for-service, volume-based reimbursement to quality-based reimbursement. The days of higher volumes equating to more revenue will soon be fully in our rear-view mirror.

This change may already be having a huge impact on your reimbursement. And if it hasn’t yet, it likely will soon: 75% of hospitals polled in a recent Advisory Board study expect to have shared savings contracts in place by 2017.

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Tell us where you stand with clinical documentation

August 15, 2014

While accurate physician documentation has always been critical to reimbursement, the transition to risk-based payments makes it essential to quality as well.

In light of this renewed focus on clinical documentation improvement (CDI) programs, we invite you to take our four-minute CDI survey to increase understanding about the current landscape.

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The critical item missing from your executive agenda

Ed Hock August 8, 2014

As we move towards a system of accountable care, executive priorities are shifting rapidly. Some agenda items have fallen off the list, while others have quickly leapt to the top. Where does accurate documentation of quality metrics fall on your list?

As I speak to executives across the country, more and more are telling me engaging with physicians to ensure high-quality documentation is at the top of their list. Why? Well, for one, we all know that properly documenting quality is critical for reimbursement. And now, with increasingly available quality reports and the shift towards performance-based payment, it’s never been more important to have top notch documentation.

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New penalties and cuts: How Medicare payments will change in 2015

August 6, 2014

CMS on Monday released the final rule for the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2015.

Overall, CMS projected that payments to acute-care hospitals would decrease by $756 million and that payment to long-term care hospitals would increase by $62 million.

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Court strikes down major part of the ACA

July 25, 2014

Two major legal rulings issued on Tuesday disagree on whether a significant part of the Affordable Care Act is legal, and raise the likelihood that the Supreme Court may hear another major challenge to the health reform law.

In a 2-1 decision issued on Tuesday morning, a three-judge panel at the U.S. Court of Appeals for the District of Columbia Circuit ruled that subsidies to help Americans purchase coverage through the ACA federal insurance exchanges are illegal.

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What CEOs should know about their CFOs

July 11, 2014

Managing Director Christopher Kerns recently finished a series of interviews with dozens of hospital and health system CFOs to find out how their roles are changing.

Two of his top takeaways? CFOs are spending more time than ever with physicians, and they're expected to increase their involvement in strategic planning. 

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'It's not my fault!': Four tips for talking to physicians about performance

Sandra Miller July 1, 2014

We all know that sharing performance data with physicians can lead to meaningful documentation improvement. But what do you do when your physicians don’t want to listen?

When approached with performance data, physicians may respond with anything from full acceptance to flat-out denial—as we know firsthand from conversations with physicians through our Physician Documentation Initiative.

Regardless of physicians' initial responses, we've also seen how slight tweaks to your messaging make a difference in ensuring your physicians buy in to improving their performance data.

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Hospitals offer 'patient-friendly' payment plans

Robin Brand June 25, 2014

Some medical professionals offer medical credit cards and lines of credit that allow patients to pay for procedures not covered by insurance. First made popular about a decade ago for cosmetic surgery and other elective procedures, the cards and loans can now be used to cover out-of-pocket expenses for basic care.

But such cards often come with interest rates of up to 30%—and that amount can increase substantially if patients miss payments.

Now, an increasing number of hospitals are offering a more "patient-friendly" option: no-interest payment plans that make it easier for patients to pay their expenses.

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