Service Line Transformation

About This Blog

Welcome to the Marketing and Planning Leadership Council’s blog, Service Line Transformation. This blog serves as the primary communication channel for our Service Line Transformation Initiative, a special multi-year research effort dedicated to helping organizations prepare key service lines for risk-based payment. We will address challenges ranging from growth strategy innovations for key services lines to chronic care strategy, service line leadership, innovative approaches to service line marketing, and more.

For more information on the Service Line Transformation Initiative, or to send us questions, comments, or leads on innovative service line and care delivery models, please email Eric Sanford.

Recent Posts

Benchmarking strategic capital: How much should we spend?

on February 21, 2013  |  Permalink

Topics: Marketing, Planning, Strategy, Leadership, Workforce, Budgeting, Finance

Shay Pratt, Marketing and Planning Leadership Council

A member health system executive recently asked us, “what percentage of the capital budget do other hospitals typically devote to strategic capital?” This question is not surprising in light of recent reports that capital spending this year will continue to be restricted.

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Benchmarking strategic capital: How much should we spend?

Incentive fees mitigate risk to hospitals in co-managed ASCs

on September 19, 2012  |  Permalink  | Comments (1)

Topics: Marketing, Planning, Strategy, Finance, Strategy Development, Physician Issues, Hospital-Physician Alignment, Collaborative Relationships

Madhavi Kasinadhuni

Co-management is an increasingly popular model for partnerships between hospitals and physician-owned ambulatory surgery centers (ASC). Under co-management, hospitals maintain full ownership of the ASC and management services are contracted to the physician group. Hospitals should negotiate a two-level payment model for co-management compensation fees in order to mitigate risk and ensure quality.

The base fee is a fixed annual fee that reflects fair market value (FMV) for management responsibilities necessary to operate the ASC, while the incentive fee is a variable fee that reflects FMV for performance on quality and efficiency goals.

With little control over supervision and delivery of services, hospitals take a significant risk by investing in ASCs and handing over management to physicians. Incentive fees help shift some of that risk from the hospital to the physician group by making a portion of the total compensation contingent on how well physicians perform their clinical and management services.

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Incentive fees mitigate risk to hospitals in co-managed ASCs

Medicare’s Prepayment Review Demonstration: Everything we know so far

Shay Pratt on July 25, 2012  |  Permalink

Topics: Planning, Strategy, Market Trends, Payer and Regulatory Policy, Medicare, Reimbursement, Finance, Revenue Cycle

Last November, CMS announced an expansion to their Recovery Audit Contractor program called the Prepayment Review Demonstration Project. Unlike previous RAC efforts that retroactively reviewed claims for billing accuracy and appropriateness, the new demonstration would switch tactics to “prevent improper payments before they are made.”

CMS initially scheduled the demonstration, expected to more than double the amount of reviewable claims to 2.7 million, to launch on January 1, 2012, and targeted 15 inpatient DRGs, including spinal fusion and cardiac implant procedures.

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Medicare’s Prepayment Review Demonstration: Everything we know so far