At the Margins

Our latest insight into health care margin improvement efforts

Map: What could the AHCA mean for hospital finances?

Eric Fontana May 23, 2017

While we await the latest Congressional Budget Office (CBO) analysis of the American Health Care Act (AHCA)—passed recently by the House—and watch as the Senate takes up the health care discussion, we've received many questions from our members about how insurance coverage and hospital financial performance have changed since the passage of the Affordable Care Act.

Many are anxious to see how key hospital financial metrics may be impacted if Medicaid expansion is rolled back and commercial insurance coverage declines, as expected if the AHCA becomes law.

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Surprising service line consequences of the new inpatient proposed rule for 2018

by Eric Fontana and Trevor Goldsmith May 18, 2017

We continue to analyze and assess CMS's Inpatient Prospective Payment System Proposed Rule for FY 2018 and just completed our webconference on the proposal which is available on-demand. We wanted to pull up for a moment to offer some early commentary on updates to the payment rates as outlined in the proposal, as we've already received several questions from members looking for clarity.

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Taking stock of surgery: Is it time to revisit your assumptions?

John Johnston, CPA, MHA May 3, 2017

Health system leaders have long known the financial importance of strong surgery volume. Through the years, most hospitals not only have streamlined operations within the operating room (OR) to maximize throughput, grow capacity, and attract new business but also have expanded their reach in the market. The question facing hospitals today is: Has our approach to surgery kept up with the new reality? 

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What your CFO needs to know about risk adjustment

Brad Howard, MD, MBA April 27, 2017

If you've joined any one of our recent Health Care Advisory Board National meetings, you've heard exactly why figuring out your Medicare risk strategy is critical to value-based reimbursement. In addition to forming an effective Medicare risk strategy, CFOs of health care organizations with risk-based contracts need to be paying close attention to risk adjustment.

In my experience leading our Clinovations consulting work that helps organizations more accurately document risk, I find most CFOs don't clearly understand the impact accurate risk adjustment has on their financial performance under risk-based payment models. But once the CFO truly understands the potentially far-reaching benefits of accurate risk documentation and capture, risk adjustment often becomes a top organizational priority.

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Early impressions: CMS's FY 2018 Inpatient Proposed Rule

Eric Fontana April 17, 2017

CMS released its Inpatient Prospective Payment System (IPPS) Proposed Rule earlier than in recent years. Once more, we're happy to wade through its 1,837 pages so you don't have to. Join us for our annual review of the proposal on Wednesday, May 17, at 3 p.m. ET. We'll examine what's on the table for Medicare inpatient payments in the coming fiscal year.

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Breaking down CMS's latest bundle delay

by Eric Fontana and Jordan Kreke April 12, 2017

We are still hearing from providers who are seeking to understand CMS's announcement on March 21 delaying the recently finalized Episode Payment Models. We thought we would answer some of the most common questions here.

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The real threat to Medicare? It may be commercial price growth, MedPAC says

by Eric Fontana and Trevor Goldsmith March 30, 2017

With the Affordable Care Act repeal fight on pause, providers may now have time to pay attention to a message that the Medicare Payment Advisory Commission (MedPAC) has developed over the past several years. Tasked with ensuring the long-term viability of the nation’s biggest payer, the Commission has been suggesting that the real threat to the program may be commercial price growth.

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3 trends we're following as our 2017 Revenue Cycle Survey kicks off

Eric Fontana March 20, 2017

Since 2006, Advisory Board has compiled and published data on revenue cycle performance from hospitals across the country. Our revenue cycle benchmarking data collection for 2017 is now live.

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