At the Margins

Our latest insight into health care margin improvement efforts

CMS hospital outpatient rule dropped this morning: 3 highlights you need to know.

by Eric Fontana and Kenna Hawes November 2, 2018

CMS this morning released its final regulations for payments to hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). CMS is adopting several key measures to curb surging HOPD spending amid modest rate updates for HOPDs and ASCs. Overall, HOPD rates will increase by 1.35% in 2019 while ASC services will rise by 2.1%, owing to a new rate update methodology. These updates will take effect on January 1, 2019.

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Want to perfect your patient financial experience? Help us help you.

by Robin Brand and Rachel Matthews October 12, 2018

As hospital margins continue to tighten, health systems face enormous pressure to offer a best-in-class patient experience that also ensures compensation for provided care. Between mobile scheduling, consolidated billing, and personalized financial counseling, satisfying today's patients can be tricky. Providers looking to improve their patient financial experience should ask two key questions: Which financial tools and resources do my patients want? Which of those tools will actually help get me paid?

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Prepare for January 2019: Take steps now to craft your price transparency response

By Robin Brand and Kenna Hawes October 9, 2018

In April 2018, CMS informed hospitals across the country that, effective January 2019, each hospital must post "standard charges" for all hospital inpatient and outpatient services online. A recently published FAQ on the topic contains additional detail. Here are the highlights:

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Q&A with Gerilynn Sevenikar: An inside look at Sharp Healthcare's revenue cycle operations

Robin Brand August 15, 2018

In an interview with Advisory Board's Robin Brand, Gerilynn Sevenikar, VP of revenue cycle at Sharp Healthcare, spoke about Sharp's "win-win" pilot program aimed at minimizing denials, the health system's plan to improve the patient financial experience, and how Sharp cut employee turnover—by "gamifying" revenue cycle productivity.

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Hospitals enter a new world order of margins

by John Johnston August 1, 2018

Experienced health system executives have become quite adept at flexing their "margin muscles" when necessary. In recent years, revenue has typically grown at a higher rate than expenses, with only occasional periods of slower revenue growth.

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3 cuts to hospitals in the just-released 2019 HOPPS Proposed Rule

by Eric Fontana and Kenna Hawes July 26, 2018

Yesterday evening—about three weeks later than usual—CMS released its latest set of proposed regulations for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) in calendar year (CY) 2019.

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Announcing Advisory Board's 2018 Revenue Cycle Executive Summit

by Eric Fontana and Robin Brand July 25, 2018

With hospitals and health systems experiencing continued margin pressures, progressive organizations are turning more attention to an often-overlooked asset: the revenue cycle. To reflect the urgent need for continuous improvement in health system revenue cycle performance, we will host the 2018 Revenue Cycle Executive Summit in Washington, D.C. on October 23 and 24.

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Penn Medicine's secret to better value management: Deliberate collaboration

by Rick Conlin, Partner at Optum Advisory Services July 11, 2018

With all the news of a grim financial outlook ahead for health systems, and especially the acceleration of cost growth, value management leaders are confronting the need to rein in spending in a meaningful way. This need is annual—and repetitive.

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