At the Margins

Our latest insight into health care margin improvement efforts

The 2021 Outpatient Proposed Rule: Our 3 key takeaways

by Stu Clark, Shay Pratt, and Lauren Robinson August 5, 2020

Yesterday, CMS released the proposed rule for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) for calendar year (CY) 2021. While our team continues to analyze the 785-page rule, there are several key items that health system and hospital leaders should know.

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The winners (and losers) in Medicare's 2021 inpatient proposed rule

by Lauren Robinson, Robert Ryan, Sebastian Beckmann, Ashley Riley, and Emily Heuser May 28, 2020

CMS recently released the Inpatient Prospective Payment System Proposed Rule (IPPS) for fiscal year (FY) 2021—and Advisory Board's experts combed through the proposal to identify the "winners" and "losers" in the proposed rule. 

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4 takeaways from revenue cycle leaders navigating Covid-19

by Robin Brand and Lauren Robinson May 22, 2020

At hospitals and health systems across the country, revenue cycle leaders are finding solutions to problems brought on by the new coronavirus epidemic.

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Facing a Covid-19 'cash crunch'? Here are 7 ways to respond.

by Robin Brand and Lauren Robinson May 14, 2020

Covid-19 has pushed the revenue cycle into uncharted waters, and leaders must adapt operations to account for the immediate cash crunch—and we can help.

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Our 6 takeaways from the 1,602-page Inpatient Proposed Rule

by Emily Connelly, Lauren Robinson, Stu Clark, and Ye Hoffman May 12, 2020

On Monday, CMS released the Inpatient Prospective Payment System Proposed Rule for Fiscal Year (FY) 2021. As we've seen with other recent policy updates, CMS largely did not include any major overhauls or provisions as providers and the agency focus efforts and resources on Covid-19 response.

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2 ways hospitals can help Covid-19 patients with their bills (without suspending billing)

Rachel Matthews March 30, 2020

Over the past two weeks, several major health systems announced that they are suspending all patient bills related to COVID-19 testing and treatment. CommonSpirit Health, Bon Secours, Providence St. Joseph Health, Prisma Health, and Advocate Aurora make up the growing list, with several others no doubt on the way.

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How to bill for Covid-19 testing and treatment

by Rachel Matthews March 20, 2020

Editor's note: This blog was updated on May 19, 2020.

In a race to support the hospitals testing and treating COVID-19 patients, CMS and the American Medical Association (AMA) have announced new billing codes for COVID-related services. We've compiled the codes below to help providers document and track care delivery in this important time.  

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Want to reduce inpatient denials? Target these 3 service lines.

by Rachel Matthews February 19, 2020

A successful denials strategy centers on denials mitigation, not management. Reworking claims during appeals is both timely and costly. As one organization recently told us, "As soon as you're appealing the denial, you've already lost."

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