At the Margins

Our latest insight into health care margin improvement efforts

Online chargemasters mean little to patients—and Congress is noticing

by Robin Brand and Rachel Matthews January 30, 2019

CMS' 2019 price transparency requirement spurred a lot of questions from our members, who were concerned about both compliance and whether or not public chargemasters would actually help patients, or just confuse the already muddy health care cost waters. RCAC continues to monitor the impact of the requirement and how it evolves.

We recently attended The Price of Good Health: Health Policies & Politics in the 116th Congress, a panel event hosted by the Council for Affordable Health Coverage. Portions of the panel focused on the CMS requirement, and several policymakers expressed frustration with the proliferation of electronic chargemasters in lieu of true hospital price transparency. Here are our key takeaways after listening to their conversation:

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What matters (and doesn't) in your patients' financial experience, according to our 1,000-patient survey

by Rachel Matthews December 12, 2018

To offer a best-in-class patient financial experience, it's critical to understand the patient. Every patient comes with a unique financial perspective—differing needs and priorities that providers must navigate. In 2018, our research team set out to chart consumer financial preferences by surveying 1,000 adult patients who underwent a non-emergency surgery within the past 18 months. Our survey had two main components:

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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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