Patient Pay. Click to edit subtitle. Pete Thompson, Sr. Solutions Architect March 14, 2017
|
|
- Anabel Ross
- 6 years ago
- Views:
Transcription
1 CLICK Trends TO and EDIT Best HEADLINE Practices to Encourage Patient Pay Click to edit subtitle Pete Thompson, Sr. Solutions Architect March 14, 2017
2 91%Healthcare is a big ticket expense Page 2
3 Agenda New Significance of Patient Pay Healthcare consumerism Growth in high deductible plans Financial dynamics Health System Response Improving the patient financial experience Internal workflow Focus on RCM improvement Creating an Effective Return on Investment Model Identifying areas of focus Utilizing proven strategies Creating and measuring to a benchmark Proven results Page 3
4 Sources: Page 4 Kaiser Family Foundation and New York Times, Copyright Gallup, 2017 Robert ClearBalance. Wood Johnson All rights reserved. Foundation ClearBalance is a registered service mark.
5 Patients Feel Financial Pressure, Too HDHPs on the Rise No end to HDHPs increase of 25% in 10 years More people are insured, but have higher medical costs 70% of Americans who struggle with healthcare debt have insurance 81% of covered, single workers have an average deductible of $1,318 Deductible = 5% + of income Out-of-pocket = 10% + of income 30% 25% 20% 15% 10% 5% 4% 5% Percent of covered workers enrolled in an HDHP/HRA or HSA-Qualified HDHP, % 8% 13% 17% 19% 20% 21% 24% 29% 0% HDHP/HRA HSA-Qualified HDHP Sources: Advisory Board Company, Commonwealth Fund, Kaiser Family Foundation, Crowe Horwath Page 5
6 Yesterday s Reimbursement Mix 50% 45% 40% 35% 30% 25% Low Margin High Margin Profitability of Medicare and commercial reimbursement once compensated for negative patient reimbursement 20% 15% 10% 5% No Margin Negative Margin 0% Medicare Commercial Medicaid Patient % of Revenue % of Cost Source: National Hospital Discharge Survey, Midwest Region 2009 Page 6 Copyright 2017 ClearBalance. All rights reserved. Do not distribute without consent.
7 Living in a Two-Payer System The reimbursement mix has changed 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% No Margin Low Margin Negative Margin Must improve for profitability Today s focus must shift: improving patient reimbursement is critical to maintain profitability 0% Medicare Commercial Medicaid Patient % of Revenue % of Cost Source: McKinsey Quarterly, 2014 Page 7 Copyright 2017 ClearBalance. All rights reserved. Do not distribute without consent.
8 Consumerism Is a Priority at the C-Level Health systems are facing a push toward consumerization, fueled by more patient financial accountability. Lisa Bielamowicz, MD, Chief Medical Officer and Executive Director, Research and Insights The Advisory Board Company CEO Top 5 Priorities MDS INVOLVED TO REDUCE VARIATION REDESIGN FOR POPULATION HEALTH 53% 52% MEET CONSUMER EXPECTATIONS 47% PATIENT ENGAGEMENT STRATEGIES CONTROL AVOIDABLE UTILIZATION 42% 42% 0% 10% 20% 30% 40% 50% 60% Page 8
9 New Significance of Patient Pay Healthcare Consumerism The impact of healthcare costs Healthcare as a big ticket expense Cost increasingly is a variable in the care selection process. Most will consider cost when selecting a physician or hospital. And a good many would delay care. 91% Patient s portion of medical bills requires financing for more than 12 months PHYSICIAN 79% HOSPITAL 81% 1-IN-3 WOULD DELAY CARE without long-term financing 34% Source: Healthcare Consumerism Study, ClearBalance, Aug Page 9
10 Experience Doesn t End at Discharge Billing and collections a lingering dis-satisfier Billing Experience Linked to Overall Experience Impact of Billing Process Satisfaction on Key Indicators n=500 15% 82% 58% 95% 33% 74% Not Easy to Pay Bills 55% 61% 65% Percentage of survey respondents reporting being sometimes or always confused by medical bills Percentage of survey respondents reporting being sometimes or always surprised by out-ofpocket costs Percentage of survey respondents indicating that clear, easy-to-understand bills would have positive impact on provider selection Would Recommend Would Return Paid Full Bill Unsatisfied with Billing Fully Satisfied with Billing Source: The Advisory Board Company Page 10 Source: Connance Inc., 2014 Connance Consumer Impact Study, 2014; TransUnion Healthcare Survey 2013; TransUnion Healthcare Cost Survey, 2015; Health Care Advisory Board interviews and analysis.
11 Improving the Financial Experience: Patient s Perspective Cultural overhaul acknowledging patients need and want financial assistance Novant Health revenue cycle revolution focused on patients who want to pay vs. those who will ultimately go to bad debt Ascension Health waived any financial responsibility for their bill for patients who fall below 250 percent of the poverty level Florida Hospital patient pay strategy evolved from collections to payment resolution Multiple payment options including online, mobile and payment plans Page 11
12 Traditional Revenue Cycle Collection Model Pre-Registration and Point of Service Business Office Primary and Secondary Bad Debt Page 12
13 Intuitive Revenue Cycle Collection Model Pre-Registration and Point of Service Business Office Primary and Secondary Bad Debt Page 13
14 Barriers to the Intuitive Revenue Cycle Process Operational Does registration staff have the tools to collect? Can you accurately know what the patient will owe? Does your staff have the skill set to carry a financial conversation? Consumer Requiring payment in full prior to service will cause patients to avoid receiving care Patients are unwilling to pay before insurance has paid Patients may not have the means to make payment Regulatory ACA prohibits collection of bills for prior services before providing medically necessary care EMTALA prevents collections in certain situations Page 14
15 Optimized Revenue Cycle Model Pre-Registration and Point of Service Business Office Primary and Secondary Bad Debt Financial Counseling to Help Patient Understand Responsibility Robust Options for Payment, Including Online Payment, Short-Term Payment Plans and Long-Term Patient Financing Page 15
16 PoS Collections Part of Comprehensive Patient Pay Strategy Collecting $20 up front from every patient reduces bad debt <4% of NPR* Health system partners focused on front/back-end strategy Better tools and payment options empower better results Estimation tools, payment platforms, dialing technologies for pre-registration Financial counseling triage augmented with payment options Baylor Scott & White Health: nearly $200,000 PoS increase weekly Novant Health: $41.4M collections increase YoY Ochsner Health System: up front financial clearance helped reduce bad debt $11M *Source: Advisory Board Company, Oct Page 16
17 Health System Response to Two-Payer Market Reducing bad debt and improving patient satisfaction are top two motivators driving consideration of more robust long term payment options REDUCE BAD DEBT 9.0 IMPROVE PATIENT SATISFACTION 8.8 REDUCE AR DAYS 8.6 IMMEDIATE CASH INFUSION 8.3 ELIMINATE COLLECTIONS OVERHEAD 8.0 IMPROVE STAFF & PHYSICIAN SATISFACTION 7.9 Source: ClearBalance Patient Pay Research, June 2014 Page 17
18 Health System Response for Financing Options Regulatory compliance review Updates to financial assistance policy (FAP) Account for 501r Truth in Lending/Regulation Z Screening for charity care Implement presumptive screening to ensure time is spent attempting collections on the appropriate patients Long-term payment plan Confine internal payment plan: 4 months or less Provide long-term option that extends to 5 or 6 years depending on balance Page 18
19 A Word About Financial Compliance Why It s Important Truth in Lending Regulation Z: Any business that allows consumers to repay in 4+ months Proper disclosure of credit terms & consumer billing rights Failure to comply could mean actual and statutory damages, civil litigation Must ensure your payment vendors early out, etc. comply ECOA: Consistent billing practices; offer patients/customers the same payment opportunities UDAAP: Must be aware of unfair, deceptive or abusive acts or practices in providing payment plans & debt collection Fair Credit Reporting Act: Proper use and protection of consumer credit reports Gramm Leach Bliley Act: Protection of consumer personal information State laws/retail Installment Act: Certain states require compliance with certain lending laws for 4+ month repayment terms Page 19
20 Payment Plan Trends Average guarantor balance for payment plan is $1,660 Average repayment terms have increased months in 2014 to months today The patient s portion has steadily increased Adding new balances for themselves, spouse, dependents Average monthly payment amount is $85 Impact of Medicaid expansion Non-expansion states, like Tennessee, show 20% - 30% increase in payment plan Health Empowerment Act likely to accelerate payment plan growth further with growth of HDHPs Total balance owed Duration Monthly payment Page 20
21 ClearBalance ROI Value Model HFMA Peer Reviewed Distinction Nationally-recognized benchmark by a panel of CFOs and financial analysts Provides transparency and translates underlying complexity into valid modeling of results and comparisons Uncovers true cost of collecting patient pay Compares performance and value when using a patient loan program Models future impact of patient pay in a do nothing scenario Delivers output in financial and operational metrics Accommodates conversion of existing payment plans HFMA staff and volunteers determined that these healthcare business solutions have met specific criteria developed under the HFMA Peer Review process. HFMA does not endorse or guarantee the use of these healthcare business solutions or that any results will be obtained. Page 21
22 The ClearBalance Benchmark Within 24 months, providers using ClearBalance Reduce bad debt by an average of 4.46% E.g. $100M annual bad debt reduced to $96.5M Reduce net AR by 1.7 Days Achieve an average Return on Investment of 2.38x ClearBalance tracks new and existing relationships to measure performance to projections Growth in patient pay has driven up bad debt Most ClearBalance clients bad debt growth rates below the national average Page 22
23 Unlocking Value with Updated Patient Pay Strategy Large IDN Leading health system Presence in four states Patient experience top priority >2,500 licensed beds ~$4 billion of net patient revenue $327 million of average patient pay AR Patient Pay Revenue Cycle Process PoS CBO Payment Plans Collection Agency Total Collected Before financing After financing Collected $16.3mm at a cost of 5.5% Collected $25.5mm at a cost of 5.5% Collected $45.7mm at a cost of 6.5% Collected $48.0mm at a cost of 6.5% Collected $22.9mm at a cost of 9.0% Collected $44.4mm at a cost of 13.0% Collected $45.7mm at a cost of 16.0% Collected $23.8mm at a cost of 16.0% $130.6mm at a cost of 10.14% $141.7mm at a cost of 9.96% $11.1mm Improvement in Total Lower Cost Page 23
24 Proven Results Health System #1 Health System #2 Health System #3 Size 16 Hospitals & 68 Clinics Stand-Alone System 22 Hospitals Actual Performance Reduced Bad Debt $5.3mm $6.4mm $13.9mm Bad Debt Reduction 6.0% 4.5% 6.4% Incremental Cost $1.5mm $1.8mm $3.4mm Return on Investment $3.8mm $4.6mm $10.5mm Return Multiple 2.5x 2.57x 3.04x Page 24
25 Patient Feedback Russell, patient from Louisiana Harold, patient from Kentucky Heather, patient from Texas You guys were a lifesaver at a time when we were overwhelmed. If it weren t for the ClearBalance program, I m not sure I could have had my procedure. I m glad my provider suggested it. ClearBalance is amazing. I told them what I could afford and ClearBalance makes it work. Bill, patient from North Carolina Leydi, patient from Florida Male patient/account holder Millennial Regardless of how good your insurance is, how good Medicare is, you re still going to get hit with your portion of the bill. To know that there s a company like ClearBalance out there, it s kind of your safety net. ClearBalance gave us peace of mind when we were hit with such a huge bill from an unexpected illness. I wouldn't have been able to find quick financing options. I'm not one to run from my debts, and definitely wanted to repay the hospital services so the ClearBalance option was tremendously valuable. Page 25 Copyright 2017 ClearBalance. All rights reserved. Do not distribute without consent.
26 ClearBalance Company Overview Experience Matters Established in % healthcare, 100% patient loans Funded $1 billion+ to healthcare providers Since 2012 Since 2011 Since 2007 Largest, longest-tenured client base of health systems Since 2004 Since 2008 Since 2002 Ability to provide loans in all 50 states Since 2013 Since 2003 Page 26 Copyright 2017 ClearBalance. All rights reserved. Do not distribute without consent.
27 Questions Page 27
THE FAST AND THE FURIOUS REVENUE CYCLE (A.K.A.) THE REVENUE CYCLE OF THE FUTURE
THE FAST AND THE FURIOUS REVENUE CYCLE - 3.0 (A.K.A.) THE REVENUE CYCLE OF THE FUTURE INDUSTRY ANALYSIS 82% of people say price is the most important factor when making a healthcare purchasing decision*
More informationTHE FAST AND THE FURIOUS Revenue Cycle 3.0
THE FAST AND THE FURIOUS Revenue Cycle 3.0 HFMA Arkansas Fall Conference October 19, 2017 Jorge Fernandez, Business Development Principal Availity Hospital Solutions Division HFMA Lone Star Chapter Secretary,
More informationThe Self-Pay Gap: Growing Opportunity or Ticking Time Bomb?
VISITPAY.COM The Self-Pay Gap: Growing Opportunity or Ticking Time Bomb? Increasing patient obligation is creating a new economy in healthcare, one that is putting additional pressure on hospital margins.
More informationMETHOD TO THE MADNESS TODAY S PRESENTER LEARNING OUTCOMES HTH FL Boot Camp. 10 payment collection strategies that work
METHOD TO THE MADNESS METHOD TO THE MADNESS 10 payment collection strategies that work 10 payment collection strategies that work Visit availity.com to download the full e-book TODAY S PRESENTER Colleen
More informationPricing Transparency. Presented by: Brian Workinger, Professional Services Manager, Craneware
Pricing Transparency Presented by: Brian Workinger, Professional Services Manager, Craneware Agenda 1 Consumerism in Healthcare 2 HFMA Region 8 and Price Transparency 3 Best Practices 4 Methods to Price
More informationBest Practices for Optimizing Patient Payment Processes. April York, Novant Health Steve Millhouse, Experian Healthcare
Best Practices for Optimizing Patient Payment Processes April York, Novant Health Steve Millhouse, Experian Healthcare Best Practices for Optimizing Patient Payment Processes Challenges facing the healthcare
More informationImproving Self Pay At All Points of Service
A RelayHealth White Paper Improving Self Pay At All Points of Service Abstract Healthcare providers are expected to provide healthcare, and they must also collect payment for it. Unfortunately, once patients
More informationPatient Engagement Through Patient-Friendly Statements and Web Portals. Mike Simms, VP Revenue Cycle Cone Health
Patient Engagement Through Patient-Friendly Statements and Web Portals Mike Simms, VP Revenue Cycle Cone Health Cone Health Cone Health Based in Greensboro, NC 6 hospitals, over 100 practices and various
More informationMINING FOR GOLD: UNEARTH COVERAGE IN SELF-PAY ACCOUNTS
MINING FOR GOLD: UNEARTH COVERAGE IN SELF-PAY ACCOUNTS November 15, 2017 2017 Navicure, Inc. All Rights Reserved. Today s Speaker LISA WATERFIELD Enterprise Revenue Cycle Consultant ZirMed Agenda Self
More informationStreamlining Patient Payment for Better Revenue Cycle Management
Healthcare The importance of a payment assurance strategy Healthcare providers need to rethink their current patient payment collections strategy, thanks to two recent phenomena: highdeductible plans that
More informationPoint of Service Collections
The Front-End Revenue Cycle Specialists Point of Service Collections Paul Shorrosh, MSW, MBA, CHAM CEO & Founder, AccuReg POS Collections What are we trying to do? Customers want three things: Product
More informationCRCE Exam Study Manual Update for 2018
CRCE Exam Study Manual Update for 2018 This document reflects updates made to the instructional content from the Certified Revenue Cycle Executive (CRCE-I, CRCE-P) Exam Study Manual - 2017 to the 2018
More informationHSA BANK HEALTH & WEALTH INDEX SM. HSA-Based Plans Drive Engagement Among Consumers
HSA BANK HEALTH & WEALTH INDEX SM HSA-Based Plans Drive Engagement Among Consumers 2018 TABLE OF CONTENTS Introduction... 1 Overview... 1 Outcomes... 2 Key Findings... 7 1: Consumers can improve their
More informationCritical Revenue Cycle Success Strategies In An Era Of Integrations
Critical Revenue Cycle Success Strategies In An Era Of Integrations Thursday, February 16, 2012 presented by: Susan E. Ziel, Partner Krieg DeVault P: 317.238.6244 Email: sziel@kdlegal.com Catherine M.
More informationMore affordable health care that puts you in control
More affordable health care that puts you in control How mychoice helps you take control More affordable than many ACA plans on the market today Tailored support just for you Call mychoice Advisors for
More informationPrompt Payment Discounts
Prompt Payment Discounts Improving Revenue Cycle Management and Business Operations NOTICE: This information is provided as a commentary on legal issues and is not intended to provide advice on any specific
More informationPrepare to pivot: Getting ahead of ACA disruptive forces
Prepare to pivot: Getting ahead of ACA disruptive forces Despite significant uncertainty about how Congress will address Medicaid, subsidies, and the exchanges, waiting to take action is chancy and risks
More informationPatient Financial Engagement (PFE)
White Paper TM Patient Financial Engagement (PFE) Enhancing the patient experience through patient payment solutions TM (C) Copyright 2016 Payspan Table of Contents Overview How patient payment solutions
More informationPropensity to Pay Delivering a Provider/Patient Win/Win! March 12, 2015
Propensity to Pay Delivering a Provider/Patient Win/Win! March 12, 2015 Mike Wilson Director/Business Services DCH Health Systems Tuscaloosa, Alabama Charles Moore, MS, MMI Informatics Strategist AccuReg
More information4 Ways to Drill Down into Bad Debt
4 Ways to Drill Down into Bad Debt By Craig Kappel and Brett McMillan Conducting this four-step analysis of your hospital s bad debt is the first step to controlling it. Revenue cycle scorecards typically
More informationEligibility and Point of Service Collection Practices that Work
Eligibility and Point of Service Collection Practices that Work Douglas Turek Senior VP of Regulatory and Governmental Affairs MedData (formerly Cardon Outreach and Alegis) TAHFA Roadshow Dallas, Texas
More informationHealthcare reimbursement is facing some of the biggest changes and challenges of the past 50 years.
Healthcare reimbursement is facing some of the biggest changes and challenges of the past 50 years. While in many ways this evolution is a good thing, it does require organizations to fundamentally rethink
More informationThe Patient Is Now Your Third Largest Payer
The Patient Is Now Your Third Largest Payer Arkansas HFMA Fall Conference October 31, 2014 Little Rock Marriott, Little Rock Arkansas Doug Bilbrey Regional Vice President, PatientMatters 1 1 Presentation
More informationBILLING AND COLLECTIONS POLICY
BILLING AND COLLECTIONS POLICY PURPOSE: To provide policies and procedures in regards to patient billing, internal collection practices, and external collection practices performed by an outside agency
More informationBringing Financial Wellness into the Conversation
Bringing Financial Wellness into the Conversation The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2016 Society for Healthcare Strategy
More informationAdvancing Risk Capability in 2015: Medicare Shared Savings Program and ACO Investment Model. March 23, 2015 // 12:00 P.M. 1:00 P.M.
Advancing Risk Capability in 2015: Medicare Shared Savings Program and ACO Investment Model March 23, 2015 // 12:00 P.M. 1:00 P.M. EST CENTER FOR INDUSTRY TRANSFORMATION The DHG Healthcare Center for Industry
More informationacknowledging the importance of BAI accounts
REPRINT SEPTEMBER 2011 FEATURE STORY Steve Levin healthcare financial management association www.hfma.org acknowledging the importance of BAI accounts Hospitals should not underestimate the importance
More informationCategory: Department: Effective: 1/1/16 Reviewed: Revised: Review Cycle: Annual Owner: AtlantiCare Board of Directors Finance Committee
PURPOSE: This policy, together with the Financial Assistance Policy (#860) and the Emergency Medical Screening, Stabilizing Treatment, Transfer and On Call Roster Pursuant to EMTALA Policy (#566), is intended
More information2013 ALABAMA SHRM STATE CONFERENCE
2013 ALABAMA SHRM STATE CONFERENCE BENEFIT TRENDS AND BEST PRACTICES 2013 & BEYOND PRESENTED BY MARK JOHNSON 1 COBRA stick Private Exchanges Better Health Decisions Penalties HIPAA carrot Safe Harbor Procedures
More informationPatient Payment Collection: Challenges for Payers and Providers
Patient Payment Collection: Challenges for Payers and Providers By Kendra Obrist Vice President, Marketing kobrist@navinet.net Eight Cambridge Center, Third Floor Cambridge, MA 02142 617.715.6000 www.navinet.net
More informationWageWorks 2009 Consumer-Directed Benefits Market Survey
WageWorks 2009 Consumer-Directed Benefits Market Survey WageWorks 2009 Consumer-Directed Benefits Market Survey Summary This report on the findings of WageWorks 2009 Consumer-Directed Benefits Market Survey
More informationEffective Billing and Collections. Copyright 2017 State Volunteer Mutual Insurance Company
Effective Billing and Collections 1 Copyright 2017 State Volunteer Mutual Insurance Company Changing Environment Shift in responsibility, payment models and adjustments High deductible health plans (HDHP)
More information35th Annual J.P. Morgan Healthcare Conference. January 12, 2017
35th Annual J.P. Morgan Healthcare Conference January 12, 2017 Safe Harbor Statement and Non-GAAP Financial Measures This presentation contains forward-looking statements, including statements regarding
More informationUnlocking and Using Practice Performance Intelligence
Unlocking and Using Practice Performance Intelligence Patti Peets, Director, Revenue Cycle Management CareCloud, Miami Patti Peets does not have a financial conflict to report at this time. 1 Learning
More informationLeveraging Big Data to Stop Big Revenue Leaks
INSIGHT GUIDE Leveraging Big Data to Stop Big Revenue Leaks One big way academic medical centers can obtain the highest hanging fruit Contents PROFITABILITY IS GETTING HARDER AND HARDER TO REACH... 3 AMCS
More informationA Bank Sales Guide to BusinessManager for Healthcare
A Bank Sales Guide to BusinessManager for Healthcare 1 BUSINESSMANAGER HEALTHCARE OPPORTUNITIES Increasing fee income while mitigating risk in the healthcare sector This guide will help to prepare your
More informationTaming the High Deductible Monster While Ensuring a Positive Patient Financial Experience
Taming the High Deductible Monster While Ensuring a Positive Patient Financial Experience HFMA Lone Star Winter Institute January 26 27, 2017 Chris Johnson VP PFS Carolinas HealthCare System Carolinas
More informationThe Health Insurance Market in Virginia. Maureen Dempsey, MD, MSc, ACC, FAAP Anthem Blue Cross and Blue Shield June 8, 2017
The Health Insurance Market in Virginia Maureen Dempsey, MD, MSc, ACC, FAAP Anthem Blue Cross and Blue Shield June 8, 2017 Anthem Inc. at a Glance Broad geographic footprint and customer base ` BCBS plans
More informationCowen and Company 37 th Annual Health Care Conference. March 6, 2017
Cowen and Company 37 th Annual Health Care Conference March 6, 2017 Safe Harbor Statement and Non-GAAP Financial Measures This presentation contains forward-looking statements, including statements regarding
More informationCenters for Medicare & Medicaid Services: Innovation Center New Direction Request For Information: Medicare Advantage (MA) Innovation Models
Centers for Medicare & Medicaid Services: Innovation Center New Direction Request For Information: Medicare Advantage (MA) Innovation Models 1. Do you have any comments on the guiding principles or focus
More informationREPORT OF THE COUNCIL ON MEDICAL SERVICE. (J. Leonard Lichtenfeld, MD, Chair)
REPORT OF THE COUNCIL ON MEDICAL SERVICE CMS Report -A-0 Subject: Presented by: Referred to: Appropriate Hospital Charges David O. Barbe, MD, Chair Reference Committee G (J. Leonard Lichtenfeld, MD, Chair)
More informationThe Affordable Care Act: Progress & Peril. John E McDonough November 2015
The Affordable Care Act: Progress & Peril John E McDonough November 2015 Presentation Outline Good News Not So Good News What I Tell Foreigners about ObamaCare Hope for the Future # Title Name Detail The
More informationHow Hospital Finance and Reimbursement Works in Five Steps
How Hospital Finance and Reimbursement Works in Five Steps Providing education, resources, leadership development to inspire excellence in health care governance. Like any industry, health care has its
More informationThe Advisory Board Company
The Advisory Board Company Managing Self-Pay in the Current Economic Environment Best Practices and Self-diagnostics February 16 th 19 th, 2010 2010 The Advisory Board Company The Nation s Preeminent Health
More informationBank of America Merrill Lynch 2013 Leveraged Finance Conference
Bank of America Merrill Lynch 2013 Leveraged Finance Conference December 3, 2013 Disclosures / Forward-Looking Statements This presentation includes forward-looking statements. Forward-looking statements
More informationGOVERNMENTAL AFFAIRS AND LEGAL MATTERS (A)
GOVERNMENTAL AFFAIRS AND LEGAL MATTERS (A) 50 Elimination of the Medicare Face to Face Reimbursement Introduced by the MSSNY Long-Term Care Subcommittee RESOLVED, that the Medical Society of the State
More information9/23/2016. Our Services. Transitioning from Fee-for-Service to Value-based Reimbursement. Key Trends and Strategies for Rural Health Providers
Transitioning from Fee-for-Service to Value-based Reimbursement Key Trends and Strategies for Rural Health Providers Paul MacLellan, CEO >> Health care consulting company >> Wholly owned subsidiary of
More informationGeorgia Chapter. Chapter Scores for CBSC: FY18 Overall High Satisfaction*: 91%
Chapter Scores for CBSC: FY18 Overall High Satisfaction*: 91% FY17 Overall High Satisfaction: 69% Favorable/Unfavorable FY17 to FY18: 22% *FY18 High Satisfaction calculated by summing the total of respondents
More informationRE: Billing and Collection Policy and Procedure. PREPARED BY: Linda Fausett REVISION DATE: 06/14/2018
Page 1 of 6 The online (server) version of this policy is official. Therefore, all printed versions of this document are unofficial copies. APPLING HEALTHCARE SYSTEM 163 EAST TOLLISON STREET BAXLEY, GEORGIA
More informationUnderstanding the Value of Self-Insured Health Plans
Understanding the Value of Self-Insured Health Plans SIIA Taft-Hartley Plan Executive Forum April 30, 2015 Copyright 2014 by The Segal Group, Inc. All rights reserved. Discussion Overview The Intent and
More informationSummary of the Financial Reports for Hospital Corporation of America (HCA)
Summary of the Financial Reports for Hospital Corporation of America (HCA) By David Belk MD Definitions: Gross Patient Revenue is the total amount all hospitals issue in billed changes each year. Most
More informationThe Top Five Healthcare Leadership Challenges in the Industry for 2017 JEOPARDY
The Top Five Healthcare Leadership Challenges in the Industry for 2017 JEOPARDY Lyman Sornberger Chief Healthcare Strategy Officer Capio Partners LLC Bethesda Hospital March 31, 2017 1 Presented by: Lyman
More informationPolicy Name: Financial Assistance and Emergency Medical Care Policy
Key Points EFFECTIVE DATE: Revision Dates: 2/14/08; 8/1/08; 10/1/08; 1/23/09; 5/5/09; 11/22/2010, 12/21/2010; 1/20/11, 5/16/11; 1/26/12; 3/13/12; 1/24/13; 2/26/13; 3/7/13; 1/22/14, 5/28/14, 6/25/14, 1/27/15,
More informationDriving Next-Level Revenue Cycle Performance: 5 Strategies for Physician Practices
Revenue Cycle Management White Paper Driving Next-Level Revenue Cycle Performance: 5 Strategies for Physician Practices Revenue cycle management (RCM) is the lifeblood of any physician practice and one
More informationeducate. elevate. HEALTHCARE FINANCIAL TRAINING GEARED TO YOUR NEEDS course catalog
educate. elevate. HEALTHCARE FINANCIAL TRAINING GEARED TO YOUR NEEDS course catalog 2017 welcome This catalog is your essential, easy-to-use reference for e2 Learning from HFMA. It identifies specific
More informationMaintaining Cash Management Health
JUNE 2012 BANK OF AMERICA MERRILL LYNCH WHITE PAPER Maintaining Cash Management Health Unprecedented changes herald new challenges for healthcare providers. Table of Contents EXECUTIVE SUMMARY Affordable
More informationThe Physician-Owned Management Services Organization
The Physician-Owned Management Services Organization By Joe Laden www.onemso.com/consulting A Management Services Organization (MSO) is a legal entity created to provide management and administrative services
More informationThe Affordable Care Act: Progress & Peril. John E McDonough September 2015
The Affordable Care Act: Progress & Peril John E McDonough September 2015 Outline The Good News The Not So Good News Messages that Work Hope for the Future Significant progress on coverage 1. Good News
More informationThree Strategies to Shrink Bad Debt:
Three Strategies to Shrink Bad Debt: Presumptive Charity Care, Propensity to Pay and Partner Management Sponsored By: Copyright.com. All rights reserved. insidearm.com Phone: 240.499.3834 E-mail: editor@insidearm.com
More informationPrinted copies are for reference only. Please refer to the electronic copy for the latest version.
Policy #: 5146 Version: 3 Page: 1 of 9 Policy: CentraState, and any other substantially related entities (as defined under the Internal Revenue Code ( IRC ) 501(r) final regulations), will comply with
More informationPRICE TRANSPARENCY Frequently Asked Questions
PRICE TRANSPARENCY Frequently Asked Questions Introduction Price transparency is one of the most confusing topics in today s healthcare world. Healthcare consumers are becoming more engaged and asking
More informationHDI. Hospital Deductible Insurance (HDI) Designed for employers transitioning to higher deductibles. Helping to fill the benefit gap when hospitalized
Enter your contact information in the space provided on page 8 and print the brochure for the client. Hospital Deductible Insurance (HDI) Supplementary Group Coverage Complementing High Deductible Health
More informationFinancial Planning on Tight Budgets
MAKING THE GRADE Containing Costs and Optimizing Benefits in Public Education Financial Planning on Tight Budgets From quaint elementary schools to sprawling high school campuses, public primary and secondary
More informationUnderstanding Benchmarking for Healthcare Organizations
Understanding Benchmarking for Healthcare Organizations Melissa M. Meeker, CPA MSA, Accounting, Franklin University Tina R. Wright, CPA, CHBC BSBA, Accounting, The Ohio State University Benchmarking Basics
More informationTHE $10,000 QUESTION: TACKLING THE COMPLEXITIES OF VALUE-BASED PHYSICIAN COMPENSATION
THE $10,000 QUESTION: TACKLING THE COMPLEXITIES OF VALUE-BASED PHYSICIAN COMPENSATION HFMA First Illinois Chapter August 12, 2014 Stu Schaff Manager, DGA Partners Agenda > Background & Context > Measures
More informationREIMBURSEMENT ARRANGEMENTS
MEDICARE PREMIUM REIMBURSEMENT ARRANGEMENTS how small employers (with fewer than 20 employees) can save money by paying for their workers Medicare Part B, Part D, and Medigap premiums Medicare Premium
More informationHDI. Hospital Deductible Insurance (HDI) Designed for employers transitioning to higher deductibles. Helping to fill the benefit gap when hospitalized
Hospital Deductible Insurance (HDI) Supplementary Group Coverage Complementing High Deductible Health Plans Designed for employers transitioning to higher deductibles Helping to fill the benefit gap when
More informationBerneta L. Haynes Director of Equity and Access Georgia Watch
Berneta L. Haynes Director of Equity and Access Georgia Watch www.georgiawatch.org Our organization Founded in 2002 Statewide advocacy organization Non-profit and non- partisan Our work Ensure consumers
More informationWHITE PAPER How Consumer-Driven Healthcare Can Drive Down Costs for Payers
WHITE PAPER How Consumer-Driven Healthcare Can Drive Down Costs for Payers INTRODUCTION The United States healthcare system needs to confront one of its biggest issues head on the escalating cost of healthcare.
More informationUsing Presumptive Analytics for Your Financial Assistance Policy:
WHITE PAPER Using Presumptive Analytics for Your Financial Assistance Policy: A TransUnion data accuracy study Introduction Recent regulations passed under the Affordable Care Act will significantly impact
More informationFifth Annual Transamerica Center for Health Studies Survey: Employers Hold Steady in Time of Uncertainty
Fifth Annual Transamerica Center for Health Studies Survey: Employers Hold Steady in Time of Uncertainty November 2017 Table of Contents About the Transamerica Center for Health Studies Page 3 About the
More informationBaird 2018 Global Healthcare Conference. September 5, 2018
Baird 2018 Global Healthcare Conference September 5, 2018 Forward-Looking Statements and Non-GAAP Financial Measures This presentation includes information that may constitute forward-looking statements,
More informationSpecialty Reimbursement. Focused Results. Specialty Reimbursement. Focused Results. Medical Reimbursements of America
Specialty Reimbursement. Specialty Reimbursement. Focused Results. Focused Results. Medical Reimbursements of America A More Granular Approach to Revenue Cycle: Digging Deeper into Specialty Reimbursement
More informationEnabling Digital Payments in the U.S. Healthcare Market: Your Transformational Opportunity
Enabling Digital Payments in the U.S. Healthcare Market: Your Transformational Opportunity MAY 2017 Prepared for: This white paper was commissioned by ACI Worldwide and written by Aite Group. All views
More informationHealth Benefits In 2010: Premiums Rise Modestly, Workers Pay More Toward Coverage
doi: 10.1377/hlthaff.2010.0725 HEALTH AFFAIRS 29, NO. 10 (2010): 1942 1950 2010 Project HOPE The People-to-People Health Foundation, Inc. By Gary Claxton, Bianca DiJulio, Heidi Whitmore, Jeremy D. Pickreign,
More informationCowen and Company 38 th Annual Health Care Conference. March 13, 2018
Cowen and Company 38 th Annual Health Care Conference March 13, 2018 Forward-Looking Statements and Non-GAAP Financial Measures This presentation includes information that may constitute forward-looking
More informationFinancial Toxicity of Cancer Challenges and Opportunities
Midwest Cancer Alliance Financial Toxicity of Cancer Challenges and Opportunities Gary C. Doolittle, MD Capitol Federal Masonic Professor of Oncology Medical Director, Midwest Cancer Alliance Midwest Cancer
More informationMEMORIAL HERMANN SURGICAL HOSPITAL KINGWOOD POLICY. Financial Assistance Policy
Page 1 of 15 MEMORIAL HERMANN SURGICAL HOSPITAL KINGWOOD POLICY POLICY TITLE: Financial Assistance Policy PUBLICATION DATE: 02/11/2019 VERSION: 3 POLICY PURPOSE: The purpose of this Financial Assistance
More informationDefinitions: As used in this Policy, the following terms have the meanings as set forth below:
Patient Information for Financial Assistance The Financial Assistance Policy (FAP) of the Medical Center Navicent Health (NAVICENT HEALTH) illustrates our commitment to our patients and the community we
More informationA Look at the Trends in Healthcare Payments Sixth Annual Report: June 22, InstaMed. All rights reserved.
A Look at the Trends in Healthcare Payments Sixth Annual Report: 2015 June 22, 2016 1 2017 InstaMed. All rights reserved. v20160129 About the Presenter Jeff Lin Senior Vice President Product Management
More informationSixth Annual Transamerica Center for Health Studies Employers Survey: U.S. Businesses Remain Committed to Employee Healthcare Benefits
Sixth Annual Transamerica Center for Health Studies Employers Survey: U.S. Businesses Remain Committed to Employee Healthcare Benefits November 2018 1 Table of Contents About the Transamerica Center for
More informationAdministrative Policy. Title: Financial Assistance, Billing and Collection
St. Joseph s / Candler Health System, Inc. Administrative Policy Title: Financial Assistance, Billing and Collection Policy Number: 1220-A Key Function: RI Effective Date: 05/22/2013 Page 1 of 10 Policy
More informationTips to Prepare for the Rise in. Healthcare Bad Debt. a prescription for hospitals fiscal well being. Photography by puuikibeach. in conjunction with
Tips to Prepare for the Rise in Healthcare Bad Debt a prescription for hospitals fiscal well being Photography by puuikibeach in conjunction with Introduction The rising cost of healthcare has captured
More information340B MEGA GUIDANCE WHAT NOW? KENTUCKY HFMA WINTER INSTITUTE JANUARY 21, 2016
340B MEGA GUIDANCE WHAT NOW? KENTUCKY HFMA WINTER INSTITUTE JANUARY 21, 2016 Brian Bell Director bbell@bkd.com Brenda Christman Managing Director bchristman@bkd.com MATERIAL COVERED TODAY The Health Resources
More informationSession 99AB Provider-Sponsored Health Plans Are Increasing in Number: What Leaders Need to Know
Prepared for the Foundation of the American College of Healthcare Executives Session 99AB Provider-Sponsored Health Plans Are Increasing in Number: What Leaders Need to Know Presented by: Bruce Henderson
More informationRobert Resnik MD MBA
Robert Resnik MD MBA Movement from FFS to Value Based Value Based Spectrum P4P Clinical Integration Shared Savings Bundled Payments Shared Risk Capitation Global Full Risk Partial Risk ACO vs. Clinically
More informationPatients are today's new payers. How are you handling this change? Tuesday, July 26th, :00pm - 1:00pm CDT
Patients are today's new payers. How are you handling this change? Tuesday, July 26th, 2016 12:00pm - 1:00pm CDT Today s agenda: Market Overview: Industry trends Market challenges Patient Experience: Consumerism
More informationCalculating the Return on Investment From External Peer Review
Calculating the Return on Investment From External Peer Review Andrew G. Rowe, CEO! AllMed Healthcare Management, Inc.! William Kramer! Kramer Healthcare Consulting Speaker Introductions Andrew Rowe: CEO,
More informationTITLE: HOSPITAL FINANCIAL ASSISTANCE POLICY
TITLE: HOSPITAL FINANCIAL ASSISTANCE POLICY X ADMINISTRATIVE CLINICAL EFFECTIVE DATE: 05/15/2017* APPROVED BY: Premier Health Board X APPROVED DATE: 4/25/2017 *Previous effective dates of 5/22/1992,1/1/2011,
More informationSutter Medical Network
Sutter Medical Network Sutter Care Pattern Analyzer making the case for affordability Fifth National Pay for Performance Summit March 9, 2010 Michael van Duren, M.D., CMO Sutter Physician Services Colleen
More informationProvider Strategies Required to Succeed in a Consumer Driven Health Care Environment
Provider Strategies Required to Succeed in a Consumer Driven Health Care Environment John F.X. Lovett Consumer Driven Health Care What is consumer driven health care and how is it impacting on providers?
More informationPhilosophy. Benefits to You. The Medicare Caddy. for Using Medicare Caddy
The Medicare Caddy Philosophy The Medicare program is confusing, complex and constantly changing. We understand that Medicare plays a significant part in the lives of many Americans - who are also living
More informationEmbracing the Future of Care Delivery: What have we learned?
Embracing the Future of Care Delivery: What have we learned? Robert Nesse, M.D. Senior Advisor for Healthcare Policy and Payment Reform CEO, Mayo Clinic Health System 2010-2015 2014 MFMER slide-1 Fundamental
More informationCurrent Trends in Rx Plan Management
Current Trends in Rx Plan Management Amy Steinkellner, Pharm.D. Vice President, Clinical Services Medco s Systemed Group Medco is a registered trademark of Medco Health Solutions, Inc. 2004 Medco Health
More informationMANAGEMENT S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS FOR ASCENSION
MANAGEMENT S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS FOR ASCENSION As of and for the six months ended December 31, 2014 and 2013 The following information should be read
More informationRe: Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans. File Code CMS 9989 P
October 24, 2011 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-9989-P P.O. Box 8010 Baltimore, MD 21244-8010 Re: Patient Protection and Affordable Care
More informationIntroducing Value-Based Care Analytics
Introducing Value-Based Care Analytics June 28, 2018 Donna Maddox, RN Director, Product Management GE Healthcare 2018 General Electric Company All rights reserved. This does not constitute a representation
More informationModernizing Your Budget Process. Northwest Ellucian User Group July 2018
Modernizing Your Budget Process Northwest Ellucian User Group July 2018 INTRODUCTION Purpose: Discuss current state of budgeting in higher education and introduce Kaufman Hall s approach Take-aways Learn
More informationConsiderations for a Hospital-Based ACO. Insurance Premium Construction: Tim Smith, ASA, MAAA, MS
Insurance Premium Construction: Considerations for a Hospital-Based ACO Tim Smith, ASA, MAAA, MS I once saw a billboard advertising a new insurance product co-branded by the local hospital system and a
More informationShifting the Self-Pay Patient Paradigm: The Economic Management of the Patient Responsibility
Shifting the Self-Pay Patient Paradigm: The Economic Management of the Patient Responsibility Gregory M. Snow March 15, 2013 Agenda Healthcare Reform» Overview of Key Mandates Shifting the Paradigm» Impacts
More information