Accounting & Financial Management
With fewer resources available and a need to control and better understand costs, UPMC has piloted a cost-analysis system that may become a national model.
Aggregated clinical data are essential to managing population health. But analyzing the financial health of various service lines is a complex undertaking.
As a result of the push towards accountable care, increased patient census no longer translates to higher revenue for hospitals. Unless costs are managed internally, higher patient volume may instead lead to narrower margins, if not outright red ink.
With the rise of value-based payment and care models, long-term hospital viability may depend on not only getting a better handle on costs, but also being able to link them to outcomes. To achieve this, hospitals need cost accounting on steroids.
In case anyone was wondering, the RACs haven't gone away for good. They're just taking a vacation. The Centers for Medicare & Medicaid Services announced a "pause" in RAC audits last month, in preparation for the procurement of the next round of RAC contracts.
The Obama Administration released its proposed federal budget for fiscal year 2015 this week. Virtually all types of healthcare providers, health plans, and drug manufacturers would be impacted by the budget provisions if adopted as proposed - although that is an unlikely scenario.
The Obama Administration recovered a record $4.3 billion last year from fraudsters trying to dupe federal health programs, or those who sought payments to which they were not entitled.
Healthcare is one of the last bastions of consumer-unfriendly billing and pricing. As individuals start to take on more responsibility for premiums, deductibles and co-pays, they are increasingly demanding more transparency. And providers will be forced to respond.
The price of an initial inpatient stay explains almost all of the wide spending variation from hospital to hospital on episodes of care, such as for knee or hip replacements, the National Institute for Health Care Reform has found.
Tenet Healthcare Corp., the nation's third largest for-profit hospital operator, said Tuesday it expects 15 percent of its uninsured patients to get covered this year as a result of the Affordable Care Act.