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Finance

Have ACOs Failed to Incentivize Providers?

September 23, 2014 by Abby Norman

incentives / shutterstock

We should recall that the initial incentive of ACOs, when they were being designed at the Dartmouth Institute, was that they would be an alternative payment style to incentivize the reduction of Medicare spending – where providers and hospitals would be responsible for achieving this in their geographic region.[read more]

Why Do I Only Get 10 Minutes with My Doctor?

September 22, 2014 by Stephen Schimpff

The doctor asks a few questions, does a brief exam, gives you a prescription, suggests you see the specialist and off you go, all within 8-12 minutes. No time for delving deeply into your issues. No time to build trust. No time for compassion. No time for actual healing. Why so quick? It is all in the numbers.[read more]

Will Physicians Ever Embrace ACOs?

September 21, 2014 by Abby Norman

ACOs

Saying goodbye to HMOs, which were not all bad, and welcoming ACOs onto the scene has been a bit of a bitter pill for physicians and payers alike to swallow. ACOs shift the concept of “being choosy” from physician and payers to patients.[read more]

How to Protect Your Hospital Marketing Job and Career

September 19, 2014 by Stewart Gandolf, MBA

“Hospitals across the nation are being swept up in the biggest wave of mergers since the 1990s,” reports The New York Times. “In fact, Booz & Company, a consulting firm, predicts that 1,000 of the nation’s roughly 5,000 hospitals could seek out mergers in the next five to seven years.” So…where does that leave your marketing job?[read more]

Why Outsourcing Your IRO Is a Good Idea

September 18, 2014 by Abby Norman

Outsourcing IROs

In any industry there are times when an outside perspective is the difference between progress and an impasse. In healthcare, where the bottom line of can be at odds with the wants and needs of the patients and payers, a third-party perspective can help to untangle the web of miscommunication.[read more]

Is NCQA Accreditation Right for You?

September 16, 2014 by Abby Norman

NCQA accreditation

In the alphabet soup of healthcare accreditation, chances are there are at least one or two accrediting bodies that you aren’t entirely sure about – one of those might be NCQA. Who are they, what do they accredit and do you need their accreditation in your organization?[read more]

Modern Family Doctor Visit

September 14, 2014 by Matthew Taber

A primary care payment model is re-emerging which reduces expenses for patients dramatically and puts practices on a cash-only / direct pay basis that completely takes fee-for-service insurance out the picture. The model, direct primary care, turns primary care practices into cash-positive businesses that work for patients and physicians.[read more]

After Fighting Mike Tyson, Wouldn't We All Need Rewards to Take On Healthcare?

September 14, 2014 by Michael Dermer

Do we realize just how much the consumer has been battered and bruised over the last few years when it comes to their personal and financial health? Despite this, we are asking them to fix the system – be healthier, get preventive care, eat better and use lower cost options. Financial rewards for healthy behavior may be the answer.[read more]

Stanford Ends Anthem Contract, Cites PriceCheck Data

September 13, 2014 by Jeanne Pinder

Stanford Medicine

Price transparency has some unexpected consequences. Stanford, the big university-centered health system, cut off its contract with Anthem Blue Cross, the big California insurer, on September 5. Anthem struck back at Stanford, announcing that Stanford had ended the contract, and citing our PriceCheck information in its press release.[read more]

The Pros and Cons of Outsourcing Medical Billing

September 11, 2014 by Alleli Aspili

medical billing

If you’re a doctor or a practice manager, one of the hardest and most financially impactful decisions that you will have to make is choosing between outsourcing your medical billing operations and keeping an in-house billing staff. To help you decide, I will lay out the pros and cons of outsourced medical billing.[read more]

China Syndrome: Rich Flee Mainland for Medical Care Abroad

September 11, 2014 by David E Williams

I feel bad for the patients profiled in "Desperate Chinese Seek Medical Care Abroad" in the Wall Street Journal. From what I’ve read here and elsewhere it’s not uncommon for hospitals and physicians to push profitable, expensive services and products that are not in the patients’ best interests.[read more]

Payor Contract Compliance and Tracking Reimbursements: Are You Being Paid Correctly?

September 9, 2014 by Andy Salmen

payor contract compliance (phasinphoto / Freedigitalphotos.net)

If you are a practicing physician in this market, you may wonder why you are working long hours and seeing as many patients as you can, yet the amount of money you are collecting seems to be decreasing. Here are some steps you can take in your revenue cycle management so that you can identify and rectify the underpayment problem.[read more]