Episode 122: Understanding Annual Wellness Visits for Healthcare Organizations
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In this episode, the discussion focuses on annual wellness visits, IPPE, and their implications for healthcare organizations. The conversation covers the requirements, coding, documentation, and common audit findings related to annual wellness visits. The speakers emphasize the importance of proper documentation, the use of resources, and a team approach to ensure compliance and successful reimbursement. · Jaci Kipreos and Erika Fisch discuss annual wellness visits (00:18) · Medicare's yearly benefit...
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Episode 121: How Non-Provider Staffing Trends Affect Physician Enterprise Performance
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In this insightful podcast for leaders of physician enterprises, we delve into the dynamic landscape of staffing trends within the healthcare sector. The discussion kicks off with a comprehensive exploration of both physician and non-provider staffing trends, providing valuable insights into the evolving workforce dynamics. The conversation then navigates through the intricate factors that contribute to staff turnover, shedding light on the challenges faced by physician enterprises in retaining their crucial personnel. Episode Synopsis The podcast guides leaders in analyzing their...
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Episode 120: Using Generative AI to Streamline Patient Navigation and Communication with Converse Health
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Chris Torregosa interviews Louis Sallerson, the CEO of Converse Health, about their generative AI assistant for orthopedic surgery clinics. Podcast Information Follow our feed in , , , , or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. · Please email us: · Connect...
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Episode 119: Navigating Patient Demand and Physician Shortages
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In this podcast episode, we delve into the critical topic of patient access and operational throughput. With growing demand for medical services and a looming physician shortage, it's essential to reframe patient access as a pivotal aspect of healthcare production, not merely patient satisfaction. Episode Synopsis Join us as we discuss current patient access challenges, highlight key focus areas for effective management, and explore the differentiation between patient access and operational throughput, emphasizing role clarity, optimizing staff utilization, and improving communication....
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Episode 118: How Provider Compensation Design Impacts Performance
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This episode delves into the complex world of compensation design within the healthcare industry, focusing on traditional hospital/employed provider models. We explore the common pain points experienced by clients of all types when incentivizing strategic goals. Episode Synopsis Join us as we discuss the various considerations hospitals and health systems face, including concerns about provider compensation spending and fair market value. We also examine incentive structures designed to foster growth and meet strategic objectives, all while ensuring that compensation plans remain...
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Episode 117: How to Be Successful with Revenue Cycle Management
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The speakers will break down various areas they review when evaluating the revenue cycle and give examples of how they evaluated and helped clients achieve success around revenue cycle improvement. They will discuss some of the key pitfalls and areas where physician enterprises struggle, and offer advice, regardless of type and size, to consider as you optimize your revenue cycle processes and performance. Episode Synopsis In the context of revenue cycle management, it's essential to emphasize that the scope extends far beyond the billing office alone. The notion of "outsourcing the...
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Episode 116: Introducing Physician Enterprise Performance Improvement (PEPI)
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This series aims to help physicians and practice administrators enhance their financial and operational performance across various domains. Episode Synopsis In this podcast series designed for physicians and practice administrators, our speakers will provide a deep dive into the reasons behind this series. They will emphasize the significance of performance improvement in healthcare organizations and specifically focus on physician enterprise performance improvement. Listeners will gain insights into how organizations can effectively evaluate their performance in relation to...
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Episode 115: How Does the Physician Compensation Roadmap Look
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Alex Kirkland joins Mark Reiboldt to discuss the state of physician compensation and what the future may hold. Hospitals have competed for physician market share in the post-pandemic world, and the influx of private equity investment alongside rising costs has pushed the survey data approach of funding physician compensation models to unsustainable levels. Episode Synopsis Many external factors have impacted physician compensation over the past several years. The extensive list includes pandemic-era volume reductions, volatile survey data, Medicare Physician Fee Schedule changes,...
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Episode 114: An Abundance of Options: A Survey of Current Alignment Trends for Physician Enterprises
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Justin Chamblee presented this webinar for the American Health Law Association. He analyzes the current state of the healthcare industry and take an objective look at options for physicians/physician enterprises, assessing some of the positives and drawbacks from each and what it may mean for the future. Podcast Information Follow our feed in , , , , or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide...
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Episode 113: Clinical Co-Management Arrangements
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Jana Sizemore joins Mark Reiboldt to discuss clinical co-management arrangements as an alternative alignment model for healthcare organizations and physician groups. Clinical co-management allows physician groups to align with hospitals and health systems without becoming employed or implementing a professional services agreement. Podcast Information Follow our feed in , , , , or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you....
info_outlineBrandt Jewell and Taylor Cowart join Mark Reiboldt to discuss the latest news for site neutrality. Hospitals have historically benefited from the Outpatient Prospective Payment System (OPPS), the reimbursement mechanism for Hospital Outpatient Departments (HOPD) facility fees, in comparison to their private practice peers functioning under the Medicare Physician Fee Schedule.
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Episode Synopsis
The procedures performed in a freestanding clinic versus an HOPD received 75% less reimbursement. Hospitals were highly incentivized to acquire independent sites, switch the designation to HOPD and begin increasing their reimbursement for the same procedures. This strategy caused HOPD billings to effectively double over the last decade.
Both Medicare and its beneficiaries were under pressure to find a solution.
Between 2018 and 2020, the Centers for Medicare and Medicaid Services (CMS) updated the OPPS rate and proposed to phase in a 60 percent reduction over two years. They believe site neutral payments will give patients more options for their care.
Alternatively, hospitals predicted a massive loss under the site neutral payments into the millions for many organizations. The American Hospital Association (“AHA”), the Association of American Medical Colleges (“AAMC”) and various other private groups took up arms against CMS, arguing that hospitals should receive additional reimbursement as it is inherently more expensive to run HOPDs based on the standards they are required to uphold.
Extras
Another Blow for Hospitals: The Ongoing Battle of Site Neutral Payments
Bonus Episode: Three Key Objectives from the 2019 State of the Union Address