Medicare reimbursement rates have always been a big focus
for healthcare managers and administrators because it is an area where
hospitals/clinics can potentially hemorrhage money. Medicare reimbursement is
not dollar for dollar for procedures that are carried out so healthcare management
is always mindful of how they can improve their hospitals to qualify for the
best reimbursement rates. However according to Medicare Payment Advisory
Commission (MedPAC) hospitals are expected to see a negative 9 percent average on their Medicare margins. This compared
to negative 5.8 margins in 2014.
So why are these margins falling? The results from MedPAC
point to declining Medicare reimbursement and the implementation of other federal
policies for example the move towards value-based payments and 0.8 percent
payment reductions to recoup improper overpayments related to coding errors.
What can healthcare management do to help lessen their
losses and the pressure they feel with all the changes occurring in the healthcare
industry? Here are a few suggestions
listed by the Advisory Board Company:
- · Instill greater employee accountability for benefit costs
- · Accelerate the transition to ICD-10 coding
- · Build clinical model for population health
- · Implement Best-in-Class CDI programs
- · Gain new patients with Convenient Offerings
- · Standardize care across Clinics and Sites of Care
Hopefully by considering new strategies to lessen losses healthcare
management can alleviate some of the strain placed on health facilities by
dropping reimbursements.
Share Your Thoughts:
How do you view the issue of declining Medicare
reimbursement margins? How would you solve the problem in Healthcare
Management? What role do you see physicians and clinical healthcare
professionals playing in the Medicare reimbursement margins?
Thank you to Baylor Healthcare MBA for introducing early on
the strengths and struggles seen daily by healthcare management.
Sources:
https://www.advisory.com/research/financial-leadership-council/resources/margin-intensive/margin-intensive-infographic
https://www.advisory.com/daily-briefing/2016/05/02/medicare-margins-projected-to-decrease
http://kalamazoohomehealthcare.com/wp-content/uploads/2014/04/Medicare-Certified-Home-Healthcare.jpg
