25Jan, 2018

Cash Patient Pricing Metrics – Facility & Surgeon

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Reference-based MMA vs Time-based fee schedule MMA (Maximum Medicare Allowable) is the standard reference based schedule for the over 100,000 CPT codes. (Current Procedural Terminology) Good or bad, high or low, every Medicare covered procedure is identified and assigned a reimbursement based on region. The variance by region is relatively small. The big variance comes in with multiple procedures. If you do two procedures then the 2nd procedure is at a big discount. Many facilities and surgeons feel this is sometimes too big of a discount. Time-based Fee Schedule can […]

8Mar, 2016

Transparency Is A Touchy Subject

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It’s one of the last market strongholds desperately clutching to its principles of price secrecy, and it won’t go down without a fight. But many experts say this stands as one of many reasons the industry continues to drag its feet in the innovation arena. A provider generally functions as a profit–driven business, and if the consumer remains unable to compare hospital prices and outcomes, the chances of crafting effective incentives to improve quality and reduce costs are effectively nearing zilch. Are hospitals with the most prestigious reputation necessarily producing […]