RCM tip of the day: Model revenue streams to help predict cash flow

Hospital CFO Report

As specialty medical practices model and manage potential revenue under value-based healthcare, they should prepare for both positive and negative financial scenarios, cautioned Parag Shah, president of practice solutions at Integra Connect, a provider of technologies and services for value-based specialty care.

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Four Ways RCM Must Transform for the Shift to Value-Based RCM

healthcare informatics

It is likely that 2018 will be remembered as the year that value-based care became a financial reality for most U.S. medical practices. Those participating in MIPS (the Merit-based Incentive Payment System) received their first round of results and a view of the impact on future reimbursement rates.

Specialists taking part in advanced alternative payment models (APMs) such as the Oncology Care Model (OCM) program were also provided performance reports from CMS, in some cases accompanied by unexpected claw back demands. Finally, commercial payers such as UnitedHealthcare and Aetna promoted research and forecasts attesting to the increasing influence of value-based contracts in the reimbursement mix.

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46 RCM tips from 2018

Hospital CFO Report

Tip #9: Parag Shah, president of practice solutions at Integra Connect, a provider of technologies and services for value-based specialty care, advised specialty medical practices to focus on performance optimization and risk management to ensure their revenue cycles meet new value-based care requirements.

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Charles Saunders, MD: Biosimilars in Specialty Pharmacy

the center for biosimilars

How are you seeing biosimilars impact the world of specialty pharmacy?

I think that the promise of biosimilars to bring down the cost of drugs is certainly out there based on the experience that we’ve had with generics. I’m not sure that we’re really seeing the impact as great, though, because the prices of the biosimilars are not that much lower than the other drugs–so, maybe 25% to 35% reduction.

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6 recent RCM tips

Hospital CFO Report

Here are six expert revenue cycle management tips, published by Becker's Hospital Review after Nov. 21.

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5. Parag Shah, president of practice solutions at Integra Connect, a provider of technologies and services for value-based specialty careadvised specialty medical practices to focus on performance optimization and risk management to ensure their revenue cycles meet new value-based care requirements.

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Common Factors Among Successful Practices in the OCM

AJMC - Managed Markets Network

Practices participating in the Oncology Care Model have now received performance results for 2 periods, and many practices were surprised that they didn’t perform as well as expected. In general, some of the practices have found it difficult to predict success in the model, but there have been positive results from the OCM.

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