Jon Melling, partner at Pivot Point Consulting: As health systems prepare their people, processes and technology for the shift from volume to value, they often overlook their chargemaster. Given the phased approach to value-based care, we expect systems must be able to handle both charges under fee-for-service as well as fee-for-value billing. If you are unsure whether your chargemaster can handle both reimbursement models, you may want to consult with your software vendors. Ask them how they plan to manage two separate chargemasters and what solutions they propose to bridge the gap.
In the months ahead, denials management and denials prevention should also receive stronger focus as organizations expand participation in value-based reimbursement and other quality payment programs. Finally, consider increased investments in staff training and education to ensure all revenue cycle stakeholders understand what’s to come under value-based billing.
Fee-for-service and value-based reimbursement are fundamentally different. Organizations will likely be managing dual financial systems for a number of years, if not longer.
To learn more about preparing for value-based billing, access this story from Becker’s Hospital Review.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the “RCM tip of the day” series.
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