He gave the example of alternative payment models, such as the Oncology Care Model. Under the oncology model, he says practices may receive upfront reimbursement to cover incremental costs for increased care coordination, but have to return payments later due to eligibility disconnects or if the practice fails to achieve performance metrics.
“To be successful, practice administrators will now have to model and manage anticipated revenue streams. By forecasting future cash flows and predicting both potential gains and losses, practices can identify early on whether they need to hedge against projected risk by invoking stop-loss insurance, savings accumulators or other measures,” said Mr. Shah.
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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