“Value-based” Payments

Healthcare in the U.S. is moving away from “fee-for-service” toward “value-based” payments. Pathologists now have the opportunity to define how provider systems can pay for the value that pathologists add. Pathology practices can also learn how to set prices for their groups using publicly available Medicare data.

HBP’s Senior Reimbursement Consultant, Robert Tessier, was recently interviewed for two articles on these topics which appeared in the Dark Report:

  1. Pathology Groups Should Act Now to Define ValueDark Report Article 8-20-2018
  2. Medicare Data Makes Pathology Prices PublicDark Report Article 10-22-2018

Click on the links above to view the articles, and email info@hbpworld.com if you would like customized pricing data for your geographical area.

 

Dark Report Webinar On Medicare Data

Bob Tessier was a panelist on the March 14, 2018 Dark Report webinar:

Using Medicare Data to Improve Revenue and Pathology Compensation

 

Topics included:

1.Why is Medicare Data Relevant?

2.New Developments in Hospital Contracts

3.How to Use Competitive Fees in Third-Party Negotiations

4.Winning Patients with Transparent and Competitive Pricing

5.Leveraging the Medicare Database to Boost Revenue and Income

6.Introduction to 2015 Medicare Provider Utilization and Payment Data

Robert Tessier to speak in New Orleans on April 17, 2018 at the AMERICAN PATHOLOGY FOUNDATION’s Coding & Practice Management Seminars.

The topic:

DESIGNING A VALUE-BASED PRACTICE MODEL: SETTING THE STAGE FOR 2018 AND BEYOND

How can you design a practice model that adds value for all stakeholders: Pathologists, Administrators and Billing Managers?

This session will cover developing a system of incentives to maximize the financial success of your practice.

LEARNING OBJECTIVES:

  • Compensate Pathologists for adding value through performance-based incentives
  • Structure bonuses for Practice Administrators generating incremental income through creative strategies
  • Develop a reward system to achieve superior billing results

For more information: http://www.apfconnect.org

 

 

 

 

 

 

 

Maximizing Pathology Income in 2018

On January 23, 2018, HBP Senior Reimbursement Consultant Robert H. Tessier gave a presentation at the University of Miami’s Leonard M. Miller School of Medicine. This was done as part of the “42nd Annual Review and Recent Practical Advances in Pathology.” His talk Maximizing Pathology Income in 2018 addressed how to:

 

1.       Implement best practices and targeted financial arrangements

2.       Negotiate third-party contracts

3.       Add performance incentives to hospital contracts to reward value creation

 

 

Compelling Annual Reports

On July 18th, the former Chair of the CAP Practice and Management Committee, Stephen Ruby, M.D., and Robert Breckenridge, M.D. presented an excellent CAP webinar on the importance of preparing Compelling Annual Reports.

 As Part A consultants, HBP is very supportive of this approach. It is an excellent way to educate the “C-suite” on what is happening in the Department, and to document “value” far beyond the traditional mechanism of time studies.

 If you are interested in learning more about preparing an Annual Report for your practice, please contact us. CAP members may download the full presentation by logging on to CAP’s website.

 

Medicare’s 2015 Physician Utilization Database

The Physician and Other Supplier Public Use File (PUF) provides information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program. The data in the PUF covers calendar year 2015. The interactive database can be found at:

Interactive Dataset: Medicare Physician and Other Supplier PUF, CY2015, Interactive Dataset

HBP also creates customized reports for pathology and other specialties based on the twenty-six fields of the database, including HCPCS code, state and place of service. Interested in what others in your city/state are charging? This information is available by procedure code.

Contact us for additional information and a sample report.

HBP Practice Mergers – Due Diligence Checklist

Following Bob Tessier’s successful CAP webinar with Dr. Karim Sirgi titled “What to expect during and after the merger or acquisition of a Pathology group,” HBP compiled a tailored checklist for Pathology practice mergers. The list includes input and advice from more than half a dozen expert advisors.

Checklist highlights include:

  • Fee schedules
  • Billing systems
  • Third party reimbursements
  • Retirement planning
  • Compliance and governance
  • Insurance issues
  • Personnel policies
  • …and much more!

For a complete list of topics or more information on how to merge your practice, contact us here.

APF Webinar: “Creating a Positive Laboratory Employee Environment”

On June 29, 2017, HBP sponsored an American Pathology Foundation webinar on the above topic. We asked Joyce Hain, the retired Lab Administrator at Thunderbird Hospital, part of Banner Health in Phoenix, to present her experience.

Topics included:

  • Getting to Know Your Staff
  • Daily Rounds with Medical Director/Pathologists
  • Developing Recognition Cards/Newsletters
  • Monthly Staff Meetings
  • Department Teams – Shared Leadership
  • The Keys to Success

CAP Webinar – June 20, 2017

Bob Tessier and Dr. Karim Sirgi to speak on what to expect during and after the merger or acquisition of a pathology group.

Topics include:

  • Differences between a merger and an acquisition
  • Financial competitive strategies
  • Selecting the best team of advisors
  • Payments models, budgeting concepts, practice operations, and cost structures to maximize income
  • How to achieve the best outcomes for Part A and third party contracts
  • Best intra- and inter-practice communication strategies
  • Use of different classes of stock
  • Post M&A professional & managerial governance and dynamics

Boosting Pathologist Income During 2017 with Creative Strategies for Part A, Pricing and Pathology Productivity

Bob Tessier made this presentation on May 2, 2017 at the Executive War College in New Orleans. The sessions objectives:

  • Calculate a pathologist’s Part A value in 2017
  • Add value-based incentives to the hospital contract
  • Extract fees from the medicare utilization database
  • Include performance measures to the billing system agreement