The new strategic pricing starts with a thorough analysis of charge and payer date to determine the unique statistical relationships that will help determine an effective pricing strategy for setting charges.
We analyze fiscal year and historical charge and payer data to determine these unique payer relationships and measure change via trend analysis. In addition, we generate a detailed analysis of all revenue-drivers that determines the effectiveness of the patient funnel and analyze your hospital market.
Hospitals file an annual Medicare cost report with CMS that approximates actual cost. Drilling-down to the real cost of each service line and at multiple levels has given cost accounting a new role.
It is a given that reimbursement contracts with different payers reimburse hospitals different amounts for the same service based on fee schedules or capitation. Growing business with select payers that reimburse the hospital a higher payment for services is smart business.
Renegotiating contractual terms based on changes in your market is a must, too.
The retail strategy of maximizing diagnostics and laboratory utilization is still a significant revenue-generator, yet the reality of more free-standing providers makes this more challenging. This is where physician loyalty comes into play.
Growing volumes in high volume service lines is still effective because you have distilled inefficiencies from the patient process and your care team provides these services routinely each day.
Factoring-in brand strength and service lines that are trending stronger in your market are obvious needs as well. We do this.
Using a multiple of cost that includes a statistically-relevant component for Medicare reimbursement produces a consistent mark-up of services. This should have a market-factored component, too.
Variations of this pricing strategy are available as well.
Our chargemaster reconfiguration uses a consistent mark-up of cost across service lines to reduce charges and contractual allowances, and preserve the existing net revenue stream.
Resetting charges strategically hangs together with your hospital’s new pricing transparency initiative.
If your hospital still has a significantly-relevant book of business with insurers who reimburse the hospital for some OP services based on a percentage of charges, we’ll use our algorithm to right-size charges that will drop-through substantially more net dollars.
This is the new strategic pricing.
See what ‘Q’ can do for you!