One question I encounter frequently is, “Why should I try to maximize my CDM when no one pays me based on it?” It may seem this way because of the change in health care the past few years, yet a competitive CDM is crucial as we move towards pricing transparency.

CMS has posted hospital prices for the most utilized services, thus knowing your competition and having an efficient and effective CDM is vital. Another reason to use strategic pricing is the reality that hospital costs don’t increase in an across-the-board fashion, so why raise charges that way?

There seem to be two reasons why many question the value of strategic pricing in today’s market. They don’t believe there is much of a correlation between the CDM and how the hospital gets reimbursed; and it’s easy to raise charges across-the-board by a fixed percentage.

I’ve been working with hospitals on CDM issues and pricing strategies for thirty years, going back to the UB-82. Although third party payer contracts are now much more complicated, many are still based on a percentage of charges for a wide variety of services.

The CDM not only is the basis for reimbursement from charge-based payers, but also serves as the basis for the calculation of cost-based reimbursement for Critical Access hospitals and DRG-exempt services. I’ve never seem a CDM that could not benefit from putting some thought into how to price services to maximize available revenue while remaining competitive with area hospitals.

The PinPoint Pricing Program eliminates many of the concerns expressed by CFO’s at budget time.

It takes time to update the CDM – we can do this for you. We’ll analyze patient charge data combined with utilization statistics to produce a detailed assessment of your CDM. This will include a projection of additional revenue above a straight across-the-board increase based on various performance measurements. We’ll also run a competitive pricing analysis to show how your hospital competes with rivals.

Finally, because this product focuses on the CDM only, our fees are extremely reasonable.

The number of closed hospitals is on the rise in the U.S. as the incidence of mergers and acquisitions has skyrocketed. Most CFO’s agree that generating more income from the revenue cycle now is an imperative.

We can help you accomplish this by updating the CDM strategically and monitoring results monthly. It’s easy to get started.