Risk-based RCM - EqualizeRCM

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Risk-based RCM

Replacing fee-for-service with risk- and value-based models not only makes sense, it makes money

Numerous healthcare providers including hospital systems, FHQCs, ACOs, multi-specialty practices and integrated delivery networks (IDNs) are swapping the fee-for-service model in favor of a risk-based model which calculates the value of a patient vs. the risks they may face based on their prior medical history.

CMS wants high-quality care at the lowest possible cost

The important metrics that allow an organization to evaluate population health, clinical outcomes and estimate future risks have at their base the information locked in correct coding of conditions submitted in insurance claims. Getting your business office staff ready to adopt this model can take outside support.

EqualizeRCM can help your staff to make the transition to risk-based RCM

The amount of dollars earned by providers using risk-based revenue accounted for 56 percent of revenues in federal settings and IDNs and 28 percent of revenues in commercial settings in 2018. This represents a dramatic leap away from fee-for-service to value-based payment models. Indeed, federal fee-for-service payment fell by 20 percent in the same time period. And commercial fee-for service payments dropped by 8 percent. This trend is only continuing.

If you haven’t made the jump, it’s time you did, and we are here to help you make it happen. Our staff has in-depth knowledge and experience and can expedite the adoption of better reimbursement through skilled risk assessment based on readily available data.

Let us help you with IT infrastructure and training challenges

You don’t have to do this alone. EqualizeRCM will help you address the internal impediments and external barriers to building a successful risk-based platform. Building the systems, IT, coding, and analytics infrastructure you need now can increase projected revenues. A conversation with us can point your organization towards a more successful future.

What Our Clients Think

My satisfaction with EqualizeRCM Services is beyond what I ever expected. The level of professionalism they have shown me, as well as their attentiveness to detail, constant communication, and timeliness have far exceeded my expectations.

A Client from California

Thanks to you and your staff for this material finding. This is just one example of how EqualizeRCM has provided a highly quantifiable and material financial benefit to this hospital and the community it serves.

A Client from New Mexico

EqualizeRCM is a very responsive partner. When I have an issue or need assistance, I can count on their team to help.

A Client from Oklahoma

I’m so happy we work with a company who clearly care about your progress as much as you do.

A Client from North Dakota

All the RCM providers sound the same after a while, but EqualizeRCM stood out because of their depth of billing expertise and their breadth of experience. They had the experience and a track record of providing impact in a variety of circumstances and with different types of practices.

I would absolutely recommend EqualizeRCM and would use them again. They’re ﬂexible, customized, and affordable. They essentially became an extension of our office.

President, California behavioral health provider

EqualizeRCM is really good at what they do. Most vendors don’t provide the depth of information – the details and reporting needed for each step – so the client has full transparency and control, but EqualizeRCM does.

EqualizeRCM is a no-risk choice. With EqualizeRCM, I no longer had to worry about the old AR or cash any more. Their work helped extend the life of our hospital.”

CFO, Colorado Critical Access Hospital

Replacing fee-for-service with risk- and value-based models not only makes sense, it makes money

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What Our Clients Think

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888-539-3339