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.