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Physician Fee Schedules: How Do They Compare and What’s Next?
When you visit your doctor, you will typically be charged a small copay, coinsurance amount, or may not even have to make a payment at all. This is done because you know that [...]
Defining a Bundled Payment Rate for Bone Marrow Transplants
Summary Insurers and providers are increasingly pushing for bundled payments and other forms of value-based reimbursement in their contracts with health systems. The ideal candidate for a bundled payment can be described as [...]
The Cost of Consolidation
Consolidation is aggressively moving through much of the US economy. Everything from coffee shops to airlines are consolidating and the effect on the consumer is varied. When it comes to healthcare the landscape [...]
Closing the Loop on Value Based Reimbursement and Incentive Programs
The phrase “closing the loop” is often used when traditional communication approaches have failed or have been ineffective. In a recent article[1], a writer said the following: “Closed-Loop Communications or Closing the loop [...]
Developing Financial Projections for Start-Up Health Plans
Summary Throughout the United States, new health plans are emerging as provider systems and nontraditional organizations seek to enter the market. Licensure of these health plans happens at the state level, and typically [...]
How is Your DOFR Doing?
Purpose of DOFRs A Division of Financial Responsibility (DOFR) is a provision in a contract between a health care provider and a health plan or payer that defines which party is financially responsible [...]