How to survive case rates and global payments
How to survive case rates and global payments
The following suggestions can be helpful when working against the financial effects of case rates, reimbursement experts say:
• Carefully analyze your average cost per procedure and negotiate case rates that at minimum cover your allocated costs.
• Set time limits of less than two years on case rates contracts, and review them regularly.
• Renegotiate contracts based on technological upgrades and advancements.
• Carve out extremely expensive but low-volume procedures such as nuclear medicine that won’t be financially viable under a case rate.
• Determine your payer’s ability to issue checks accurately and regularly under case rates using present technology.
• Negotiate separate arrangements with multiple surgeries that are specific and account for all services.
• Look at the full spectrum of services being negotiated, and offset expected losses from some procedures with carveouts on others.
• Don’t flatly accept the Medicare ambulatory surgery center rate without negotiating a higher rate.
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