The Changing World of Oncology Reimbursement – Are You Ready?

The expenses associated with cancer care in the United States are staggering and only expected to climb.  In 2010, the total cost was $125 billion.  By 2020, with more individuals living with cancer as a chronic disease, costs are expected to grow by 36% and exceed $170 billion.  Faced with escalating costs, the government, payors, and providers are engaging in various activities to test different reimbursement methodologies for cancer care. Continue reading

Gain Industry Insights and Perspectives in One Comprehensive Resource

We are pleased to present our 2014 Thought Leadership Compendium. In its seventh year of publication, our compendium provides a comprehensive summary of industry knowledge written or presented by ECG consultants throughout 2013. What we spoke or wrote about reflects the focus of numerous client engagements and the critical issues you face daily, Continue reading

The ICD-10 Transition: Updating Payor Contracts

One often overlooked but potentially critical step in the preparation for the now delayed April 2015 transition from ICD-9 to ICD-10 is updating agreements between providers and payors.  While the change is ultimately expected to be valuable due to the increased specificity and granularity of diagnosis coding, the potential for unintended financial consequences must not be understated.  Most providers are well under way with their operational transition plans, but many have not considered amending their payor agreements to mitigate the potential impact of problems that arise. Continue reading

Prepare for Meaningful Use Stage 2: Step 3

Develop a practice culture that sees the “meaning” in meaningful use.

“Meaningful use” started out as two simple words in a piece of legislation passed by Congress in 2009. Since that time, the term has grown, changed, and taken on a variety of new connotations. Dr. David Blumenthal, the National Coordinator for Health Information Technology at the time the legislation was passed, stated shortly after, “The meaningful use framework will be about the goals of care, not the technology.”

Five years later, many have lost the connection between meaningful use and these goals. According to a recent poll conducted by Stoltenberg Consulting at the 2014 HIMSS Conference, 70% of respondents don’t think their organizations are realizing the full potential of meaningful use. Continue reading

Promoting Engagement Through Patient Portal Adoption

In today’s consumer-driven and regulation-heavy environment, there are financial, regulatory, and competitive imperatives for health organizations to promote patient engagement through user-friendly patient portal applications.  In fact, the utilization of patient portals is a key exercise for satisfying meaningful use (MU) criteria in 2014. Continue reading

Regionalization: Do You Have A Plan?

Service distribution and optimization planning, including the design and execution of regionalization strategies, doesn’t occur through osmosis.  It necessitates a deliberate process that encourages innovative thinking and ensures candid discussion of critical issues and available options.  The numerous challenges of regionalizing health services are more easily conquered when guided by a well-defined framework.  Regardless of how services are or will be redistributed across a system, there are critical elements that should be integrated into any framework for regionalization. Continue reading

Prepare for Meaningful Use Stage 2: Step 2

In a previous post, we discussed how preparation by providers for Stage 2 of CMS’s meaningful use is a multi-step initiative.  The best place to begin is with a list of the Stage 2 measures, divided into three categories:  threshold increases, measures that move from menu to core, and new measures.  Once these designations are made, planning should begin on the most difficult measures.  In Year 1 of Stage 2, attestations are tied to each calendar quarter (instead of to any 90-day period, as with Stage 1), so there will only be four chances to attest successfully in 2014.  With fewer Year 1 attestation opportunities in Stage 2, mastering the more challenging measures in a timely manner will prove vital to continued meaningful use progress.MU_Stages_14M03D21

Continue reading