Description

 Part of a generalized chargemaster sequence of presentations. Associated with special payment system presentation on APCs and DRGs.

Why Should You Attend? 

• Why are hospital charges and pricing so controversial?
• How did hospital prices become inflated?
• What is this ‘transparent pricing’?
• What are these device-dependent APCs and DRGs?
• What is all the fuss about ‘charge compression’?
• How can we control our cost-to-charge ratios?
• How should we be pricing devices? Supplies? Drugs? Biologicals
• Are we missing charges in connection with supplies and pharmacy items?
• What can we do to adjust our pricing and address charge compression?
• How does all this affect APC and DRG reimbursement?
• How does our pricing structure impact the cost report?

Objectives of the Session: 

• To Appreciate Why Hospital Charges and Pricing Are In The Spotlight
• To Appreciate The Need for Transparent Pricing and Public Relations
• To Understand Why Charges Are Important for APCs and DRGs.
• To Appreciate the Cost Report and Cost-to-Charge Ratios (CCRs)
• To Understand The Concept of ‘Charge Compression’
• To Understand Special Charge Development Techniques
• To Recognize When Charges May Be Inappropriate
• To Recognize When Full Charges Are Not Being Reported
• To Appreciate How Charges and Pricing Impact on the Cost Report
• To Review Action Steps to Adjust Pricing

Agenda of the Session: 

1. Overview of Developing Chargemaster Pricing and Charges
   1. The Need For Change
   2. Charge Formulas and Mark-Up Formulas
   3. Strategies for Adjusting Pricing
   4. Transparent Pricing
   5. Strategic Pricing
   6. Geographic Pricing
   7. Pricing Disparities Among Hospitals
2. Types of Payment Systems and Use of Charge Data
   1. APCs
      1. Increased Packaging
      2. Comprehensive APCs
   2. DRGs
   3. MPFS
   4. Cost Based Payments
   5. Contractual Payment Strategies
3. Charge-Compression, Cost-to-Charge Ratios and the Cost Report
   1. Tiered Pricing for Supplies and Drugs
   2. Charge Compression and Cost-to-Charge Ratios
   3. Cost Reporting Issues
   4. RTI International Recommendations
   5. Medicare Changes to the Cost Report for Devices
   6. Cost Report Changes for Special Areas
4. CMS Use of Charges to Determine Weights
   1. Converting Charges to Costs
   2. APCs
   3. MS-DRGs – Charge-Based vs. Cost-Based
5. Pricing and Charge Formulas
   1. Overall Charge Philosophy
   2. Bundling versus Separately Charging
   3. Proper Charging Even Though No Separate Payment
6. Making Pricing More Transparent
   1. Patient Sensitivity
   2. Release of Hospital Chargemaster – What Good Does it Do?
7. Cost Report Impact Through Charges and Pricing Structures
   1. Compliance Issues for Establishing Charge Structures
   2. Patient Acceptance and Understanding of Charge Structures
8. Chargemaster Coordinator Action Steps

Suggested Attendees: 

• Chargemaster Coordinators
• Billing and Claims Generation Personnel
• Compliance Personnel
• Patient Financial Management Personnel
• Cost Accounting Personnel
• Cost Report Personnel
• Financial Analysts
• Managed Care Contract Personnel
• Revenue Enhancement Personnel
• Chief Financial Officers
• Chief Compliance Officers
• Financial Planners
• Reimbursement Specialists
• Revenue Cycle Specialist
• Public Relations
• Planning Specialists
• All Other Hospital Personnel Interested in Pricing