3 Specialty Reimbursement Trends to Watch Out for

Trends in specialty reimbursement can make a difference in your business and bottom line. If you’re running a hospital or a pharmaceutical business, here are trends you’ll need to watch out for:

Bundled payments

With more and more employers taking notice of bundled payments for many medical procedures, hospitals and private practices will need to make certain adjustments to align their care policies with these changes. If you aren’t on top of these changes, though, you will have a tougher time ensuring that your business remains competitive. And what will often make a difference in bundled care programs is data analysis, Managed Healthcare Executive. That’s why partnering with market intelligence firms is a must, ensuring much-needed updates about trends in specialty reimbursement.

Two-midnight rule

This had a massive effect on providers, making it harder to shift patients to inpatient status. Fortunately, the CMS stopped imposing an inpatient payment cut to hospitals that were operating under the two-midnight rule. As a result, observations have increased.

Site neutral payments

CMS has a proposal that targets off-campus hospital outpatient departments. These departments will then be reimbursed for applicable services. The implementation of the proposal will likely reduce payments under the Hospital Outpatient Prospective Payment System by as much as 500 million dollars. That’s a colossal amount of savings.

Finding help

Given the following trends, hospitals, private practices and pharmacies will need to stay on top of these developments. Knowing trends in specialty reimbursement will also help you put together a better approach to inventory management. This will ultimately help your organization cut down on spending costs. Make sure you find a reputable market research firm, though. Look for a provider of syndicated market research with plenty of years and experience in the field. That should be a good place to start a long-term professional relationship.

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