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