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PDS Shows Payment Variances for MediCal HMO Patients
Leslie Gold, PDS
As more patients become eligible for MediCal, and more of these patients move into managed MediCal plans, more attention needs to be focused on managing the revenue for this population. The PDS data indicates that deliveries are among the highest volume of managed MediCal patients for most hospitals, and that reimbursement and c-section rates differ significantly. The plans will be paying attention to the data, so you need to as well.
In order to create a win-win-win scenario, you need to be a hospital with relatively high payments for vaginal deliveries and lower payments for c-sections relative to the market average, and a low c-section rate given the percentage of high risk deliveries. This implies a lower cost per delivery for the payer, a shorter LOS and faster recovery for the patient, and given the shorter LOS, a higher payment per day for your hospital.
Take a look at the Southern California averages for our higher volume hospitals. Do you know where you stand?
- Average C-Section Rate 34% (range 23%-46%)
- Median C-Section Payment: $5679
- Median Vaginal Delivery Payment: $3597
For more detail, please contact me.
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Revenue Management Helps Marriott Weather Recession's Aftermath
For more than 20 years, Marriott has led the hotel industry in the practice of revenue management. This practice of collecting and analyzing revenue data from its competitors has allowed Marriott to weather the storm of the recession and come out on top. By analyzing data that has been consolidated and simplified, Marriott leaders have been able to make better pricing decisions, which have resulted in growth in over all revenues, despite the difficult economy. This article by Lauren Esposito of Revenue Analytics details the results. Read the article.
At PDS, we want to give hospitals this same powerful tool to help them weather the storm of reform. Our revenue data base allows hospitals to see where they stand in the market and make adjustments to their overall strategy.
In continued partnership,
Jim Barber
Chairman & CEO, PDS
President & CEO, HASC
"Errors using inadequate data are much less than those using no data at all" -- Charles Babbage
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| 5 Ways Cleveland Clinic Leads the Way in Transparency
The Cleveland Clinic is using data to improve transparency, patient satisfaction, and health outcomes. Cleveland Clinic CEO Delos "Toby" Cosgrove, MD, is credited with developing the system's "outcomes books" when he served as chief of
 surgery. The physician leader brought outcomes reporting to the forefront of the system's culture, as many of the system's institutes now publish their outcomes in the books, which are mailed to physicians across the country. This article by Molly Gamble in the Becker's Hospital Review, outlines the 5 keys to a culture of transparency for hospitals and health systems. Read the article. |
| PDS University -
PDS 101 - Overview of the Reports
This 20 minute class will give you a quick overview of all of the PDS reports, what the data shows, and how to use
this powerful revenue benchmarking and market analysis tool.  Bring your thoughts for future classes - what areas would you like to dig down deeper into and get a better understanding. Kick off 2013 with a data driven mind set!
Date: January 29th
Time: 11:00 a.m. PST, 1:00 p.m., CST
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Do You Have a Success Story?
If you have a success story in using data to improve patient quality, patient satisfaction, or your bottom line, we would love to hear it. Submit your story for review and we might just publish it in this newsletter. Email us your story today. |
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