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Providers seek new reimbursement tools

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KPMG suggests that only 15 percent of healthcare providers’ finance departments have the “very sophisticated” capabilities needed to support capitation, bundled payments and quality-based payments that account for an ever-larger part of revenue,¬†

The findings also showed, reports Becker’s Hospital Review, that:

“1. Sixty-one percent of respondents said their finance departments are gathering tools and conducting analysis about getting their finance function ready for new payment models.”

“2. Thirteen percent of respondents described their finance function as ‘undeveloped’ for managing risk and accounting for these new payment mechanisms.”

“3. Many healthcare providers are well aware of the challenges of adapting to value-based payments…..”

“4. When asked how CMS’s objectives of linking 90 percent of reimbursements to value or quality-based measures by fiscal year 2018 influenced their organization the most, only 26 percent of those surveyed said their strategic approach to migrating and preparing for value-based payments has not changed.”

“5. Twenty percent¬†¬†percent of survey respondents said they are measuring risk and accounting for it in their fees and another 23 percent are using data and analytics to measure and improve efficiency and quality. Other respondents said they are revamping finance/accounting functions or updating their contracts.”

“6. {P}redictive modeling (30 percent) and analytic tools (27 percent) were where organizations needed the most help, surpassing organizational culture, measuring clinical variability, showing the connection between quality and incentives and improving reporting transparency to stakeholders.”


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