Thought Leadership

INSIGHTS

Lower cost

Care Management Process Redesign: Helping Organizations Mitigate Financial Margin Losses and Achieve Fiduciary Responsibility

November 2017 – Tina Williams, Managing Director

In this edition of IMA Insights, we will share the experiences IMA Consulting has had with healthcare clients needing support with Care Management. Care Management departments report to a myriad of senior leaders including finance, nursing, and quality. Much of what we find is leaders who receive responsibility for Care Management is due to their success in managing complex processes requiring attention to detail in which those leaders have been successful. However, in the arena of Care Management our clients tell us “we really don’t know what we don’t know” and the impact on the financial success of the organization can be unexpected. Often this lack of awareness results in government repayments, fines, and revenue not captured due to failing process issues. Those process issues frequently occur between physicians, health information management, coding, and case management (emergency department, acute care, and transitions of care), and clinical documentation. Read More


Lower cost

The Power of Comparative Benchmarking

October 2017 – Chris Strano, Manager

In this ever-changing world of healthcare, data is the driving force for healthcare reform. If you are preparing to improve in areas such as discharge planning, value based care, length of stay, readmissions, or even identifying high compliance risk areas, comparative benchmarking data will enable you the ability to provide data-driven evidence of improvement and results. More importantly it can help you unlock millions of dollars in lost revenues and help protect against multi-million dollar compliance fines and penalties. Read More


Lower cost

Pre-arrival Services – Differentiator for Patients

September 2017 – Terri Donohue, Director

Patients are becoming savvy healthcare consumers and taking a more active role in selecting where they want to go for services. Healthcare providers need to make sure they are delivering a positive patient experience in the first point of contact with the patient. One opportunity is to offer pre-arrival services over the phone prior to the date of service. Pre-arrival services include scheduling, pre-registration, insurance verification, payer authorization confirmation, patient liability identification, and collection, as well as wayfinding and testing preparations. Healthcare providers that offer these services reduce payer denials, decrease bad debt, and receive high customer satisfaction scores from their patients. Read More


Lower cost

Talk About a Mouth Full: Risk Adjustment and Hierarchical Condition Category (HCC)

August 2017 – Mary Ellen McLaughlin, Manager

Hierarchical Condition Category (HCC) is a payment model mandated by the Centers for Medicare and Medicaid Services (CMS). It was written into law in 1997 and implemented in 2004. CMS-HCC is used to identify Medicare Managed Care beneficiaries with serious or chronic illnesses. It assigns a risk factor score to the person based upon a combination of the individual’s health condition(s) and demographics.

The cost to physician practices that care for patients enrolled in Medicare Advantage (MA) Plans can be high for those practices that do not master the CMS-HCC coding model. Medicare Physician Group Practice (PGP) demonstration site shows a combined savings of $171, per person, a year. Additionally, Medicare will pay bonuses to the participating PGPs. These bonuses averaged $102, per beneficiary, a year. Reports show that 27% of all Medicare beneficiaries are enrolled in a Medicare Advantage plan which could lead to a substantial savings if done correctly. Read More


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SUCCESS STORIES


UPCOMING EVENTS

HFMA Region 10 & 11 Symposium

January 14-17, 2018
Las Vegas, NV
IMA Consulting is a proud Bronze Sponsor – visit us at booth #332.
More information to come.

HCCA Compliance Institute 2018

April 15-18, 2018
Las Vegas, NV
IMA Consulting is a proud Exhibitor – visit us at booth #319.
Click here for more information.

IN THE NEWS

November, 2017

Jim Collins, Director, and Mario Feher, Director, spoke at the HFMA TX Gulf Coast Luncheon HFMA TX Gulf Coast Luncheon on Revenue Recovery.

October, 2017

Mary Ellen McLaughlin, Manager, and Shawn Seguin, Consultant, had an article published in HCCA’s Compliance Today.

July, 2017

Terri Donohue, Director, spoke at the AAHAM Keystone Chapter Conference in a session on Denials.

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PRESS RELEASES

June 26, 2017 – IMA Consulting honored by Philadelphia Business Journal

Firm named among Best Places to Work in 2017

May 20, 2017 – IMA Consulting Named One of Modern Healthcare’s Best Places to Work

Firm recognized nationally as one of the Best Places to Work in Healthcare.

May 10, 2017 – IMA Consulting Engages Cradles to Crayons for Community Day

Consulting Firm Selects Local Back-to-School Campaign for Annual Community Day.

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