Rate Analysis
A rate analysis evaluates a health care organization’s price structure and identifies opportunities for increased net revenues. Computer software is used to calculate net realizable revenue for each item in the charge master. With this information, prices can be set at a level that can reduce overall charges while increasing net revenues. Payer mix determines which items are increased or decreased to yield the optimal result with parameters established by the client. Annual prices increases implemented "across the board" have a tendency over time to inflate overall pricing levels. Much of the increase ends up in third-party discounts with no effect on reimbursement.With a rate analysis, an organization can actually reduce some prices and improve operating results. Prices can be reduced for items covered by a "fixed payment" and prices can be increased for items that are not "capped," resulting in higher margins and lower average charge levels. BKD Health Care Group can make the most of shrinking bottom lines with a rate analysis that involves:
Potential Benefits to You
- Improved net revenue
- Enhanced rate calculations opposed to “across the board” increases
- Reduced contractual discounts
- Selecting top five payer contracts
- Comparing change master line item charge amounts to managed care contracts and Medicare reimbursement rates
- Quantifying the revenue impact related to charge amount discrepancies
- Identifying deleted codes
- Identifying illogical pricing structure for services
For More Information
Contact your BKD advisor or:Eddie Marmouget
Hospital Center of Excellence Coordinator
417.865.8701
