Benefits to expanding from Medicare to all payers

jeausherman@comcast.net

I am intereted in talking organizations who have expanded their programs from solely Medicare to all payers,. Specifically, I would like to talk about the benefits in both Quality and financials.
Jean Banzhof 717.544.4426

lprescott

Jean, we expanded to all payors when we added on the second CDI about a year ago. we are a hundred bed hospital (small). I asked our consultants to review for financial gain and they estimated as compared to baseline over a million dollars in revenue gain from the non medicare payors. Now, I caution to take a consultants estimates with a grain of salt but I do believe we did positively influence revenue.

But you must also look at how we might have assisted with decreased retro queries (improved DNFB), I would hope we may also have affected denials. And there is also an added gain in consistency with the doctors- all charts are being reviewed and queried upon. Lastly, for compliance purposes to say you review ALL payors just looks better.

Laurie L. Prescott RN, MSN, CCDS, CDIP
lprescott@morehead.org