BIRMINGHAM, Ala., Nov. 12, 2013 /PRNewswire/ -- Healthcare providers have a tough pill to swallow. They are being evaluated and compensated in an entirely new way. It's no longer about how many patients a provider can see in the course of one business day. It's no longer a compensation model based on how many tests or procedures are performed.
Driven by the Centers for Medicare & Medicaid Services (CMS), that change is to tie provider compensation directly to patient outcomes. Medicare is the largest payer of healthcare services in the United States. And where they go, so go other payers.
For their part, hospital administrators are standing at attention. In recent months, they have seen their Medicare reimbursements cannibalized. Astute administrators see the writing on the wall. They understand that volume is no longer driving the conversation about healthcare. Instead, it's all about value.
Gina McWilliams, founder and CEO of RealTime Medicare Data (RTMD), is helping providers achieve this. Before they can do so, McWilliams says they must learn to think like the patients they serve.
"CMS expects providers to deliver the right care, at the right time, at the right cost," said McWilliams. "Patients are becoming more empowered about their own healthcare. They are asking more questions. Patients, and payers, are demanding more value for their dollar. This is the new normal, and it's not going away. Hospitals that cling to the old way of doing business will be left behind."
To help providers adapt to these changes, McWilliams is providing an asset unmatched in the marketplace – actual Medicare claims that are as recent as 90 days post service. This information allows each hospital to view a current report card of its performance. Where are the Medicare patients in a hospital's service area seeking care, and how does its market share compare over time with its competitors? What are the most promising service line opportunities for a hospital's growth? Are a hospital's average lengths of stay for a given procedure on par with that of other hospitals nearby? And if not, why not? These are just a few of the many questions RTMD is helping its clients answer.
"Hospitals cannot manage what they do not measure," said McWilliams. "Many people like to talk about healthcare analytics, but what does that even mean? RTMD wants to help providers keep people well to survive financially. When providers deliver optimal patient outcomes, the profitability should take care of itself."
Incorporated in 2002, RealTime Medicare Data (formerly RealTime Medical Data) has changed the way that health systems and provider organizations approach their strategic planning, physician relations, business development, operations, public relations, marketing, and staff recruitment. Its patent-pending process affords timely insights and competitive analysis based on a healthcare organization's entire Medicare beneficiary service area. To date, RTMD services more than 70 hospitals across 17 states and the District of Columbia. www.rtmd.org.
SOURCE RealTime Medicare Data