payer mix

payer mix

Medical practice The type–eg, Medicaid, Medicare, indeminity insurance, managed care–of monies received by a medical practice. Cf Patient mix, Service mix.
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Diversified payer mix between private insurance, Medicare, Medicaid and cash.
Hellweg adds that the company has been able to respond to greater competition in the commercial market and a less favorable payer mix with acquisitions and the strategic use of big data.
Medicaid patients and non-paying patients dominate the payer mix at safety nets, and that presents a challenge, said University of New Orleans health care economist Walter Lane.
Payer mix: Payer mix is important in understanding the rules of reimbursement for the many different third-party payers.
When considering today's reimbursement landscape, follow-on deals might bring along an opportunity to leverage the organization's payer mix as well.
Specific to reimbursement, coverage gains among commercial payers has resulted in the overall payer mix for H.
With more patients covered under high-deductible plans or Medicaid managed care plans, the new payer mix has shifted more of the burden for payment onto the patient and collection onto the provider.
We streamlined the workflow and processes, so providers can grow their business by expanding into the ever growing hospice market and diversifying their payer mix.
They included system affiliation, ownership, payer mix, nurse staffing, birth volume, distance to and birth volume in the closest hospital providing obstetrics, and county-level provider supply and population characteristics.
Depending on where they are with their patient mix and how their payer mix has changed, hospitals may be moving more toward outcome-based reimbursement models," comments Lightfoot.
First, scrutinize your payer mix well beyond the traditional insurance categories such as "Cares," "Caids," "Blues" and "Commercials.