Critical Access Hospital reimbursement modeling

Critical Access Hospital reimbursement modeling
Critical Access Hospitals (CAHs) and other provider types with
• Enables the organization to review scenarios, forecast and
cost-based reimbursement under the Medicare program are
make knowledgeable future strategic decisions around service
often challenged with quantifying the impact to their future
offerings and planning
reimbursement from modifications made to their charge practices,
cost structure and other related items. Changes to a CAH’s square
footage, chargemaster design or staffing can have a significant
impact on future Medicare reimbursement that may not be
• Allows an organization to meet compliance objectives, while
improving performance
Other reimbursement services
identified until after the annual cost report is prepared. To assist
In addition to the reimbursement modeling tool, McGladrey’s health
CAHs in this effort, McGladrey health care consultants have
care reimbursement professionals provide the following services developed a customizable, user-friendly tool for clients to test the
to CAHs:
reimbursement impact of potential changes to their operations,
• Cost reporting and compliance review
as well as allow for more accurate reserve-setting through more
• Chargemaster and revenue assurance analysis
frequent cost report settlement calculations.
• Strategic pricing model analysis
Cost report model tool
• Revenue cycle management assistance
Created in an easy-to-use Excel spreadsheet format, McGladrey’s
• Evaluation of nonreimbursable and non-cost-based cost centers
cost report modeling tool is designed with a layout and flow that
is similar to the Medicare cost report. Users can quickly update the
cost report model with their most up-to-date trial balance and
facility statistics to generate an updated cost report settlement
for their CAHs, allowing users to better manage cash flow, analyze
margins, assess cost-to-charge ratios and more, all within the ease of
a straightforward spreadsheet that’s simple to navigate and can be
customized to your organization’s unique needs.
The other benefit of the cost report model includes the ability to run
forecasting scenarios to test the impact of adding new service lines
or making changes to existing operations. Users can modify their
current trial balance and change statistics to model a hypothetical
scenario and receive guidance on how future planning could impact
their organization’s Medicare reimbursement.
Tool benefits
• Enhances an organization’s overall reimbursement process efficiency
• Provides the ability to make informed decisions around
reimbursement and addresses errors and challenges in a quick,
consistent and efficient way
• Feasibility studies and implementation assistance
and their impact on reimbursement
• Evaluation of cost allocation methods
Learn more about McGladrey’s reimbursement services by
contacting our health care industry professionals.
Tony Cawiezell, Principal, 563.888.4027
Sue Ankeny, Director, 507.526.4428
Dan Linhart, Manager, 563.888.4404
This document contains general information, may be based on authorities that
are subject to change, and is not a substitute for professional advice or services.
This document does not constitute assurance, tax, consulting, business, financial,
investment, legal or other professional advice, and you should consult a qualified
professional advisor before taking any action based on the information herein.
McGladrey LLP, its affiliates and related entities are not responsible for any loss
resulting from or relating to reliance on this document by any person.
McGladrey LLP is an Iowa limited liability partnership and the U.S. member firm
of RSM International, a global network of independent accounting, tax and
consulting firms. The member firms of RSM International collaborate to provide
services to global clients, but are separate and distinct legal entities that cannot
obligate each other. Each member firm is responsible only for its own acts and
omissions, and not those of any other party.
McGladrey®, the McGladrey logo, the McGladrey Classic logo, The power of being
understood®, Power comes from being understood®, and Experience the power of
being understood® are registered trademarks of McGladrey LLP.
2015 McGladrey LLP. All Rights Reserved.