CostFlex Systems, Inc.

According to a S & P global ratings, more than half of Medicare recipients are also enrolled in Medicare advantage. Due to a lack of reimbursement and claims denials some hospitals have terminated those contracts or had to close their doors. Scipps in San Diego is terminating its contract with Medicare Advantage January 1. #CostFlex #hospitaldecisionsupport #costaccounting #healthcarefinance Are you covering the costs in your contracts? We can help! https://lnkd.in/de3-ZiCR https://lnkd.in/g3YRDf3F

The 2024 “Medscape Physicians and RVUs Report” from March 1 – May 26 reported that more than half of physicians find the RVUs unfair and not accurate and current. Some physicians cited increased pressure to increase patient counts and to use higher billing codes. #CostFlex #hospitaldecisionsupport #costaccounting #healthcareleadership We can help you look at not only your costs and service lines but compare different physicians as well. https://lnkd.in/gzpS79ab https://lnkd.in/gDv_6fDm

Medicare enrollment is growing, and some larger insurers are expected to exit the market in 2025 due to reimbursements and rising costs. Some self-insured employers are being sued over claims of mismanagement and alternative payment options are increasing. Some examples include narrow network plans (similar to HMO plans), reference-based pricing, direct contracting and individual coverage health reimbursements. #CostFlex #hospitaldecisionsupport #hospitalcostaccounting #healthcareleadership CostFlex's Payer Contract Analyzer software can automate 100% of all payer contracts (including the government). https://lnkd.in/gmdY8rRg https://lnkd.in/g4DTDD39

Texas Gov. Abbott issued a press release on August 8, 2024 to require hospitals to report on the cost of care to illegal immigrants beginning November 1. The Texas Hospital Association said in a statement that patient immigration status is a new requirement and will not affect hospitals from providing any life-saving treatment. #CostFlex #hospitaldecisionsupport #costaccounting We can help you calculate losses by patient demographics and by service lines. Let us know, if we can help. www.CostFlex.com https://lnkd.in/gRCsAMnu

Fitch’s August 12, 2024, report said that operating margins are still below pre-pandemic numbers. Liquidity and leverage are unchanged, and labor challenges are improving. 2025 should show if operating margins will continue in the 1-2% range. #CostFlex #hospitalcostaccounting #hospitaldecisionsupport Does your hospital c-suite know which service lines are profitable or losing money? Which contracts are profitable? We are here to help! www.CostFlex.com https://lnkd.in/gvkath5C

CMS reported on August 1, 2024 that starting in 2025 hospitals that use Medicare’s Hospital Inpatient Quality Report Program will face new age-friendly care standards. There are five areas addressing patients’ medications, mentation and mobility. Failing the standards will result in a reduction in funding from CMS. #CostFlex #hospitaldecisionsupport #costaccounting Let us know if we can assist you in modeling Medicare contracts or costs. www.CostFlex.com https://lnkd.in/g8XimJGb

The CMS released the 5-star rating from QMS on July 31, 2024. The ratings are based on safety of care, mortality, patient experience, readmission rates and timely & effective care. #CostFlex #hospitaldecisionsupport #costaccounting CostFlex would like to congratulate our clients on making the list! www.CostFlex.com https://lnkd.in/gBzUQjvv

The Centers for Medicare & Medicaid Services (CMS) is proposing another cut for 2025. The AMA is calling for a legislative solution. AMA President Bruce Scott, MD said that the gap between physician payment and cost of care is widening and will lead to lack of access for patients. #CostFlex #hospitalcostaccounting #hospitaldecisionsupport Are your reimbursements covering your costs? www.CostFlex.com https://lnkd.in/eu-Z6fpD

U.S. News & World Report reported on July 24 that more patients (former athletes) are having hip and knee replacements at a younger age. The trend is expected to grow and is an outpatient procedure with an effective recovery time. Richard Berger, MD said the average age of his patients is around 57. He said this age is less apprehensive about surgery and the patients don’t want to live on pain pills. #CostFlex #hospitaldecisionsupport #costaccounting Do you know which procedures cost more? Are you interested in benchmarking with peers? Let us know if we can help. https://lnkd.in/gC4Bna5S https://lnkd.in/g8qvfc7m

Some health systems were having issues July 19 after the CrowdStrike issue disrupted Microsoft customers. Several health systems had to postpone or delay surgeries and close outpatient facilities. Epic and Meditech EHRs were affected by the outage resulting in thousands of computers being disrupted. #CostFlex #costaccounting #hospitaldecisionsupport We can help you calculate not only your costs but also losses from disruptions. Your data is kept on-site and secure. Let us know if we can help! www.CostFlex.com https://lnkd.in/ekcGmdgk