cleverley + associates
Learn more about us
Pricing Commodity Outpatient Procedures - Assessing the Impact
In the past five years, managed care payers have been pressuring urban and many rural hospitals to lower outpatient prices by threatening to divert their beneficiaries to lower-cost freestanding providers. These efforts have mostly focused on three types of outpatient services or products that are beginning to be perceived as commodities: surgery, imaging, and lab. With commodity products, each unit is perceived to be ide
How Hospitals Approach Price Transparency
The issue of price transparency has become more prevalent in health care recently, but hospitals may have different views of the concept depending on their relative charge levels.
The ‘Lesser of’ Conundrum: Solving the Puzzle Through Payment Terms and the Chargemaster
Many commercial contracts include “lesser of” language obligating healthcare providers to accept the lower of contracted
rates or billed charges. On the surface, the language appears to be a straight forward provision. However, key differences in lesser of types and applications can result in sizable payment differences for providers.
Cleverley + Associates works with hundreds of hospitals each year to develop transparent and defensible pricing strategies (click here for more details)
Current data from CMS is available for custom comparative analyses on HospitalDx® Reports! (click here for more details)