PMMC Kicks off Chargemaster Pricing Reviews for Five Healthcare Organizations

February 28, 2017

PMMC, ranked by Modern Healthcare Magazine as the nation’s fifth largest revenue cycle management company, was recently selected by several hospitals and healthcare systems across the country to conduct a Chargemaster (CDM) review which will ensure accurate and fair pricing for its patients.

Hospitals selecting PMMC for pricing strategies include Banner Health (Phoenix, AZ), Virginia Mason Medical Center (Seattle, WA), Southeastern Ohio Regional Medical Center (Cambridge, OH), and Covenant HealthCare (Saginaw, MI).

Banner Health focused on a more traditional Chargemaster pricing review that analyzed pricing adjustments in each of their 28 hospital markets.  The goal was to strategically reduce gross charges in some areas in order to stay competitive in their respective markets, while maintaining a strong net revenue position. Another healthcare organization – Greenville Health System – focused more specifically on a pharmacy pricing analysis.

“We’ve produced more Chargemaster pricing reviews in the last year than we have ever before,” said Greg Kay, Senior Vice President at PMMC. “PMMC’s hospital pricing strategies provide in-depth analysis and review of pricing to help our clients meet their net revenue goals while also providing pricing recommendations based on individual market factors.  By modeling the impact of unit-pricing adjustments through the actual payer contracts and historical claim/service-mix, PMMC provides one of the most accurate Chargemaster modeling engagements in the market today.”

With increased scrutiny on overall pricing transparency in the healthcare industry in recent years, healthcare organizations are looking for more than the standard “across-the-board” price increase. More frequently, hospitals are lowering charges in market-sensitive service lines.  The key is to identify where and how to best adjust charges. 

"Hospitals are starting to shift away from the standard price increases,” added Tara Bogart, Vice President of Consulting. “It’s simply not a thorough enough strategy and doesn’t take into account key factors like individual market data.”

PMMC's innovative Chargemaster pricing review combines software with consulting expertise to accurately predict new net revenue. This data-driven approach starts with an assessment of the hospital's gross charge and net revenue goals, then processes historical claims, weighs different market factors, and analyzes charge codes to successfully predict new net revenue.

About PMMC

PMMC provides high value revenue cycle software and services to improve the financial performance of healthcare organizations. Our software and expertise focuses on payment accuracy and identifying more revenue opportunities across the revenue cycle. 

PMMC helps hospitals identify underpayments and denials, increase price transparency, and manage bundled payments. Clients see, on average, a 10 to 1 return on investment with software and services. Additionally, PMMC has earned the Peer Review designation for both its Contract PRO and Estimator PRO solutions.

For more information, visit www.PMMConline.com.