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Provider Payment
The Lewin Group assists federal, state and local governments, as well as physician specialty associations and other providers, in developing and/or assessing provider payment policies and conducting financial analyses. The Lewin Group is currently assisting the Centers for Medicare and Medicaid Services (CMS) in evaluating its physician practice expense methodology as well as a state workers' compensation program in moving to a resource-based physician fee schedule. Lewin has also recently appraised the appropriateness of Medicaid hospital and provider payments in Connecticut, Pennsylvania, and Massachusetts and conducted an overall assessment of hospital financial status for the State of Connecticut. Lewin has extensive experience with Medicare Cost Reports, state Medicaid financial information and American Hospital Association Annual Survey financial information, as well as financial analysis of individual organizations.
Key Services
- Assist states in assuring Medicaid provider payment equity.
- Conduct detailed analysis of the financial status of community hospitals, children's hospitals, safety net providers and, academic medical centers.
- Assist drug manufacturer in determining Medicare cost impact of selected treatments.
- Develop fee schedules for physician fee schedules and prospective payment systems for hospitals.
- Conduct physician work value and practice expense studies for physician specialty groups and others.
- Develop physician work values for new technology for manufacturer.
- Simulate the financial implications of major legislation (e.g. Balanced Budget Act) and CMS regulations on institutions.
- Conduct analysis of fair market prices for sellers and purchasers of health care services.
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