Healthcare Financial Management articles from August 2004

Healthcare Financial Management archives from August 2004

Subcommittees examine hospital charging and collection practices: hospitals today are restructuring charging and collection practices, according to recent House subcommittee testimony on billing of the uninsured.(Policy Watch)
August 1, 2004... At a June 24 hearing by the House Committee on Energy and Commerce (E&C) Subcommittee on Oversight and Investigations, a panel of hospital system CE0s said they are taking steps to reduce the rates charged to uninsured patients. Further, they...

Supreme Court limits patients' right to sue HMOs.(Policy Watch)(Brief Article)
August 1, 2004... On June 21, the Supreme Court ruled that the federal Employee Retirement Income Security Act (ERISA) preempts state law, and it must be the federal courts that hear cases against managed care companies when refusal to pay for treatment...

Medicare increases ambulance service payments.(Policy Watch)(Brief Article)
August 1, 2004... On July 1, CMS published an interim final lade that provides an $840 million boost in Medicare payments for ambulance services over a five-year period. The interim final rule, which implements four provisions contained in the Medicare...

CMS clarifies Form 1500 billing at incident-to services.(Policy Watch)(Brief Article)
August 1, 2004... CMS published a manual update clarifying billing policy when both an ordering provider and a supervising provider are involved in a service (known as an "incident-to service"). The billing number of the ordering provider should not be used if...

Policy change for MA patients with partial billing period.(Policy Watch)(Brief Article)
August 1, 2004... CMS has changed its Medicare provider policy when a patient is a member of a Medicare Advantage (MA) organization for only a portion of the billing period. According to a June 18 CMS transmittal, if the provider is an inpatient acute care...

CMS announces coverage of PET for Alzheimer's.(Policy Watch)(Brief Article)
August 1, 2004... CMS announced it would cover the use of positron emission tomography (PET) for the diagnosis of Alzheimer's disease (AD). Based on scientific review, CMS determined that use of PET for the diagnosis of suspected AD would be covered for patients...

CMS published the annual ICD-9-CM coding update effective October 1, 2004.(Centers for Medicare and Medicaid Services )(Brief Article)
August 1, 2004... CMS published the annual ICD-9-CM coding update, effective October 1, 2004. Providers will have 171 new ICD-9 codes to use this year, and for the first time, there will be no grace period for obsolete codes. Therefore, providers need to keep...

Beginning October 1, 2004, Medicare will reject all outpatient claims with ICD-9 procedure codes, CMS announced in transmittal 175, dated May 14.(Centers for Medicare and Medicaid Services )(Brief Article)
August 1, 2004... Beginning October 1, 2004, Medicare will reject all outpatient claims with ICD-9 procedure codes, CMS announced in transmittal 175, dated May 14. Medicare has not been rejecting outpatient claims if they contain ICD-9 procedure codes, but this...

CMS issues instructions on Part B "line item date of service".(Centers for Medicare and Medicaid Services)(line item date of service)(Brief Article)
August 1, 2004... Effective October 4, 2004, all outpatient and inpatient Part B claims will need a specific line item date of service (LIDOS) for each revenue code. Claims containing a date range in the LIDOS field will be rejected to prevent duplicate payment...

CMS Manual changed to address service denials to alien beneficiaries.(Centers for Medicare and Medicaid Services )(Brief Article)
August 1, 2004... CMS has created a new section of the Medicare Claims Processing Manual help providers clarify the billing or denial of claims for services to alien beneficiaries. The section changes wording of information of the same title published in...

Pharmaceutical access and cost control measures: a 2004 overview: according to the Congressional Budget Office, spending on prescription drugs grew at an annual inflation-adjusted average of 14.5 percent from 1997 to 2002.(State Policy Watch)
August 1, 2004... Even though recent industry reports indicate prescription drug spending is on the decline for the second year in a row, spending still outpaces that of every other category of health care, and drug prices are growing faster than inflation. With...

A gem of a program: as I begin participating in HFMA's U.S./U.K. Exchange for the second time, I am struck by how truly unique and special this program is.(From The Chairman)(Healthcare Financial Management Association)
August 1, 2004... Each year, HFMA U.S. participates in an exchange program with our sister organization in England, HFMA U.K. The program alternates location annually, allowing 12 pairs, or "twins" to those from across the pond, to visit each other's homes, get...

S&P: not-for-profit financial indicators may have peaked.(Standard & Poor)
August 1, 2004... Standard & Poor's midyear analysis of the healthcare industry calls recent financial indicators "the strongest set of medians in many years," but also cautions that the indicators may be at, or near, their peak. According to the report,...

Senior manager survey addresses CPOE barriers.(Industry Watch)(computerized physician order entry)(Brief Article)
August 1, 2004... Obstacles to hospitals implementing computerized physician order entry (CPOE), including high costs and physician resistance, can be addressed by strong hospital and physician leadership and a focus on the patient safety improvements CPOE can...

MedPAC weighs in on key Medicare operational issues.(Medicare Payment Advisory Commission)(Brief Article)
August 1, 2004... The Medicare Payment Advisory Commission (MedPAC) issued its June 2004 Report to the Congress: New Approaches in Medicare, devoted to certain Medicare policies that affect various segments of the U.S. healthcare system, and how changes in the...

S&P: malpractice poses significant risk.(Industry Watch)(Standard & Poor's)(Brief Article)
August 1, 2004... Some providers see a potential solution to rising malpractice costs through self-insurance, but poor management of self-insurance liability can pose an added credit risk, Standard & Poor's (S&P) cautioned in a June 14 commentary. In other...

Healthcare spending growth slows.(Industry Watch)(Brief Article)
August 1, 2004... Healthcare spending per privately insured American increased 7.4 percent in 2003--the first major slowdown in spending growth in nearly a decade, according to a study by the Center for Studying Health System Change (HSC). However, healthcare...

Study: health plans focus on evidence-based care.(Industry Watch)(Brief Article)
August 1, 2004... Health plans are making substantial changes to shift responsibility to consumers for health decisions and encourage physicians to practice in accord with evidence based guidelines, according to a recent study by the Vanderbilt Center for...

Almost 20 million American families face medical debt.(Industry Watch)(Brief Article)
August 1, 2004... Nearly 20 million American families had problems paying medical bills in 2003, according to a national study by the Center for Studying Health System Change (HSC). The HSC's Community Tracking Study 2003 Household Survey sampled 25,400 families...

Percentage of population with no usual source of care, by race/ethnicity and age.(Industry Watch)(Illustration)
August 1, 2004... Total Population 18.4% <6 7.6% 6-18 13.4% 19-24 37.7% 25-54 23.9% 55-64 11.6% 65+ 6.3% Hispanic 30.8% Black 19.3%...

GAO provides more insight to geographical area designation changes.(Industry Watch)(Brief Article)
August 1, 2004... In a June report, the GAO examined how the 2000 geographical area standards, to be used by Medicare in the 2005 hospital inpatient PPS update, differ from the 1990 standards. Additionally, the report addresses how the application of the...

Quotes of note.(Industry Watch)(Brief Article)
August 1, 2004... "These [lawsuits] will consume already limited healthcare resources that hospitals need to continue their daily work of caring for the uninsured and all other patients in their communities." --Alicia Mitchell, a spokesperson for the...

Ranks of uninsured Americans increase.(Industry Watch)(Brief Article)
August 1, 2004... The total number of uninsured Americans increased to 43.6 million in 2003 (15.2 percent of the population), up from 41.5 million in 2002, according to an early release of health insurance estimates released by the Centers for Disease Control...

Iowa Chapter receives Shelton Award.(HFMA News)(Robert M. Shelton Award to Iowa Chapter)(Brief Article)
August 1, 2004... HFMA's Robert M. Shelton Award for Sustained Excellence was presented to the Iowa Chapter on June 28 at HFMA's Annual National Institute in Nashville, Tenn. The Shelton Award is given in recognition of five years of sustained excellence in...

Anspaugh receives Morgan Award.(Industry Watch)(Frederick C. Morgan Achievement Award to Ronald D. Anspaugh )(Brief Article)
August 1, 2004... HFMA has awarded Ronald D. Anspaugh, FHFMA, the 2004 Frederick C. Morgan Achievement Award--the Association's highest individual honor. Anspaugh is the 46th recipient of this award that honors contributions to healthcare financial management...

Memories of ANI 2004.(HFMA News)(Annual National Institute)(Brief Article)
August 1, 2004... Those attending HFMA's 2004 Annual National Institute in Nashville, Tenn. discovered "Ideas that Work," with more than 2000 speakers and vendors offering practical solutions for addressing the industry's challenges in patient financial...

Bush versus Kerry: the healthcare philosophy debate: with Washington and the rest of the country well into the political season and the candidates (not yet officially designated at the time of this writing) speaking around the country with increasing frequency, it is hardly surprising that health care is once again a favored topic of political conversation.(Eye On Washington)(John Kerry, George W. Bush)
August 1, 2004... Two of the issues most frequently discussed, growing public concerns about the rising cost of health care and the increasing numbers of uninsured, have been major areas of contention in previous elections. The third area most frequently...

Forecasting demand and capacity requirements.(Business)
August 1, 2004... AT A GLANCE A large health system is using a two-step forecasting approach to project future demand and capacity. Comparing its 10-year demand and capacity forecasts that were completed in 2001 with current data, the system was able to...

A proactive (and financially beneficial!) Approach to utilization management.(Revenue Cycle)
August 1, 2004... AT A GLANCE Today's environment offers a host of utilization management challenges for healthcare providers. If hospitals are to minimize denials and reduce costs amid these pressures, they will need to adopt several key strategies,...

Reconcilable differences mending payer-provider relationships.(Managed Care)
August 1, 2004... AT A GLANCE The advent of real-time, web-based technologies is having a surprisingly positive impact on health plans and providers. By being "connected" to health plans, providers have the information they need to operate their practices,...

Emerging roles in revenue cycle leadership.(hfma roundtable)(Panel Discussion)
August 1, 2004... Help Wanted Multihospital healthcare system seeks revenue cycle leader to uncover hidden revenue opportunities to generate internal cash flow and access to capital. Ideal candidate has revenue cycle "vision" and global understanding of the...

Light at the end of the tunnel for denials management: denials management is too important to a provider's financial health to be addressed haphazardly. The Six Sigma performance-improvement methodology can ensure your organization receives the full payment to which it is entitled.(Cover Story)
August 1, 2004... A wretched soul, bruised with adversity, We bid be quiet when we hear it cry; But were we burdened with like weight of pain, As much or more we should ourselves complain. --William Shakespeare A Comedy of Errors Denied claims are a...

Investing in clinical IT: hospital CFOs can play a key role in health care's long-overdue productivity revolution.(Commentary)(chief financial officers)
August 1, 2004... AT A GLANCE To ensure that clinical IT implementation is accomplished properly, healthcare organization executives should involve care givers and gain medical staff support. CFOs need to stretch beyond their own comfort zones and become...

Improving operating room performance in a center of excellence: when implementing a center-of-excellence strategy, a hospital needs to revise its accountability structure, modify its information and reporting system, and establish a culture that supports effective utilization of operating room resources.
August 1, 2004... AT A GLANCE The financial success of centers of excellence typically depends on effective utilization of the OR. Therefore, it's important to align the strategy, structure, information and reporting systems, culture, and behavior of both...

10 ways to improve healthcare cost management: if your hospital hasn't been achieving cost savings, maybe you need to make--or renew--a commitment to cost management.
August 1, 2004... AT A GLANCE As a healthcare CFO, you know that effective financial control has enormous impact on a hospital's bottom line. But how do you maintain that financial control? Well, a few simple improvements in cost management...

Bad debt rising: when to sell your accounts receivable.
August 1, 2004... They merged their identities, their facilities, and their mission statements. And then they attempted to merge their bad debt. In the case of two large Midwest hospitals that merged in 1997, determining what to do with a combined bad debt of...

2004-05 HFMA leadership directory.(Healthcare Financial Management Association)
August 1, 2004... HFMA's Board of Directors is composed of 15 members--10 elected directors, one appointed director, three officers, and the President (HFMA's chief staff officer). The three officers serve one-year terms, and the elected and appointed directors...

Managing yourself: we've all been there: a calendar jam-packed with meetings, e-mails that never stop coming, phones that never stop ringing, and a dizzying number of deadlines that seem to grow exponentially in number and difficulty.(Leadership And Management)
August 1, 2004... As CFOs, we're so busy playing catch-up or platting out fires that there's no time for anything else. It's a part of the job, we tell ourselves. But when those nightmarish days happen more and more frequently, it's time to look at how we manage...

The path to EHR: all signs are pointing to electronic health records (EHRs). President Bush included a statement in his 2004 State of the Union address on the need for computerizing health records.(Digital Perspectives)
August 1, 2004... Several hills before Congress would require adoption or EHRs. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 includes an electronic prescription program. And in the words of David Brailer, MD, PhD., the HHS national...

The importance of being earnest about your business plan: writing about the importance of business planning for a financially oriented audience may equate with preaching to the choir.(New Revenue Growth)
August 1, 2004... But an important question to consider is: Why is so little rigorous business planning done in not-for-profit health care? In other industries, and in for-profit health care, business planning is regularly and effectively used. Why is it so...

Critical access hospitals enter a new era of capital finance: one day this month, with the grand opening of Rio Grande Hospital in Del Norte, Colo., the healthcare industry will have cause to celebrate the completion of the first critical access hospital (CAH) financed with bonds enhanced by HUD FHA-242 mortgage insurance (average interest rate: 5.45%; rating: AA/Aa/AA).(Capital Finance)
August 1, 2004... This event will also mark the beginning of an era of hospital capital finance equivalent to the inauguration of the Hill-Burton hospital construction program in the mid-20th century. With some luck, local media coverage of the ceremony will...

Medication Safety and Cost Recovery: a Four-Step Approach for Executives.(Brief Article)
August 1, 2004... Chip Caldwell, FACHE Charles R. Denham, M.D. Health Administration Press 174 pages; $68 www.ache.org/hap.cfm Think medication safety is a challenge too costly and insurmountable to address? Not so, say Chip Caldwell and Charles R. Denham....

A Concise Guide to Getting Grants for Nonprofit Organizations.(Brief Article)
August 1, 2004... Mark Guyer Nova Publishers/Kroshka Books 122 pages; $19.50 novapublishers.com A Concise Guide to Getting Grants for Nonprofit Organizations is an easy-reading guide to the grant process. But don't let the easy reading fool you. The...

Calendar.(Illustration)(Calendar)
August 1, 2004... Fall 2004 Seminars 9/27-30 10/11-14 Level Seminar Englewood, CO Cambridge, MA Financial Management I/A Achieving-Breakthrough ...

J. Michael Davis (First Illinois Chapter).(People)(Brief Article)
August 1, 2004... Mr. Davis has been appointed senior vice president, health care real estate group, Cain Brothers, Chicago. He had been senior manager, real estate capital markets group. Ernst & Young, Chicago.

Kathy Wood, FHFMA (North Carolina Chapter).(People)(Western Governors University)(Brief Article)
August 1, 2004... Dr. Wood has received her PhD from Capella University. She is faculty mentor, Western Governors University. Sail Lake City.

Diane Christensen Wilson (Iowa Chapter).(People)(Mary Greeley Medical Center)(Brief Article)
August 1, 2004... Ms. Wilson has been appointed director, business office and medical records. Mary Greeley Medical Center, Ames, Iowa. Formerly, she was director, patient accounts. Broadlawns Medical Center, Des Moines, Iowa.

Steven R. Wagoner, CPA (Lone Star Chapter).(People)(Certified public accountants)(National Care Network)(Brief Article)
August 1, 2004... Mr. Wagoner has joined National Care Network, Grapevine, Tex., as director of finance. Previously, he was CFO, North Texas Healthcare Network, Irving, Tex.

Randolph Galler (Tennessee Chapter).(People)(Knoxville Pediatric Associates)(Brief Article)
August 1, 2004... Mr. Galler has been promoted from financial manager to assistant administrator, Knoxville Pediatric Associates, P.C., Knoxville, Tenn.

Jeff Morrow (Louisiana Chapter).(People)(Mt. San Rafael Hospital)(Brief Article)
August 1, 2004... Mr. Morrow has been named COO, Mt. San Rafael Hospital, Trinidad, Colo. Previously, he was assistant administrator, Doctors" Hospital, Shreveport, La.

Linda Hartzfeld Maine (Arizona Chapter).(People)(Option 1 Nutrition)(Brief Article)
August 1, 2004... Ms. Hartzfeld Maine has been named controller, Option 1 Nutrition, Chandler, Ariz. She had been accounting manager, United Healthcare, AmeriChoice MSO. Phoenix.

Spotlight on HFMA members.(Healthcare Financial Management Association)
August 1, 2004... HFMA Is about Sharing Membership in HFMA can offer much more than an opportunity for professional growth. It can be richly rewarding personally, as well. Kimberly Farmer, a member of the Georgia Chapter, shared with us some of her thoughts...

Plante & Moran: helping hospitals meet the financial challenges facing the industry.
August 1, 2004... Hospitals continue to be faced with rising costs, declining reimbursement, and limited resources. Aggressive planning and ongoing cost management are critical to survival in today's health care environment. Additionally, hospitals need to...

U.S. hospitals see opposing trends in cost per discharge versus paid hours per discharge.(Data Trends)
August 1, 2004... After six years of steady increases, cost per case-mix-index (CMI)-adjusted discharge showed encouraging signs of leveling off in 2003. For U.S. hospitals on average, the sharpest single-year jump during this period occurred in 2002, when cost...

Good actors in a bad movie: given the current swirl of activity surrounding charging, discounting, and collection activities by hospitals related to the uninsured, many healthcare executives feel like good actors in a bad movie.(From The President)
August 1, 2004... That is, they are trying to play their roles as best they can within a script of illogical, contradictory, and byzantine regulations and payment systems. It is no wonder that most are bewildered by the latest onslaught--more than two dozen...