Healthcare Financial Management articles from August 2008

Healthcare Financial Management archives from August 2008

Second national scorecard on U.S. Healthcare System finds no overall improvement.(Healthcare Quality)
August 1, 2008... A new national scorecard from The Commonwealth Fund Commission on a High Performance Health System finds that the U.S. healthcare system has failed to improve overall and that scores on access have declined significantly since the first...

Sounds like a good idea to us.(Healthcare Quality)(reducing admistrative cost on health insurance)(Brief article)
August 1, 2008... SOUNDS LIKE A GOOD IDEA TO US: Reducing health insurance administrative costs to the average level of countries with mixed private/public insurance systems would free up $51 billion annually, or more than half the cost of providing...

State Legislatures still finding ways to fund and deliver health care--or not.(State Watch)
August 1, 2008... Tax breaks, insurance policy reforms, increases in cigarette taxes, and expansion of children's healthcare programs are some of the ways the states have been addressing (or trying to address) health care during their 2008 legislative sessions....

... The Centers for Medicare and Medicaid Services (CMS) has announced that it will add Elsevier Gold Standard's Clinical Pharmacology compendium to the list of Medicare anticancer treatment compendia.(CMS)(Brief article)
August 1, 2008... ... The Centers for Medicare and Medicaid Services (CMS) has announced that it will add Elsevier Gold Standard's Clinical Pharmacology compendium to the list of Medicare anticancer treatment compendia. Medicare local contractors use compendia...

... In accordance with the sunset of the Medicare, Medicaid, and SCHIP Extension Act, which expired June 30, 2008, Carriers/AB Medicare administrative contractors are now required to implement provider education activities.(CMS)(Brief article)
August 1, 2008... ... In accordance with the sunset of the Medicare, Medicaid, and SCHIP Extension Act, which expired June 30, 2008, Carriers/AB Medicare administrative contractors are now required to implement provider education activities to notify the...

... In November 2006, CMS determined that percutaneous transluminal angioplasty (PTA) and stenting of intracranial arteries are reasonable and necessary for treatment of cerebral artery stenosis greater than or equal to 50 percent in patients with intracranial atherosclerotic disease when furnished in accordance with FDA-approved protocols governing Category B investigational device exemption (IDE) clinical trials.(CMS)(Brief article)
August 1, 2008... ... In November 2006, CMS determined that percutaneous transluminal angioplasty (PTA) and stenting of intracranial arteries are reasonable and necessary for treatment of cerebral artery stenosis greater than or equal to 50 percent in patients...

A heart-stopping figure.(NEWS WATCH)(higher revenue from cardiology procedures )(Brief article)
August 1, 2008... A HEART-STOPPING FIGURE: Cardiology procedures are the most lucrative for hospital outpatient departments, according to HealthLeaders Media July Fact File. At $11.2 billion, they bring in the highest total annual revenue.

... CMS received a request from the American Academy of Otolaryngology-Head and Neck Surgery to reconsider its 2005 NCD for continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) to allow for coverage of CPAP based on a diagnosis of OSA by home sleep testing (HST).(CMS)(Centers for Medicare & Medicaid Services)(American Academy of Otolaryngology - Head and Neck Surgery)(Brief article)
August 1, 2008... ... CMS received a request from the American Academy of Otolaryngology-Head and Neck Surgery to reconsider its 2005 NCD for continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) to allow for coverage of CPAP based...

Who needs tonsils, anyway?(NEWS WATCH)
August 1, 2008... WHO NEEDS TONSILS, ANYWAY?: Ear, nose, and throat specialists perform 111 tonsillectomies per year, on average, making them the most valuable specialists per capita. Cardiologists perform an average of only 53 left heart catheterizations...

... By means of a final rule (Federal Register, June 27, 2008), CMS has established appeals processes for all providers and suppliers, including durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers whose enrollment, reenrollment, or revalidation application for Medicare billing privileges is denied and whose Medicare billing privileges are revoked.(FEDERAL REGISTER)(Brief article)
August 1, 2008... ... By means of a final rule (Federal Register, June 27, 2008), CMS has established appeals processes for all providers and suppliers, including durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers whose...

Sometimes 4 percent is a pretty big number.(NEWS WATCH)(using electronic records could save expenses)(Brief article)
August 1, 2008... SOMETIMES 4 PERCENT IS A PRETTY BIG NUMBER: The Center for Information Technology Leadership estimates that electronic health records could save $77.8 billion a year-or about 4% in a $2 trillion health system, according to the June issue of...

... Medicare regulations to implement section 935(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 have been modified by a final rule (Federal Register, June 27, 2008) pertaining to the use of repayment plans (also known as extended repayment schedules [ERS]) for Medicare provider and supplier overpayments.(FEDERAL REGISTER)(Brief article)
August 1, 2008... ... Medicare regulations to implement section 935(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 have been modified by a final rule (Federal Register, June 27, 2008) pertaining to the use of repayment plans...

... By means of a final rule (Federal Register, June 27, 2008), CMS provides a special enrollment period (SEP) for Medicare Part B and premium Part A for certain individuals who are sponsored by prescribed organizations as volunteers outside the United States and who have health insurance that covers them while outside the United States.(FEDERAL REGISTER)(Brief article)
August 1, 2008... ... By means of a final rule (Federal Register, June 27, 2008), CMS provides a special enrollment period (SEP) for Medicare Part B and premium Part A for certain individuals who are sponsored by prescribed organizations as volunteers outside...

The last frontier.(NEWS WATCH)(Alaska to look after health insurance of retirees)(Brief article)
August 1, 2008... THE LAST FRONTIER: Alaska is one of two states (the other is Ohio) that have constitutional guarantees of healthcare benefits for retired employees. But Alaska faces a potential per capita healthcare obligation for state residents of between...

HFMA releases report on payment system reform at ANI.(Quick Hits: Top News Stories of the Month)(Healthcare Financial Management Association)(Brief article)
August 1, 2008... At its Annual National Institute in Las Vegas on June 24, HFMA released the first in a series of reports that will collectively address building a new healthcare payment system. Healthcare Payment Reform: From Principles to Action. The report...

House, Senate override Bush veto of physician payment fix.(Quick Hits: Top News Stories of the Month)(Brief article)
August 1, 2008... On July 15, as expected, President Bush vetoed the Medicare bill containing the physician payment cut restoration--and both the House and Senate overrode the veto within hours of his action. The House vote was 383 to 41: in the Senate. it was...

Employer medical costs to increase by 9.6 percent in 2009: report.(Quick Hits: Top News Stories of the Month)(Brief article)
August 1, 2008... Although medical costs have increased steadily for decades, the rate of growth has been slowing in each of the past five years. No more, however: In 2009, the downward trend is expected to level off, and actual medical costs are expected to...

More than $7 million in incentive payments to go to top hospitals.(Quick Hits: Top News Stories of the Month)(United States. Centers for Medicare and Medicaid Services)(Brief article)
August 1, 2008... The Centers for Medicare and Medicaid Services (CMS) announced on June 17 that it will award incentive payments of more than $.7 million to 112 top -performing hospitals in the third year of the CMS/Premier Hospital Quality Incentive...

Access to care deteriorates between 2003 and 2007: study.(Quick Hits: Top News Stories of the Month)
August 1, 2008... More than 20 percent of the U.S. population in 2007--one in five people--reported not getting or delaying needed medical care in the previous 12 months, up significantly from 14 percent in 2003, according to a national study released June 26 by...

CMS proposes 3 percent inflation update for ASC services for 2009.(Quick Hits: Top News Stories of the Month)(Centers for Medicare & Medicaid Services )(Brief article)
August 1, 2008... CMS issued a proposed rule on July 3 intended to update payment rates for CY09 and improve quality of services provided in hospital outpatient departments and ambulatory surgical centers. The rule includes a 3 percent annual inflation update to...

Riding for kids: Cheryl Cohen bicycled 500 miles in July to make a difference for at-risk youth and their families.(Member Spotlight)(Cheryl Cohen)
August 1, 2008... A week after the Fourth of July fireworks exploded against a summer night sky, Cheryl Cohen, FHFMA, burst forth on her bicycle on a 500-mile trek to help at-risk youth. Cohen, a member of HFMA's New Jersey Chapter, bicycled from Rutland,...

Savor the flavor of these award-winning hospital meals.(hospital food services taking quality care of inpatient)
August 1, 2008... Imagine you're a hospital inpatient and these gourmet meals are yours for the choosing: * Morel-and-rosemary-crusted pork chop with sauteed baby carrots, mini zucchini, and fingerling potatoes in bourbon demi-glace *...

Consumer-friendly EOBs from health plans? Not likely.(VIEWS)(Tommy Thompson)(explanations of benefits)(Viewpoint essay)
August 1, 2008... Recently I attended the annual institute meeting of America's Health Insurance Plans (AHIP). During one session, former Secretary of Health and Human Services Tommy Thompson, along with former senators William Frist and John Breaux, offered...

Unexpected connections: as you travel through life, you never know how you will influence those around you.(making connections)(Personal account)
August 1, 2008... Recently, I was having breakfast prior to attending an HFMA regional meeting. A gentleman sitting at the next table was talking with one of the HFMA chapter members. The man, who looked to be about 70 years old, was asking about privacy of...

Talking risk: we were on our way to buy a used car, and so the idea of risk was on my mind.(FROM THE EDITOR)(Editorial)
August 1, 2008... From the passenger seat, I asked the kids to tell about a time they've taken risks. "I take risks on my reading tests," our 8-year-old called out from the back seat. "Sometimes I answer what I think is best even if I think there's a more...

Addressing roadblocks to hospital-physician alignment: the Hippocratic Oath is a guiding force behind every decision that a physician makes. But it would be idealistic not to acknowledge that physicians have economic as well as humanitarian interests at stake whenever they take on a new patient or order a diagnostic test. The same, of course, is true of hospitals.(HEALTHCARE REFORM)
August 1, 2008... Hospitals and physicians should work hand in hand to ensure patients receive high-quality care at the lowest possible cost. But this utopian vision ignores two major monetary roadblocks: malpractice and the practice of defensive medicine, and...

The rewards of accurate clinical documentation.(REVENUE CYCLE)
August 1, 2008... Hospitals are in their first year of transition to the Medicare severity-adjusted diagnosis-related group (MS-DRG) system, adapting to a Centers for Medicare and Medicaid Services (CMS) recalibration that introduced new or modified DRGs to...

Lessons learned with MS-DRGs getting physicians on board for success.(MEDICARE/MEDICAID)(medical severity diagnosis-related groups)
August 1, 2008... The preparation was long and arduous, but it has paid off. One year after Medicare's biggest modification to the inpatient prospective payment system (IPPS) since the 1980s, revenue cycle departments are involved, CFOs understand the financial...

Managing risk in a challenging financial environment: in the wake of the subprime mortgage crisis, it is time for risk to receive the attention it deserves in executive suites and boardrooms of the nation's hospitals and health systems.(Cover story)
August 1, 2008... The subprime mortgage crisis of 2007, whose effects continue to be felt throughout the capital markets, is demonstrating to many healthcare financial executives the downside of risk. Up to the point when hospitals felt the impact of this...

The failure of AHERF: 5 important lessons: the AHERF bankruptcy highlighted the importance of strong leadership and governance oversight of management in healthcare organizations.(FEATURE STORY)(Allegheny Health and Education Research Foundation)(Reprint)
August 1, 2008... [ILLUSTRATION OMITTED] July 21, 2008, marks the 10th anniversary of the bankruptcy filing and payment default of Allegheny Health and Education Research Foundation (AHERF). With $2 billion in revenue and $555 million of outstanding debt,...

Liability-driven investing an enterprise risk management strategy: learn more about how your organization's liabilities can figure into an effective risk management strategy.(FEATURE STORY)
August 1, 2008... To best navigate the bumps and turns in the healthcare road, the savvy hospital financial executive should understand risks at all levels of the organization and how they may potentially interact. Yet many facilities wear blinders when they...

Grasping recent changes to the PRRB appeal process: the Centers for Medicare and Medicaid Services recently adopted new regulations for appeals to the Provider Reimbursement Review Board. What will the changes mean for your organization?(FEATURE STORY)
August 1, 2008... In Medicare, nothing endures like change. On May 23, 2008, the Centers for Medicare and Medicaid Services (CMS) published a final rule adopting several substantial changes to the regulations governing appeals to the Medicare Provider...

Concierge services helping employees and the bottom line: looking for creative ways to add to employee benefits, some healthcare organizations are offering concierge services.(FEATURE STORY)(HealthOne Corp.)
August 1, 2008... Imagine arriving at work only to receive a phone call from your son or daughter at school saying he or she left an important assignment at home that morning and needs it right away. Then your boss stops by and asks whether you would mind taking...

Want independent validation and assurance? Ask for a SAS-70: if your organization is preparing to enlist (or currently uses) a third-party service provider to initiate a process or record transactions on its behalf, you should request a SAS-70 audit report.(FEATURE STORY)(Certified public accountants)
August 1, 2008... The term SAS-70 is a shorthand reference to two types of service audit reports described in Statement on Auditing Standards No. 70, Service Organizations, an auditing standard developed and issued by the American Institute of Certified Public...

Balance sheet assets and credit rating what's the connection? Your organization's investment decisions can have a significant impact on key credit metrics.(FEATURE STORY)
August 1, 2008... Historically, investment committees have relied on risk/return asset-only strategies when making investment decisions for balance sheet asset pools. However, recent research confirms that these allocation strategies can have a significant...

The rise of the bank infomediary in health care: privacy and security regulations and the rise of consumer-driven health care are changing the role of banks in health care.(FEATURE STORY)
August 1, 2008... For many years, banks have been considered money changers that ply their trade in between healthcare stakeholders. The emergence of data privacy and security mandates coupled with growth in account-based health plans managed by banks is...

ANI rewind: an HFMA news special: Monday-Thursday, June 23-26, 2008.(A RECAP OF HFMA'S 2008: ANI: The Healthcare Finance Conference)(Conference news)
August 1, 2008... It's a time to rekindle your passion for the work you do, to reconnect with friends new and old. and to realize new opportunities to learn and grow, whether personally or professionally. It's also a time to celebrate the achievements of your...

Clinical documentation specialist staffing requirements.(hfm TOOLBOX)(Medicare severity diagnosis-related group)
August 1, 2008... Changes in 2008 to the inpatient prospective payment system, which established the Medicare severity diagnosis-related group (MS-DRG) system, can significantly affect a hospital's bottom line. The MS-DRG system is designed to capture...

2008-09 HFMA leadership directory.(2008-09 National Board of Directors--2008-09 NATIONAL ADVISORY COUNCILS)(Directory)
August 1, 2008... 2008-09 National Board of Directors [ILLUSTRATION OMITTED] CHAIRMAN Robert L. Broadway, FHFMA Vice President, Corporate Strategy Bethesda Healthcare System Boynton Beach, Fla. [ILLUSTRATION OMITTED] ...

2008-09 HFMA leadership directory.(2008-09 CHAPTER PRESIDENTS)(Directory)
August 1, 2008... Region 1 [ILLUSTRATION OMITTED] Connecticut Chapter James M. Harris Director of Budget and Reimbursement Saint Francis Hospital and Medical Center Tolland, Conn. [ILLUSTRATION OMITTED] Maine Chapter ...

Leading innovation in a risk-averse healthcare environment: the role of the healthcare CFO is changing.(LEADERSHIP AND MANAGEMENT)
August 1, 2008... The days of managing solely by the numbers are over. Increasingly, healthcare CEOs are looking to their organizations' CFOs to help determine how the organization can do things better and faster. More and more, the CFOs are expected to bring...

HIEs: survival of the fittest: an estimated 130 health information exchange (HIE) organizations exist today--and many of these fledgling HIEs are at risk.(INSIDE IT)
August 1, 2008... Some HIE organizations have already gone out of business, while new ones continue to form. Although they go by different names--local health information organizations (LHIO), regional health information organizations (RHIO), sub-network...

What would you do? Affiliate, merge, or stay independent?(STRATEGY CHALLENGE)(Financial report)
August 1, 2008... The Problem Metro Mercy Hospital (MMH) has been in a downward spiral, resulting in losses in the past few years and a tenuous cash position. Although a new CEO has recently been hired and a turnaround begun, the board is unclear as to...

National events.(Conference news)(Calendar)
August 1, 2008... October 27-29 HFMA's 2008 Revenue Cycle Strategies Conference Las Vegas This year, HFMA's Revenue Cycle Strategies Conference is combining hands-on peer workgroups with hot topic breakout sessions and general sessions to provide...

Supply chain benchmarking.(DATA TRENDS)(using business logistics in hospital)(Financial report)
August 1, 2008... Many organizations rely on industry benchmarks to evaluate labor productivity, but only a few use a similar approach to address nonlabor expenses. It can be instructive to compare supply chain metrics among different sizes of hospitals, in...

AHERF and enterprise risk management: this year marks an unhappy anniversary: ten years have passed since the largest not-for-profit healthcare bankruptcy in history.(FROM THE PRESIDENT)
August 1, 2008... In this issue of hfm, Lisa Goldstein, senior vice president and team leader of Moody's Investors Service, writes about the 10th anniversary of the Allegheny Health, Education, and Research Foundation (AHERF) bankruptcy and what that financial...

Strategies and tools for improving transcription and documentation.(hfma roundtable)(interview of)(Gloryanne Bryant of HIM compliance, Catholic Healthcare West)(Christopher A. Clarke of UCSD Medical Center)(Stephen S. Cooley of MediCorp Health System)(Interview)
August 1, 2008... Failure to accurately document care provided is a significant threat to hospital revenue and compliance. What's more, it's only expected to become more important as documentation efforts grow increasingly more sophisticated to respond to the...

Leveraging business intelligence for revenue improvement.(HFMA EDUCATIONAL REPORT)
August 1, 2008... [ILLUSTRATION OMITTED] The workflow processes that influence the financial performance of a hospital are diverse, ranging from scheduling and registration to coding, billing, and collections. And so are the many stakeholders' roles and...