Healthcare Financial Management articles from December 2004

Healthcare Financial Management archives from December 2004

Final outpatient rule tightens outlier criteria.(Policy Watch)(Brief Article)
December 1, 2004... Criteria for outlier payments are more stringent in the final rule regarding the 2005 Medicare hospital outpatient PPS than in the rule CMS proposed August 9. Otherwise, the final rule adopts most provisions of the proposed rule. To...

2005 physician fee schedule increases payments, preventive care.(Policy Watch)(Brief Article)
December 1, 2004... CMS has implemented the MMA's second consecutive 1.5 percent physician payment increase and new preventive care benefits in the final physician fee schedule update for 2005. This 1.5 percent increase comes in place of a 3.3 percent decrease...

Psych PPS phase-in to start January 1.(Policy Watch)(prospective payment systems)(psychiatric)(Brief Article)
December 1, 2004... CMS has released the final rule establishing a PPS for inpatient psychiatric facilities (IPFs) and units built around per diem payments, a shift from the current per-case, cost-based system. The IPF PPS will be launched with reporting periods...

CMS: presenting symptoms should determine medicare ED payments.(Policy Watch)(Centers for Medicare and Medicaid Services)(Brief Article)
December 1, 2004... Under the Emergency Medical Treatment and Labor Act (EMTALA), intermediaries must base payment decisions on the information that is available to the treating physician when determining whether a service is reasonable and necessary. according to...

CMS issues instructions on FY05 inpatient PPS final rule.(Policy Watch)(Centers for Medicare and Medicaid Services)(prospective payment systems)(Brief Article)
December 1, 2004... On October 1, CMS published instructions on certain pricer program and provider specific provisions of the 2005 inpatient PPS final rule. Hospitals considered low volume would receive a a5 percent bonus to the operating final payment, according...

Reminder: grace period ending for discontinued HCPCS codes.(Policy Watch)
December 1, 2004... CMS has issued a reminder that, effective January 1, 2005, Medicare providers will no longer have a 90-day grace period for the use of discontinued healthcare common procedure coding system (HCPCS) codes for services rendered in the first 90...

A provision to bar the Department of Labor (DOL) from implementing controversial regulations on overtime exemptions was dropped from the final version of the American Jobs Creation Act of 2004 (HR 4520).(Brief Article)
December 1, 2004... ... A provision to bar the Department of Labor (DOL) from implementing controversial regulations on overtime exemptions was dropped from the final version of the American Jobs Creation Act of 2004 (HR 4520). The DOL regulations revised and...

CMS published a transmittal clarifying Medicare's role as secondary payer in situations of temporary leave of absence.(Centers for Medicare and Medicaid Services )(Brief Article)
December 1, 2004... ... CMS published a transmittal clarifying Medicare's role as secondary payer in situations of temporary leave of absence. According to CMS, if an employee is on a temporary leave of absence, Medicare remains the secondary payer because the...

CMS expands on summary instructions for billing noncovered charges to intermediaries.(Policy Watch)(Centers for Medicare and Medicaid Services)(Brief Article)
December 1, 2004... Effective April 1, 2005, CMS will allow institutional providers to submit noncovered provider liable outpatient claims to fiscal intermediaries without condition codes 20 (provider liable claims) or 91 (demand bills), according to change...

CWF edits to be revised for SNF consolidated billing payments.(Policy Watch)(common working file)(skilled nursing facility)(Brief Article)
December 1, 2004... Effective January 1, 2005, changes to HCPCS codes and the Medicare physician fee schedule designations will be used for the 2005 update of the common working file (CWF) edits. These code changes will allow carriers to make payments in...

State interim activities focus on health insurance access and cost: the activities of state legislatures between sessions are strong indicators of the issues state policymakers will consider during the regular legislative session.(State Policy Watch)
December 1, 2004... Five states--Arkansas, Nevada. North Dakota, Oregon, and Texas--have pursued significant interim activities that have important implications with respect to health insurance access and costs. Each of these states convenes its legislative...

Mining for gold: patient satisfaction is not uppermost in every healthcare financial manager's mind. But it should be.(From The Chairman)
December 1, 2004... How patients perceive the healthcare experience can mean the difference between turning a profit or showing a loss. Marketing professionals regularly quote the following facts about customer satisfaction: * For every one customer who...

Hospital chains' latest reports reflect uncertainty.(Industry Watch)(Brief Article)
December 1, 2004... Third quarter reports to investors reflect notable variations in financial performance for six of the nation's for-profit hospital chains. Reports recently issued were from Community Health Systems (CHS), Hospital Corporation of America (HCA),...

Study: vendors using EHR standards in product design.(Industry Watch)(electronic health records)(Brief Article)
December 1, 2004... A majority of healthcare IT companies are using the HL7 electronic health record (EHR) draft standard for trial use (EHR-S DSTU) in the design of their EHR product, according to a survey conducted by the American Health Information Management...

Healthcare employment costs rise.(Industry Watch)(Brief Article)
December 1, 2004... Third-quarter 2004 compensation costs for health services rose 1.3 percent, up from 0.8 percent in the second quarter, according to Bureau of Labor Statistics Employment Cost Index data released October 29. The rate of increase outpaces...

State spending controls hinder Medicaid, SCHIP enrollment.(Industry Watch)(State Children's Health Insurance Program)(Brief Article)
December 1, 2004... States that are striving to provide health insurance coverage to low-income populations are still burdened by pressures to reduce spending, according to a recent report released by the Kaiser Commission on Medicaid and the Uninsured. Total...

Health plan rate increases decline, CDH plan offerings rise.(Industry Watch)(consumer drive health)(Brief Article)
December 1, 2004... Milliman's annual survey of HMOs and preferred provider organizations (PPOs) indicates a slowing of renewal rate increases. The anticipated 2005 renewal rate increase of 11 percent for HMOs is down from the 15 percent reported in the 2003...

Study cites health insurance gap.(Industry Watch)(Brief Article)
December 1, 2004... The health insurance gap among Latino, black, and white Americans persisted in 2003, with one in three Latinos, one in five blacks, and one in 10 whites under age 65 lacking health insurance, according to a national study released today by the...

Weight-loss surgery effective for extremely obese patients.(Industry Watch)(Brief Article)
December 1, 2004... Bariatric surgery may be an effective weight reduction option for extremely obese patients who have tried and failed to lose weight with exercise and diet, especially those with life threatening illnesses, according to a report issued October 8...

Health organizations: electronic records will have positive impact.(industry watch)(Brief Article)
December 1, 2004... A recent Capgemini survey found that the majority of executives at major health organizations believe that electronic health records (EHRs) will have a positive financial effect on their organizations over time. More than 70 percent of...

AHA assesses specialty hospital impact.(Industry Watch)(American Hospital Association)(Brief Article)
December 1, 2004... The American Hospital Association's (AHA's) latest analysis of trends and developments affecting hospitals finds the tremendous growth in specialty, or limited-service, hospitals can result in negative financial outcomes and potential patient...

Hospitals receive slightly higher payments in September.(Industry Watch)(Brief Article)
December 1, 2004... The Producer Price Index (PPI) for hospital services rose by 0.2 percent in September, recovering from the slight 0.1 percent dip in August, the Bureau of Labor Statistics reported October 15. Payments received by hospitals have increased 5.2...

Quotes of note.(Industry Watch)(Brief Article)
December 1, 2004... "It is clear that closing the coverage gap for low-income families will require additional federal resources if states are to expand coverage." Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, on...

HFMA conference to focus on the uninsured.(HFMA News)(Healthcare Financial Management Association)(Brief Article)
December 1, 2004... As the uninsured population continues to grow, HFMA is helping healthcare leaders implement proactive practices that satisfy patients, the government, the community, and healthcare organizations' financial obligations. At HFMA's 2005 Spring...

HFMA leaders exchange ideas during Fall Presidents Meetings.(HFMA News)(Healthcare Financial Management Association)
December 1, 2004... Presidents and presidents elect from HFMA's 70 chapters provided ideas and feedback about local education, charter requirements, chapter awards, performance benchmarks, and other chapter concerns during this year's Fall Presidents Meetings. The...

Reich to speak at Region 11 Healthcare Symposium.(HFMA News)(Robert Reich)
December 1, 2004... Robert Reich will deliver one of this year's keynote addresses at the HFMA Region 11 Healthcare Symposium, January 23-26 in Las Vegas. Reich, an economist, author, and former cabinet member, has served in three national administrations, most...

Four more years! time to celebrate ... or prepare? The 2004 elections are history. It's time for the industry to begin assessing the outlook for the next four years and developing plans that account for some pretty significant "what-ifs.".(Eye On Washington)
December 1, 2004... Bush Lite We (the collective "we") opted for no change in the federal administration. The Republican and Democratic healthcare platforms were characterized in some quarters as "too little" and "too much," respectively. The Republicans,...

'I like a challenge; I don't like status quo.' "Challenge" is a word that perhaps could be better defined by Michael W. Louge, CPA, CFO of OhioHealth, than by Merriam-Webster. An operating loss of $30 million, a revenue cycle meltdown, and a $142 million technical bond default faced Louge during his first two weeks on the job.(hfm Interview)(chief financial officer)
December 1, 2004... The largest hospital system in central Ohio, not-for-profit OhioHealth was an AA-rated system in the early 1990s. However, following the passage of the Balanced Budget Act of 1997, the hospital-system began to decline; in 1999, it suffered a...

Strengthening hospital-physician relationships.(Business)
December 1, 2004... When hospitals and physicians work well together, they can Better provide patient care efficiently and cost-effectively. But hospitals and physicians face many challenges today that can undermine their close working relationship. For optimal...

Are you speeding toward revenue loss?(Revenue Cycle)
December 1, 2004... It's the mantra of the PFS professional: Keep your eye on days in accounts receivable. Sometimes, however, even this cardinal rule is made to be broken. Too often, a steadfast reliance on cash-flow goals results in revenue management...

Looking ahead to Medicare 2005: successful hospitals know how to manage both revenue and costs to survive under a tightened Medicare reimbursement structure.(Cover Story)
December 1, 2004... What's on the healthcare industry horizon in terms of Medicare payment for hospitals? Although much has changed over the past year in the political, economic, and social markets for health care, the underlying payment mechanics and long-term...

The price is right: for optimal price setting, you'll need a strategic focus that adjusts for recent industry trends.(Feature Story)
December 1, 2004... At most healthcare systems, commercial pricing approaches tend to follow three common themes: Most systems will price at the margin, meaning they consider pricing new business to cover variable costs and margin if capacity exists. If no excess...

Blending hospital economics with quality of care: a case study: regulatory and market forces are combining to drive U.S. health care toward integration of clinical quality and healthcare finance--and creating new challenges for healthcare CFOs.(Feature Story)
December 1, 2004... Looming on the healthcare horizon is pay-for-performance, an emerging payment model that bases reimbursement on clinical outcomes as well as resource utilization. CMS and employer coalitions such as The Leapfrog Group have initiated programs to...

Cool, calm, and collected medical center successfully regroups after financial crisis: true leaders don't panic when the going gets tough. They know calm perseverance and a clear plan of action will carry their organizations through even the worst storms.(Feature Story)
December 1, 2004... "Out of life's school of war: What does not destroy me, makes me stronger." --Friedrich Nietzsche The key to strong executive leadership is knowing when and how to act in a crisis. When you are in a crisis, maintaining the status quo...

Receivables asset behavior dashboard.(Toolbox)(Illustration)
December 1, 2004... AR PORTFOLIO INDICATORS Position Target Variance Days Revenue Outstanding: 68.4 (8.0) Total AR Position: $164,109,119 -$19,109,119...

Thinking beyond the traditional receivables asset behavior dashboard.(Toolbox)
December 1, 2004... Dashboards are an excellent means of communicating information throughout an organization, and provide the quickest way for managers to see in an instant how they are performing, what has changed, and what processes and trends are affecting...

Inside the real world of capital allocation.(Brief Article)
December 1, 2004... "Ask, and you shall receive" isn't a motto you're likely to find framed on the wall of a healthcare finance manager's office. Although there's no shortage of routine or strategic requests for capital funds, access to capital is still tight....

Roundtable participants.(roundtable)(Brief Article)
December 1, 2004... Joe Byorick, Senior vice president and CFO, Lancaster General, a multi entity healthcare system based in Lancaster, Penn., that includes the 521-bed Lancaster General Hospital. Richard L. Clarke, FHFMA, President and CEO, Healthcare...

Roundtable discussion.(roundtable)(Panel Discussion)
December 1, 2004... * Let's talk about the process of collecting requests for capital projects. How should the process work? How does it work at your health system? * Byorick: For routine capital planning each year, we rely on our VP team to gather requests...

Due diligence in everyday decision making: the wisest healthcare financial managers are taking their due diligence responsibilities seriously.(Leadership And Management)
December 1, 2004... Our June column introduced the relationship between due diligence and leadership. The column reviewed the origins of due diligence in the Federal Sentencing Guidelines as the concept is applied to important legal decisions regarding mergers and...

5 rules for effective IT investment planning: making a poor choice when it comes to investing in IT not only can be costly, it can prevent your organization from achieving optimal operations. In worst-case scenarios, poor investments may even impede your organization's performance--possibly, for years to come.(Digital Perspectives)
December 1, 2004... With so much on the line, what can you do to increase your likelihood for success? Hospital executives are best served by following the five steps for effective IT investment presented below. 1. Decide where you want to go as a business...

To divest or not to divest? That is (sometimes) the question.(new revenue growth)
December 1, 2004... To date, my "New Revenue Growth" columns have focused on growth strategies, arguing that purposeful, systematic, managed growth is feasible and desirable for most healthcare organizations. Pursuit of such growth in the logical, orderly way...

Followership: a Practical Guide to Aligning Leaders and Followers.(Brief Article)(Book Review)
December 1, 2004... Tom Atchison Health Administration Press 236 pages, $65 www.ache.org/hap.cfm According to the authors, followership is the single defining factor for leadership. True leaders inspire commitment from executives, managers, physicians, and...

The Health Care Industry: a Primer for Board Members.(Brief Article)(Book Review)
December 1, 2004... Dennis D. Pointer and Stephen J. Wiliams Jossey-Bass 160 pages, $37 www.josseybass.com The Health Care Industry: A Primer for Board Members helps board members understand the importance and complexity of the industry they have chosen to...

Calendar.(Calendar)
December 1, 2004... Spring 2005 Seminars Level Seminar March 14-17 San Francisco Financial Management I/A Achieving Breakthrough...

Dianne L. Bornia.(People)(appointments at Perot Systems Revenue Cycle Solution)(Brief Article)
December 1, 2004... Dianne L. Bornia, RHIA, CHFP (Southern California Chapter) Ms. Bornia has joined Perot Systems Revenue Cycle Solution, HIM Practice, Lake Forest, Calif., as senior manager. Previously, she was compliance/privacy officer and corporate...

Barry Gold.(People)(appointments)(Brief Article)
December 1, 2004... Barry Gold, FHFMA, CPA, CPE (Metropolitan New York Chapter) Mr. Gold has been appointed CFO. Visiting Nurse Association, Vero Beach, Fla. Formerly, he was founder and president, Caduceus Management, LLC, New York.

David Epstein.(People)(appointments)(Brief Article)
December 1, 2004... David Epstein (San Diego Chapter) Mr. Epstein has joined BDO Seidman, LLP, Costa Mesa, Calif., as director of healthcare advisory services. He had been vice president, business development, financial services division, QuadraMed, Eneinitas,...

Jeff Ladenburger.(People)(appointments, Catholic Healthcare Partners)(Brief Article)
December 1, 2004... Jeff Ladenburger, FHFMA, CPA (Southwestern Ohio Chapter) Mr. Ladenburger has been appointed audit director, Catholic Healthcare Partners. Cincinnati. Previously, he was vice president, audit. CHAN Healthcare Auditors, Cincinnati.

Nikki Parham.(People)(appointments, Eligibility Services Inc.)(Brief Article)
December 1, 2004... Nikki Parham (Lone Star Chapter) Ms. Parham has been appointed vice president, business process outsourcing operations, Eligibility Services, Inc.. Dallas. She had been director, healthcare strategy and operations, EDS Corporation, Piano,...

Thomas Evans.(People)(appointments at North Ottawa Community Health System)(Brief Article)
December 1, 2004... Thomas Evans (Western Michigan Chapter) Mr. Evans has been named vice president, fiscal services/CFO, North Ottawa Community Health System, Grand Haven, Mich. Previously, he was CFO, Oaklawn Hospital, Marshall, Mich.

Robert J. Hemmen, Jr.(People)(appointments at Alaska Primary Care Association)(Brief Article)
December 1, 2004... Robert J. Hemmen, Jr., CPA (Washington/Alaska Chapter) Mr. Hemmen has been promoted from finance officer to deputy director/CFO, Alaska Primary Care Association, Anchorage, Alaska.

Michael J. Yont.(People)(appointments at CCA Healthcare Receivable Solutions)(Brief Article)
December 1, 2004... Michael J. Yont, CHFP (Colorado Chapter) Mr. Yont has been named regional director, business development, CCA Healthcare Receivable Solutions, Parker, Colo. Previously, he was CEO, Advantage Network Systems. Albuquerque, N.M.

Dalton Tong.(People)(awards)(Brief Article)
December 1, 2004... Dalton Tong, FHFMA, MBA, CPA, FACHE (Washington Metropolitan Chapter) Mr. Tong, a former member of HFMA's National Board of Directors, was awarded the Faculty of the Year Award for excellence in teaching by the Johns Hopkins University...

Mark Farlin.(People)(appointments)(Brief Article)
December 1, 2004... Mark Farlin (Lone Star Chapter) Mr. Farlin has been named vice president, Healthcare/Energy Finance Group, Dallas. Formerly, he was vice president, senior account/business development manager, GE Healthcare Financial Services, Dallas.

Robert Allen.(People)(appointments)(Brief Article)
December 1, 2004... Robert Allen (Lone Star Chapter) Mr. Allen has been appointed controller, University Medical Center, Dallas. Formerly, he was controller, Presbyterian Hospital of Dallas.

Insurance rates for hospital professionals may slow in 2005.(Data Trends)
December 1, 2004... The rapid rise in professional liability insurance rates that hospital professionals and physicians have experienced in recent years may be slowing, results of a recent study indicate. The study, conducted by Aon, looked at 10 years of loss...

The elections are over--now what? The most hotly contested, advertised, and debated presidential election in years is finally over--alleluia.(from the President)
December 1, 2004... In the end. President Bush won a second term and the Republicans retained control of the Congress. Regardless of your politics, its important now to look ahead to see what might be in store for healthcare organizations. During the...