Healthcare Financial Management articles from December 2005

Healthcare Financial Management archives from December 2005

OIG counsel emphasizes caution on gainsharing ventures.(POLICY WATCH)
December 1, 2005... Gainsharing arrangements may violate the civil monetary penalty rule and pose a substantial risk of violating the federal anti-kickback statute, concluded Lewis Morris, chief counsel of the Department of Health and Human Services Office of...

Medicare, Medicaid spending packages reveal deep divide.(POLICY WATCH)
December 1, 2005... The federal budget process inched forward at the end of October as congressional committees with jurisdiction over Medicaid and Medicare spending completed FY06 budget reconciliation packages. On Nov. 3, the Senate passed a reconciliation...

Medicare coding and billing update.(POLICY WATCH)(Brief Article)
December 1, 2005... CMS has published new transmittals that affect the coding and billing of Medicare claims. Included among the transmittals over the past four weeks are: * New ICD-9-CM codes for chronic kidney disease * "Source of admission" code D ...

IRS to shine compliance spotlight on exempt hospitals.(POLICY WATCH)(Brief Article)
December 1, 2005... Tax--exempt hospitals will be the focus of a new compliance and enforcement initiative, according to IRS FY06 Exempt Organizations Implementing Guidelines released in October. The guidelines state that the Exempt Organizations Compliance Unit...

CMS.(Brief Article)
December 1, 2005... CMS has announced a three-pronged approach to fight fraud in the new Medicare Part D program, including new techniques in data analysis; cooperation with law enforcement, health plans, and consumer groups; and consumer education. For more...

In a study of the effect of a prototypical pay-for-performance program on quality of care.(Brief Article)
December 1, 2005... In a study of the effect of a prototypical pay-for-performance program on quality of care, physician groups with baseline performance at or above the plan's threshold improved the least but garnered the largest share of the bonus payments,...

IRS.(Internal Revenue Service)(Brief Article)
December 1, 2005... The IRS has announced the cost-of-living adjustments applicable to dollar limitations for pension plans and other items for tax year 2006. For more information, go to www.irs.ustreas. gov/newsroom/article/ 0,,id=149631,00.html.

CMS has updated the FY06 health professional shortage area bonus payment file.(Centers for Medicare and Medicaid Services)(Brief Article)
December 1, 2005... CMS has updated the FY06 health professional shortage area bonus payment file. The update includes files for automated payments of HPSA bonuses for services rendered Jan. 1 through Dec. 31, 2000. For more information, go to www.cms.hhs.gov/...

Hospital outpatient rule provides 3.7 percent update.(POLICY WATCH)(Brief Article)
December 1, 2005... On Nov. 2, the Centers for Medicare and Medicaid Services posted the final rule for the 2006 Medicare hospital outpatient PPS update. As with the proposed rule, the final rule is influenced heavily by demographics. The 3.7 percent market basket...

Home health payments to rise 2.8 percent in 2006.(POLICY WATCH)
December 1, 2005... Home health agencies will receive a 2.8 percent increase in their 2006 Medicare payment rates, CMS announced in a final rule published in the Nov. 2 Federal Register. Under the rule, the CY06 payment rate update will be the home health market...

The Department of Defense has published, in the Oct. 24 Federal Register, FY06 updates to the Tricare DRG-based payment system that conform to changes made to the Medicare PPS, effective for admissions occurring on or after Oct. 1.(Brief Article)
December 1, 2005... The Department of Defense has published, in the Oct. 24 Federal Register, FY06 updates to the Tricare DRG-based payment system that conform to changes made to the Medicare PPS, effective for admissions occurring on or after Oct. 1. In the same...

Employers' hourly costs for health insurance rose an estimated 6.7 percent for the year ending September 2005, according to the Bureau of Labor Statistics.
December 1, 2005... Employers' hourly costs for health insurance rose an estimated 6.7 percent for the year ending September 2005, according to the Bureau of Labor Statistics. The bureau also provides a table breaking down employer costs for healthcare and social...

Long-term care facilities required to post nursing staff data.(Brief Article)
December 1, 2005... Effective Dec. 27, skilled nursing facilities and nursing facilities will be required to follow new data collection, posting, and recordkeeping requirements, as specified in the Medicare, Medicaid, and State Children's Health Insurance Program...

More published on technology safe harbors.
December 1, 2005... Hospitals, group practices, prescription drug plan sponsors, and Medicare Advantage organizations would gain a safe harbor for the donation of technology for electronic drug prescribing and electronic health records under two proposed rules...

2005: the best and the worst.
December 1, 2005... As 2005 comes to an end, we reflect on the events of the past year. It was the best of times. HFMA successfully met all of its balanced scorecard goals for the year. Developed in the 1990s by Robert Kaplan, PhD, and David Norton, the...

Publishing by association: you probably know Groucho Marx's line about not wanting to belong to a club that would have him as a member. But it's a whole different feeling when everyone else wants to loin your club.(FROM THE EDITOR)
December 1, 2005... I recently returned from the Folio Show, a conference of mostly for-profit magazine publishers. And I was struck by the way in which several top-notch commercial publishers described their efforts to enhance their businesses. Their...

Growth in uninsured Americans outpacing federal spending on the healthcare safety net.(INDUSTRY WATCH)(Brief Article)
December 1, 2005... At a Nov. 4 policy briefing examining the latest health coverage trends and the implications for the nation's healthcare safety net, the Kaiser Commission on Medicaid and the Uninsured profiled the growing uninsured population and portrayed the...

Uninsured class action settlement announced.(Brief Article)
December 1, 2005... Providence Health System has settled a state class action lawsuit that claimed uninsured patients were charged higher hospital rates than insured patients, The Oregonian reported on Nov. 2. The settlement in state court, believed to be the...

Illinois approves plan to expand health coverage to all children.(INDUSTRY WATCH)
December 1, 2005... Illinois could become the first state to offer insurance coverage for all children, if Gov. Rod Blagojevich gets his way. In October, the Illinois General Assembly approved the governor's plan to provide health coverage to uninsured children...

Margins for Medical Groups decreased in 2004.(INDUSTRY WATCH)
December 1, 2005... Margins for medical group practices dropped in 2004, according to a new 2005 cost survey by the Medical Group Management Association. According to the survey, margins for internal medicine single-specialty groups decreased by 5.5 percent to...

Study finds altered billing and collection practices.(Brief Article)
December 1, 2005... The Center for Studying Health System Change has found many hospitals have adopted more generous charity care guidelines for uninsured patients in the aftermath of publicity about aggressive hospital billing and collection practices and several...

Uninsured billing lawsuit granted class action status.(INDUSTRY NEWS)
December 1, 2005... A circuit court judge in Portland, Ore., has granted class action status to plaintiffs in a lawsuit filed against Legacy Health System, Portland, according to a press release issued by the Scruggs Law Firm. The lawsuit, which is the first of...

RWJF launches initiatives to reduce healthcare disparities.(Robert Wood Johnson Foundation )(Brief Article)
December 1, 2005... The Robert Wood Johnson Foundation announced on Oct. 6 three initiatives aimed at reducing racial and ethnic healthcare disparities by identifying their causes and developing best practices to improve outcomes. A University of Chicago-based...

Shapard to depart as Tenet's CFO.(Robert S. Shapard leaves Tenet Healthcare Corp., joins TXU Corp.)(Brief Article)
December 1, 2005... Tenet Healthcare Corporation announced Oct. 20 that Robert S. Shapard, who joined the company as CFO in March, has decided to rejoin Dallas based TXU Corp., his former employer, as a strategic adviser. Shapard was scheduled to depart Tenet in...

Quotes of note.(INDUSTRY WATCH)
December 1, 2005... "The Medicare prescription drug benefit is already $43 billion over budget and it hasn't even started yet." --Senate Budget Committee Chair Judd Gregg (R-N.H.), suggesting that a federal budget crisis exacerbated by Hurricane Katrina might...

Insurers to offer more consumer-directed health products.(Brief Article)
December 1, 2005... Most health insurance providers intend to offer a consumer-directed health product to employers within the next year, according to results from the latest annual survey of group health insurers conducted by Milliman Consultants and Actuaries....

New report outlines capital allocation strategies for hospitals.(HFMA NEWS)
December 1, 2005... The challenges of caring for aging baby boomers, keeping up with advancements in healthcare technology, and improving facilities have put enormous financial pressure on hospitals. A new report published by HFMA in partnership with two...

Dave Barry to headline HFMA's Region 11 symposium.(Brief Article)
December 1, 2005... Longtime humor columnist and commentator Dave Barry will be the keynote speaker for HFMA's Region 11 symposium, to be held Jan. 29-Feb. 1, 2006, at Caesars Palace Resort in Las Vegas. Barry's columns have appeared in more than 500...

HFMA to partner with patient safety foundation.(Healthcare Financial Management Association)(National Patient Safety Foundation)(Brief Article)
December 1, 2005... HFMA has agreed to partner with the National Patient Safety Foundation on a new project aimed at improving the adoption and integration of patient safety solutions. The NPSF Value Proposition Template Initiative will create templates to...

Former HFMA chairman receives national award.(Healthcare Financial Management Association)(Intermountain Health Care)(Brief Article)
December 1, 2005... William H. Nelson, president and CEO of Intermountain Health Care in Salt Lake City and a former chairman of HFMA, recently was named the first recipient of the National Healthcare Leadership Award. Presented by the National Center for...

Meeting the pay-for-performance imperative: pay for performance is one of Washington's most popular healthcare buzzwords.
December 1, 2005... Although the term has raised the ire of some physicians, who seem to think it suggests being paid something "more" for what they are or should already be doing, most have embraced the concept as representing an important payment reform. Two...

'The mission is still the mission'.(Interview)
December 1, 2005... In August, Robert Ramsey, FHFMA, CPA, CFO of Our Lady of the Lake Regional Medical Center in Baton Rouge, La., gained a new appreciation for the word "sudden." Between August and September, the hospital's census increased 18 percent as a result...

Smart strategic planning for cardiovascular services.
December 1, 2005... Cardiovascular disease remains the top cause of death in the United States. As the nation's elderly population grows, the need for advanced cardiovascular services, in both urban and community settings, will rise exponentially over the next...

Breaking the code.
December 1, 2005... It's a common challenge for healthcare organizations: improving the timeliness and accuracy of coding. For University Physician Associates of New Jersey, the difficulties of a poor payer mix and a high amount of charity care led the...

Are you keeping an eye on your organization's financial pulse?
December 1, 2005... This project is a collaborative effort by Innovative Health Solutions and the Healthcare Management Association There's net revenues, patient admissions, and inpatient surgeries. And of course, outpatient surgeries, labor costs, supply...

No small change: payment trends call for big preparations for 2006: payment trends in 2005 posed severe challenges for hospitals due to changing payment methods and increased denials and underpayments. What trends should you look to in 2006 to protect your financial performance?(Cover Story)
December 1, 2005... Quality in a product or service is not what the supplier puts in. It is what the customer gets out and is willing to pay for. A product is not quality because it is hard to make and costs a lot of money, as manufacturers typically believe. This...

The next big thing: health care when the patient pays; the consumer-directed healthcare movement is designed not to create a new market, but to move the present market to a less expensive model.(FEATURE STORY)
December 1, 2005... Whether or not consumer-directed health care addresses high costs, quality-of-care issues, and other problems in our healthcare system, the fact remains that this movement represents a profound change in how consumers soon may be paying for...

Dealing with self-pay patients--compassionately: like the sword of Damocles, collecting from self-pay patients should be approached with caution--and resolve.(FEATURE STORY)
December 1, 2005... Surely no hospital CFO has walked into his or her office, looked up to the ceiling, and discovered a sword hanging there, dangling precariously by a solitary hair. But like Damocles. who did look up to see a sword dangling by a single...

Capturing the benefits of web-based connectivity: provider-payer relationships are improving, thanks to third-party web-based solutions.(FEATURE STORY)
December 1, 2005... Administrative waste, caused partly by a backlog of paper, phone, and fax transactions in healthcare organizations, is costing the healthcare industry up to $100 billion per year, according to a March report, America's Hidden Healthcare Crisis,...

Minding your business: outpatient physical therapy services can produce a significant ROI if they are managed well. Learn how to get the most from your investment.(FEATURE STORY)
December 1, 2005... Although hospitals expend extensive energy on improving their inpatient business processes, they often overlook a potentially strong source of revenue: outpatient physical therapy. Outpatient physical therapy is capable of producing a...

Point-of-service collections.(Brief Article)
December 1, 2005... Triad Hospitals, Inc., which operates 52 hospitals and 10 ambulatory surgery centers in 15 states, began to use point-of-service collection analytics to track performance by multiple factors. For example, the organization derived a target POS...

Leadership and power.(The American Heritage Dictionary of the English Language, Fourth Edition)(Book Review)
December 1, 2005... Integrity (noun): Steadfast adherence to a strict moral or ethical code. --The American Heritage Dictionary, Fourth Edition, 2000. Having been in health care since the 1970s, we have seen a lot of changes. One constant over those years...

Demystifying 'digital hospitals': the IT industry is at it again. The term digital hospital is spreading fear, uncertainty, and doubt among hospital executives. What is it? Do I need to be one? How can I become one?(DIGITAL PERSPECTIVES)
December 1, 2005... The concept of a digital hospital is being treated like some new, scary species--possibly from outer space. And because it is so new and scary, we don't really understand it or know what to do about it. To quote Mary Poppins, "Posh, pish!"...

Revenue growth how to win the war for markets and share.
December 1, 2005... In this column over the past two years, I have discussed n different approaches that healthcare organizations can use to grow revenues in a financially prudent manner. What I haven't covered is a discussion of the fundamentals of "blocking and...

Staci M. Hicks, CPA (Indiana Pressler Memorial Chapter).(joins Morgan Health Services)(Brief Article)
December 1, 2005... Ms. Hicks has been appointed controller, Morgan Health Services/Physician Specialists and assistant controller, Morgan Hospital and Medical Center, Martinsville, Ind. She had been cost accountant, St. Francis Hospital, Indianapolis.

Katharine S. Klein (Maryland Chapter).(joins GE Healthcare Financial Services)(Brief Article)
December 1, 2005... Ms. Klein has joined GE Healthcare Financial Services, Bethesda, Md., as managing director, strategic relationship group. She had been senior vice president, corporate development and strategic planning, Advanced TelCom Group, Inc., Santa Rosa,...

Thomas W. MacVaugh (Appalachian Chapter of Central Pennsylvania).(promoted at Strategic Initiatives in Healthcare, LLC)(Brief Article)
December 1, 2005... Mr. MacVaugh has been promoted from interim president to president and CEO, Strategic Initiatives in Healthcare, LLC, Philadelphia Penn.

Shasta Manuel, CPA (Oklahoma Chapter).(promoted at Tulsa Regional Medical Center)(Brief Article)
December 1, 2005... Ms. Manuel has been promoted from controller to CFO, Tulsa Regional Medical Center, Tulsa, Okla.

Darlene Rodowicz (Massachusetts Chapter).(promoted at Berkshire Health Systems)(Brief Article)
December 1, 2005... Darlene Rodowicz (Massachusetts Chapter) Ms. Rodowicz has been promoted from associate vice president of finance to CFO, Berkshire Health Systems, Pittsfield, Mass.

Rebecca Speight, FHFMA, CPA (Oklahoma Chapter).(joins Tulsa Regional Medical Center)(Brief Article)
December 1, 2005... Ms. Speight has joined Tulsa Regional Medical Center, Tulsa, Okla., as controller. She had been managing consultant, BKD, LLP, Tulsa. To have your professional announcement published in "People," contact Dorothy Karmowski at (800) 252-HFMA,...

Coins to cheesecake: forces of influence in healthcare finance.(First Class Solutions, Inc.'s Rose Dunn)(Biography)
December 1, 2005... Every HFMA member has his or her unique reasons for choosing a career path in healthcare finance. And every member has an individual story to tell about his or her career journey, lessons learned along the way, and secrets of success. Rose...

U.S. medical liability trend showing strong signs of improvement.(Medical Injury Compensation Reform Act)( Medical Care Availability and Reduction of Error Act)
December 1, 2005... In recent years, the U.S. healthcare industry has been in a costly and escalating state of crisis resulting from the culmination of increased litigation, lack of affordable medical malpractice insurance, and a deficiency in consumer...

Consumer-directed pricing: five dollars for an aspirin ... 10 dollars for a Band-Aid ... the highest prices charged to those least able to pay.(FROM THE PRESIDENT)
December 1, 2005... Pricing policies for medical services are easy to criticize and hard to justify. No wonder stories in the press sensationalize the problem. And the advent of consumer-directed health care with high-deductible health insurance plans will...