Healthcare Financial Management articles from July 2008

Healthcare Financial Management archives from July 2008

RWJF Commission holds first public hearing.(Children's Health)
July 1, 2008... The Robert Wood Johnson Foundation (RWJF) Commission to Build a Healthier America heard testimony from more than a dozen experts in early life experiences and interventions at its first public hearing June 12 in North Carolina. The purpose of...

Rx for the Palmer method?(NEWS WATCH)(Report)(Brief article)
July 1, 2008... Rx for the Palmer method?: More than 3.52 billion prescriptions are now written annually in the United States, according to a report released in June by eHealth Initiative and the Center for Improving Medication Management. And pharmacy staff...

Repot shows child well-being has improved only slightly since 2000.(NEWS WATCH)(Report)(Brief article)
July 1, 2008... National trends in child well -being taken together have improved slightly since 2000, according to a report released June 12 by the Annie E. Casey Foundation. The 19th annual KIDS COUNT Data Book indicators show: * Five areas of...

The Centers for Medicare and Medicaid Services (CMS) on June 5 announced changes to ensure that the most up-to-date information is used to determine which drugs may be covered under Medicare Part B to treat patients undergoing chemotherapy.(CMS)(Brief article)
July 1, 2008... The Centers for Medicare and Medicaid Services (CMS) on June 5 announced changes to ensure that the most up-to-date information is used to determine which drugs may be covered under Medicare Part B to treat patients undergoing chemotherapy. ...

Out of control--er, we mean out of pocket.(NEWS WATCH)(Brief article)
July 1, 2008... OUT OF CONTROL--ER, WE MEAN OUT OF POCKET: Out-of-pocket spending for Medicare grew 7.5% a year from 1980 t0 2003, according to the Hay 2008 AARP Bulletin. But the Social Security cost-of-living adjustment grew just 3.2%.

Many states lack consumer protection against insurance company abuses, says study.(Healthcare Insurance)(Survey)(Brief article)
July 1, 2008... A 50-state survey of insurance commissioners, released June 12, reveals that insurance companies in many states are not prohibited from denying health coverage to people with pre-existing conditions, refusing to pay for services, or rescinding...

It has come to the attention of CMS that some contractors are misapplying initial certification and recertification requirements, thereby inappropriately denying claims when a facility is not immediately recertified at the end of a two-year period.(CMS)(Brief article)
July 1, 2008... It has come to the attention of CMS that some contractors are misapplying initial certification and recertification requirements, thereby inappropriately denying claims when a facility is not immediately recertified at the end of a two-year...

In its July update to the 2008 Medicare physician fee schedule database, CMS explains that payment files were issued to contractors based on the 2008 Medicare physician fee schedule (MPFS) final rule.(CMS)(Brief article)
July 1, 2008... In its July update to the 2008 Medicare physician fee schedule database, CMS explains that payment files were issued to contractors based on the 2008 Medicare physician fee schedule (MPFS) final rule. CMS is amending those payment files and...

We just thought you should know.(NEWS WATCH)(Brief article)
July 1, 2008... WE JUST THOUGHT YOU SHOULD KNOW: Medicare accounts for 14% of the total federal budget-more than the 7% accounted for by Medicaid, but a smaller share than Social Security (22%) or defense (20%), according to the Kaiser Family Foundation.

ONCHIT to fund assessment of medical identity theft problem.(Health IT)(Brief article)
July 1, 2008... The Office of the National Coordinator for Health Information Technology announced on June 11 the award of approximately $450,000 to Booz Allen Hamilton to assess and evaluate the scope of the medical identity theft problem in the United...

By means of a final rule (Federal Register, June 5, 2008), CMS revises the existing conditions of participation that hospices must meet to participate in the Medicare and Medicaid programs.(FEDERAL REGISTER)(Brief article)
July 1, 2008... By means of a final rule (Federal Register, June 5, 2008), CMS revises the existing conditions of participation that hospices must meet to participate in the Medicare and Medicaid programs. The final conditions address the comments that the...

An interim final rule with comment period issued by CMS (Federal Register, May 22, 2008) implements certain provisions of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 relating to long-term care hospitals (LTCHs) and LTCH satellite facilities.(FEDERAL REGISTER)(Brief article)
July 1, 2008... An interim final rule with comment period issued by CMS (Federal Register, May 22, 2008) implements certain provisions of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 relating to long-term care hospitals (LTCHs) and...

That's some market share.(NEWS WATCH)(Brief article)
July 1, 2008... THAT'S SOME MARKET SHARE: Medicare Advantage plans enrolled a record 9.8 million beneficiaries as of April 2008, according to the Kaiser Family Foundation-representing an increase of more than 800,000 beneficiaries in just tour months.

Total national expenditures for the State Children's Health Insurance Program and payment per individual, FY02-07.(NEWS WATCH)(Statistical table)(Brief article)
July 1, 2008... Total National Expenditures for the State Children's Health Insurance Program and Payment per Individual, FY02-07 Expenditures (in millions) 2002 $3,776 2003 $4,276 2004 $4,644 2005 $5,089 2006 $5,453 2007 $6,038...

CMS has issued a final rule (Federal Register, May 28, 2008) allowing the Health and Human Services (HHS) Secretary to collect claims data that are currently being collected for Medicare Part D payment purposes for other research, analysis, reporting, and public health functions.(FEDERAL REGISTER)(Medicare Modernization Act of 2003)(Brief article)
July 1, 2008... CMS has issued a final rule (Federal Register, May 28, 2008) allowing the Health and Human Services (HHS) Secretary to collect claims data that are currently being collected for Medicare Part D payment purposes for other research, analysis,...

By means of a proposed rule (Federal Register, May 16, 2008), CMS would make revisions to the Medicare Advantage (MA) program (Part C) and prescription drug benefit program (Part D).(FEDERAL REGISTER)(Brief article)
July 1, 2008... ... By means of a proposed rule (Federal Register, May 16, 2008), CMS would make revisions to the Medicare Advantage (MA) program (Part C) and prescription drug benefit program (Part D). The regulation contains new regulatory provisions...

Feeling the competition?(NEWS WATCH)(Brief article)
July 1, 2008... FEELING THE COMPETITION?: More Americans than ever-113 million adults, according to a 2006 study by the Pew Internet & American Lite Project-look online for health information. But a Kaiser Family Foundation survey found that only 3% of...

Tailgating 101.(Member Spotlight)
July 1, 2008... For Paula Dillon and her husband, John, tailgating is an art form--and tasty one, at that. This is not your typical tailgating spread: * Shrimp cocktail, Cuban sandwiches, and key lime pie, with rum beverages to wash it down (Chicago...

Techniques for "Finding Honey Under Your Nose".(20 Years Ago in hfm)(Cover story)(Brief article)
July 1, 2008... The cover feature in the July 1988 issue of hfm, "Finding Funds Under Your Nose Using New Capital-Raising Techniques," dealt with the effects of competition and declining reimbursement and inpatient utilization on hospital profit margins. ...

What's new on our web site.(ETCETERA)(www.hfma.org/library)(Brief article)
July 1, 2008... The following documents are located in the Resource Library (www.hfma.org/library) unless otherwise noted. Recovery Audit Contractor (RAC) Program. See "Reimbursement," then "Medicare," and click on the title of the document. Recovery...

The price of putting things off.(VIEWS)(Brief article)
July 1, 2008... Economists are saying that the United States is already in a recession--and blaming the federal government for waiting too late to issue an economic stimulus package. In order to ward off the wave of foreclosures, this needed to happen at the...

Medicare bad debts--take two.(VIEWS)
July 1, 2008... Since the submission of my article regarding Medicare bad debts ("Medicare Bad Debts: Are You Losing Money?" hfm, June 2008), two wildly inconsistent and extremely significant events have occurred that will materially impact the reimbursement...

Transformation through connections: does your organization provide a commodity, an experience, or a transformation?(making connections)
July 1, 2008... In the book The Experience Economy: Work Is Theatre & Every Business a Stage, authors James H. Gilmore and Joseph Pine II list a progression of business types and the value they provide to consumers. Healthcare leaders should ask themselves...

Eric Langshur: improving the patient experience.(hfm Q&A)(Interview)
July 1, 2008... Acts of kindness, words of encouragement, and a support network all mean a lot to those who are facing challenges, such as health problems. Receiving support and encouragement is a comfort to hospitalized patients. In a technology-savvy...

HFMA's connections: "nice tie, Bob.".(FROM THE EDITOR)(Editorial)
July 1, 2008... I was on my way to meet HFMA's 2008-09 Chairman, Bob Broadway, at his Bethesda Healthcare System office in Florida. When I arrived, Bob told me that our meeting would be interrupted because Florida Gov. Charlie Grist would be arriving soon for...

HFMA releases report on payment system reform.(HFMA NEWS)(Report)
July 1, 2008... [ILLUSTRATION OMITTED] As attention to healthcare reform intensifies, it is important to remember that real and sustainable reform can be achieved only if the fundamental financial incentives within the delivery system are changed. HFMA...

William J. Lubaway named Morgan Award recipient.(HFMA NEWS)
July 1, 2008... [ILLUSTRATION OMITTED] HFMA awarded the 2008 Frederick C. Morgan Achievement Award--the Association's highest individual honor--to William J. Lubaway, FHFMA, CPA, principal at Lubaway Masten & Company Ltd. in Novi, Mich., at ANI: The...

Payment by episode: momentum building for bundling? All those wanting to be part of the Medicare payment-by-episode demonstration (aka bundled payment), come on down! And bring your data and signatures.(EYE ON WASHINGTON)
July 1, 2008... Participants in CMS's demonstration, officially called the Acute Care Episode (ACE) demonstration, will need to provide data on their orthopedic and/or cardiovascular services, and on their quality improvement efforts. And they'll need...

Reducing variation in healthcare delivery: the lack of clinical and administrative standardization across the provider and payer spectrum creates variation and inefficiency.(HEALTHCARE REFORM)(Column)
July 1, 2008... Ray Lefton's June column outlined the need for meaningful healthcare reform and presented 14 reform strategies. This month, Lefton examines two of these 14 strategies-both of which relate to the need for more standardization and consistency in...

Clinical decision support: the power behind the electronic health record.(TECHNOLOGY)
July 1, 2008... The use of clinical decision support (CDS) can lead to safer, less expensive, and higher-quality care. However, effective CDS use faces several complex obstacles that, if not addressed, can significantly reduce the value of the technology to...

HDHPs: serving a demanding patient demographic.(MANAGED CARE)(Medicare Modernization Act of 2003)
July 1, 2008... It has been more than four years since the Medicare Modernization Act of 2003 gave a major push to consumerism in health care with the creation of tax-advantaged health savings accounts (HSAs). The intent of this legislation was to promote...

Hospital financial performance: trends to watch: financial indicators derived from Medicare cost report data are reliable tools for assessing the effectiveness of a hospital's operations.
July 1, 2008... The delivery of patient care has not been especially lucrative for short-term acute care hospitals (STACHs) in recent years. Financial indicators derived from Medicare cost reports show that these hospitals are actually losing money on patient...

Measuring service line success: the new model for benchmarking: the service line model benefits nearly all stakeholders involved in healthcare delivery. But how is its success measured?(FEATURE STORY)
July 1, 2008... [ILLUSTRATION OMITTED] As health care becomes more complex and specialized, providers are realizing that they cannot "be all things to all people" and are focusing their financial and human capital resources on a smaller set of programs...

Finding the ROI in EMRs: financial data in clinical studies that document the value of electronic medical records (EMRs) must be adjusted for use in ROI calculations to provide credible estimates of EMR benefits.(FEATURE STORY)(Cover story)
July 1, 2008... American hospitals and physician practices are spending more on clinical information systems than ever before--and the fastest growing segment is "advanced" electronic medical record (EMR) systems. Computerized provider order entry (CPOE),...

Productivity improvement: Catholic Health East reaps rewards: productivity improvement can help healthcare organizations achieve significant efficiencies and cost savings. What CFO wouldn't like those results?(FEATURE STORY)
July 1, 2008... Improving workforce performance management in some of its hospitals saved Catholic Health East (CHE) $34 million in one year alone. In today's challenging economy, many healthcare organizations would benefit from adopting a similar approach....

Is your patient throughput sending out an SOS? Emergency department throughput can be either a sign of a hospital's healthy operational efficiency or a symptom of inefficient processes and lost revenue opportunities.(FEATURE STORY)(Cover story)
July 1, 2008... Although the front-line management team and medical staff are most immediately responsible for ensuring a high-quality emergency department (ED) operation, the CFO is in a position to leverage financial insight into the ED operation to achieve...

A physician's due: measuring physician billing performance, benchmarking results: today's complex reimbursement environment requires physician groups to master the intricacies of billing.(FEATURE STORY)(Health Insurance Portability and Accountability Act of 1996)(Cover story)(Survey)
July 1, 2008... Physician billing can be a daunting, if not overwhelming, task. Transactions are submitted for thousands of services to hundreds of insurance payers, all with different payment rifles and regulations. And in this day of consumerism, billing and...

Getting a handle on analytics for strategic success: in the current economy, it is more crucial than ever for healthcare financial executives to identify and manage the metrics that determine strategic success.(FEATURE STORY)(Cover story)
July 1, 2008... Rates of change and complexity have accelerated to new levels, requiring health systems to respond to fundamental shifts in the healthcare industry such as increased competition, pay for performance, consumerism, and market consolidation....

Automating reconciliations for high-volume processes.(htm TOOLBOX)
July 1, 2008... A financial process is similar to an assembly line with multiple steps. Any initiative to consolidate on a single platform or to increase volume will have implications for the staff at the end of the assembly line, typically the accountants,...

Managing people--when you really don't like to! Moving up the career ladder usually involves managing people.(LEADERSHIP AND MANAGEMENT)
July 1, 2008... Some enjoy this role, but many others find it to be an exhausting and thankless task. Although inadequate people skills can destroy a career, not enjoying the people management part of our jobs need not be career limiting. There are lessons to...

Wanted: the common sense to blow on hot soup.(CAPITAL FINANCE)
July 1, 2008... He was the successful former hospital CFO and elegantly graying managing director at the busiest hospital investment banking firm in the country. I was the young kid who had just convinced him to hire me as the new associate in the firm. ...

Calendar.(Calendar)
July 1, 2008... Calendar Sept. 22-25 Oct. 13-16 Level Seminar Minneapolis Phoenix Financial Management Strategies and Operations B/C Fundamentals of Healthcare...

Financial impact of MS-DRG conversion for high-volume admissions.(DATA TRENDS)
July 1, 2008... As the Centers for Medicare and Medicaid Services (CMS) moves forward with the implementation of the Medicare severity-adjusted diagnosis-related group (MS-DRG) system, a brief look at the impact of the changes on some high-volume current...

Healthcare reform depends on payment reform: during the next four months, the airwaves will be filled with sound and images of Barack Obama and John McCain sparring over the economy and the war in Iraq.(FROM THE PRESIDENT)
July 1, 2008... I am pleased to say that they also will be talking about healthcare reform. Both candidates have published their plans on how to provide universal access to health insurance as well as how to rein in healthcare costs. One area that...

Your strategies for improving patient registration processes.(hfma roundtable)(Interview)
July 1, 2008... Many of today's strategies and technologies focus on the back end of the healthcare revenue cycle, such as claims editing management, remittance and denial management, and contract management. Yet significant potential for cleaner claims,...