Healthcare Financial Management articles from October 2003

Healthcare Financial Management archives from October 2003

CMS clarifies EMTALA.(Policy Watch)(CMS publishes a final rule to clarify the obligations of hospitals to patients wanting treatment for emergency medical conditions)
October 1, 2003... On August 29, CMS published a final rule clarifying the obligations of hospitals to patients requesting treatment for emergency medical conditions under the Emergency Medical Treatment and Active Labor Act (EMTALA). In his announcement of...

Electronic claims rule includes exemptions.(Policy Watch)(starting 10/16/03, Medicare claims must be submitted electronically in a HIPAA-compliant format)
October 1, 2003... Beginning October 16, 2003, Medicare claims must be submitted electronically in a HIPAA-compliant format, according to a CMS interim final rule published in the August 15 Federal Register. The anticipated rule, mandated by the Administrative...

CMS issues ambulatory surgery payment rates for 2004.(Policy Watch)(Brief Article)
October 1, 2003... On August 8, CMS issued program memorandum (PM) AB-03-0116 announcing that an increase in the ambulatory surgical center (ASC) payment rates and wage index would become effective October l, 2003. The new rates for facility services furnished on...

CMS proposed rehab rule fails to deliver needed criteria change.(Policy Watch)(Brief Article)
October 1, 2003... CMS proposed changes to the criteria facilities must meet to qualify for payment under the inpatient rehabilitation facility (IRF) PPS, but fell short of responding to providers' appeals for more realistic and up-to-date criteria. The proposed...

NCCI edits now available on-line.(Policy Watch)(National Correct Coding Initiative )(Brief Article)
October 1, 2003... CMS recently posted National Correct Coding Initiative (NCCI) edits on its web site, making available to physicians and other providers edits used to identify incorrect claims. Prior to September 2, the NCCI edits were available only on a...

Disease management: patient management in disguise.(State Policy Watch)
October 1, 2003... Seven of every 10 deaths in the United States are due to chronic health conditions, including heart disease, stroke, cancer, and diabetes, according to the Centers for Disease Control and Prevention. Chronic diseases affect the quality of...

Enrich your life through HFMA: being a member of HFMA has enriched my life in so many ways.(From the Chairman)
October 1, 2003... Knowledge that I've gained from my fellow members and from HFMA educational programs has helped me advance in my career. The networking opportunities have been invaluable. And, as I've said, I've made many friends through HFMA. Paul T....

Employer health benefits survey foretells greater workload for PFS.(Industry Watch)(a discussion of the 2003 Annual Employer Health Benefits Survey)(Brief Article)
October 1, 2003... Employers continue to shift costs, according to the 2003 Annual Employer Health Benefits Survey released September 9 by the Kaiser Family Foundation and Health Research and Educational Trust. The typical family health insurance policy now costs...

Aging baby boomers boost physician visits, diagnostic tests.(Industry Watch)(Brief Article)
October 1, 2003... More than half (53 percent) of patients visiting a physician in 2001 were over age 45, compared with 42 percent in 1992, according to the National Center for Health Statistics. During the past decade, the number of people over age 45 rose 11...

HMO resurgence in Orange County, Calif., bucks national trend.(Industry Watch)(health maintenance organizations continue to dominate the market in Orange County, California)(Brief Article)
October 1, 2003... Bucking the national retreat from tightly managed care, health maintenance organizations continue to dominate the Orange County, Calif., healthcare market, according to a new report released on August 14 by the Center for Studying Health System...

AMA: paper claims may swamp payment systems after October 16.(Industry Watch)(Brief Article)
October 1, 2003... The American Medical Association (AMA) warns that physician practices not compliant with HIPAA's electronic transaction standards by the October 16 implementation deadline could face a reimbursement logjam. An AMA survey of physicians, reported...

Health insurance scams are on the rise.(Industry Watch)(Brief Article)
October 1, 2003... The United States is experiencing" a new wave of health insurance scams, spurred by rising healthcare costs and increasing numbers of uninsured, the Commonwealth Fund reported in August. (See also "Careful: The Health Insurer Near You May Be a...

Top publicly traded hospitals companies by number of beds.(Brief Article)(Illustration)
October 1, 2003... Top Publicly Traded Hospitals Companies by Number of Beds Tenet Healthcare 29% HCA, Inc. 38% Province Healthcare 2% LifePoint Hospitals 3% Community...

Survey delves into hospitals' pricing practices.(Industry Watch)(Brief Article)
October 1, 2003... In response to a survey by The Governance Institute, CEOs clearly considered competitors' pricing when setting their own. Out of 105 responses (a 25 percent response rate) to the late July survey, more than 7Z percent said consideration of...

Quotes of note.(Industry Watch)(Brief Article)
October 1, 2003... "What we've got now under the current healthcare currents are system in the U.S. is a giant food fight between doctors, hospitals, patients, and insurance companies as to who gets stuck with the bill." --Steffie Woolhandler, associate...

2004 US/UK exchange set for New York.(HFMA News)(Brief Article)
October 1, 2003... Invitations to HFMA's 24th Annual US/UK International Exchange & Seminar will be sent to all senior financial executive members near the end of November. The event is scheduled for July 28-30, 2004,in New York. First conducted in 1980,...

Emerging trends, strategies explored.(HFMA News)(Healthcare Financial Management Association's fall seminar series)(Brief Article)(Calendar)
October 1, 2003... Healthcare leaders can stay on top of industry trends with HFMA's fall seminar series. Locations and dates for the event are: * Atlanta, October 27-30 * Phoenix, November 17-20 * Chicago, December 8-11 The series, which...

Electronic claims submission assistance available.(HFMA News)(Healthcare Financial Mnaagement Association document released)(Brief Article)
October 1, 2003... As of October 16, 2003, CMS can deny Medicare payment for services unless claims are submitted in electronic form. To aid providers in their compliance efforts, HFMA recently released "Highfights: Electronic Submission of Medicare...

HFMA president makes 100 most powerful list.(HFMA News)(Richard L. Clarke, FHFMA, president and CEO of the Healthcare Financial Management Association, was named one of the 100 most powerful people in health care)
October 1, 2003... HFMA president and CEO Richard L. Clarke, FHFMA, was named one of the 100 most powerful people in health care in the August 25 issue of Modern Healthcare magazine. The list, in its second year, was compiled from readers' votes on people...

HFMA holds Revenue Cycle Strategies Conference.(HFMA News)(Healthcare Financial Management Association)(Brief Article)
October 1, 2003... HFMA will host the Fall 2003 Revenue Cycle Strategies Conference October 19-21 in Las Vegas. Participants will learn how to lead, strengthen, and integrate revenue-cycle performance objectives. Among the available sessions are: * Denials...

Careful: the health insurer near you may be a scam: with healthcare insurance costs once again on a double-digit tear, fast-buck insurance plans are on the rise.(Eye on Washington)
October 1, 2003... A recent report from the Commonwealth Fund documented a dramatic increase in the number of unlicensed insurers selling fraudulent health insurance policies. (a) Particularly targeted have been small employers struggling to make ends meet in a...

Building a better balance sheet: Bob Gill believes in taking bold steps. Gill is CFO of HealthEast Care System, St. Paul, Minn., a system that is struggling to regain positive credit ratings. He discussed with hfm the bold steps the system needs to take and the operational goals that must be achieved to make those steps possible.(Executive Insights)
October 1, 2003... More than anything, we need to regain our access to the capital marketplace. Currently, we are below investment grade with all three of the rating agencies. In June 2001, Moody's gave us a "negative-outlook" status. They recently revised that...

Expenditures for prescription drugs: too much or not enough?(Business)
October 1, 2003... Prescription drug expenditures in the United States have been the fastest growing component of healthcare spending over the past several years. Although the actual rate of increase varies from year to year, and differs based on the source data,...

District court affirms CMS's hold-harmless policy for DSH.(Medicare/Medicaid)(disproportionate share hospital adjustment)
October 1, 2003... In June of this year, a federal district court in Minnesota issued the first judicial opinion on yet another hotly contested dispute as to the calculation of the Medicare disproportionate share hospital (DSH) adjustment. (a) The controversy in...

Capacity planning seeing the forest for the trees: the recent return to increasing demand for inpatient capacity may have surprised many healthcare leaders, but broad population and technology trends suggest it was inevitable.
October 1, 2003... Hospital facility construction is booming. Inpatient utilization is on the rise. What happened to the conventional wisdom that hospitals have too many beds? Or that demand for inpatient services will decline as patients flock to outpatient...

Capital allocation three cases of financing the future: three CFOs share how they assess pressing capital needs in an era of tight resources.(Feature Story)(Cover Story)
October 1, 2003... When it comes to capital, executives of hospitals and health systems are between a rock and a hard place--capital projects loom large, and capital resources are tight. There is no lack of worthy proposals for new facilities, increased services,...

Evidence-based financial management: evidence-based financial management can be critically important to an organization's financial success.(Feature Story)
October 1, 2003... To save money, a hospital laboratory administrator replaced a continuous flow analyzer that performs 20 tests at once with a discrete analyzer that can perform any subset of the 20 tests. The discrete analyzer is more expensive per test but can...

Assessing new technology: how are other hospitals facing the challenge? Ever wonder how your peers decide which new technologies to adopt? A VHA West Coast hospital survey provides insight into common committee structures, review criteria, and processes.(Feature Story)
October 1, 2003... There's no denying that the constant evolution o f technology is one of the most significant factors affecting hospital operations and patient care. Yet surprisingly, the important function of determining how best to assess and review these...

Rx for low cash yields: not-for-profit hospitals can use three strategies to increase investment yields without sacrificing safety or stability.(Feature Story)
October 1, 2003... The unrelenting expense pressures faced by not for profit hospitals come from every direction: labor shortages combined with increasing patient volumes, skyrocketing liability premiums, shrinking Medicare payments, mounting costs for...

The benevolent autocrat: is it the right fit for the times? By now, most managers have hung their autocratic management style in the back of the closet.(Leadership And Management)
October 1, 2003... Workplace expectations seem to have rendered that style out of fashion. But a careful look at workplace expectations may suggest autocracy should be back in vogue. The basis for employment relationships is the employment contract. In all...

7 strategies for increasing delivery of IT value: healthcare organizations make significant investments in information technology (IT).(Digital Perspectives)
October 1, 2003... These organizations expect that these investments will increase revenue, reduce costs, enhance service, and improve the quality of patient care. Yet all too often, the results are disappointing. The expected gains seem to bare vanished or...

Calendar.(listing of various healthcare industry events)(Calendar)
October 1, 2003... Calendar Level Seminar 10/27-30 11/17-20 12/8-11 Atlanta Phoenix Chicago Financial Management/ Reimbursement 2 Using...

2002-2003 Annual Report: HFMA brings perspective and clarity to the industry's complex issues for the purpose of preparing our members to succeed. Through our programs, publications and partnerships, we enhance the capabilities that strengthen not only individual careers, but also the organizations from which our members come.
October 1, 2003... DURING A CHALLENGING ECONOMIC YEAB AMERICA, HFMA remains strong and continues to be an indispensable resource for healthcare finance professionals. The theme "Create the Future" challenged us to be involved with the issues that affect our...

Oklahoma Hospital Association. (Oklahoma Chapter).(People)(named Ms. Andersen vice president, finance and information services)(Brief Article)
October 1, 2003... Ms. Andersen has joined Oklahoma Hospital Association, Oklahoma City, as vice president, finance and information services. Formerly, she was CFO, vice president, finance, Duncan Regional Hospital Duncan, Okla.

Duane Morris.(People)(Mr. Knapp named a partner)(Brief Article)
October 1, 2003... Mr. Knapp has joined Duane Morris, LLP, Philadelphia, as partner. Formerly, he was senior member, Cozen O'Connor, Philadelphia.

Windham Hospital.(People)(appointed Mr. Papadakos vice president, finance, CFO)(Brief Article)
October 1, 2003... Mr. Papadakos has been appointed vice president, finance, CFO, Windham Hospital, Willimantic, Conn. Previously, he was CFO, Maine Coast Memorial Hospital, Ellsworth, Me.

Hallmark Health System.(People)(Ms. Sorel appointed director, decision support/financial analysis)(Brief Article)
October 1, 2003... Ms. Sorel has been appointed director, decision support/financial analysis, Hallmark Health System, Malden, Mass. Previously, she was manager of decision support, Caritas--St. Elizabeth Medical Center, Boston.

Fitch Ratings.(People)(Mr. Wetzler has been appointed vice president of FSA)(Brief Article)
October 1, 2003... Mr. Wetzler has been appointed vice president, FSA, New York. Previously, he was director, Fitch Ratings, Tampa, Fla.

Venable, LLP.(People)(appointed Mr. Ramirez partner, healthcare practice)(Brief Article)
October 1, 2003... Mr. Ramirez has joined Venable, LLP, Washington, D.C. as partner, health care practice. Previously, he was partner, Arter & Hadden LLP, Washington, D.C.

Oregon Health & Science University.(People)(Mr. Rodeen named accounting manager, department of fiscal services)(Brief Article)
October 1, 2003... Mr. Rodeen has been named accounting manager, department of fiscal services, Oregon Health & Science University, Portland, Ore. He had been controller, Pacific Medical Group, PC, Portland.

Sky Ridge Medical Center.(People)(new controller appointed)(Brief Article)
October 1, 2003... Ms. Johnson has been appointed controller. Sky Ridge Medical Center, Lone Tree, Colo. Previously, she was assistant controller, HealthOne Swedish Medical Center, Englewood, Colo.

Commerce Bank.(People)(Mr. Braca appointed senior vice president market manager)(Brief Article)
October 1, 2003... Mr. Braca has been appointed senior vice president market manager, Commerce Bank, New York. Formerly, he was senior rice president, healthcare, Fleet Bank, New York.

Duke University Health System.(People)(named Mr. Moore manager of external reimbursement reporting, corporate finance)(Brief Article)
October 1, 2003... Mr. Moore has been named manager of external reimbursement reporting, corporate finance, Duke University Health System, Durham, N.C. He had been director of reimbursement, North Carolina Baptist Hospitals, Inc., Winston-Salem, N.C.

Mr. Mozola has been named manager, patient accounts, Trinity Health, West Michigan Financial Shared Services, Grand Rapids, Mich.(People)(Brief Article)
October 1, 2003... Mr. Mozola has been named manager, patient accounts, Trinity Health, West Michigan Financial Shared Services, Grand Rapids, Mich. Formerly, he was manager, patient financial services, Sparrow Health System, Lansing, Mich.

Blue Cross Blue Shield.(People)(Mr. Mincher named senior consultant, network development west, Blue Cross Blue Shield of Oklahoma)(Brief Article)
October 1, 2003... Mr. Mincher has been named senior consultant, network development west, Blue Cross Blue Shield of Oklahoma, Tulsa. He had been director, business officer, Valley View Regional Hospital, Ada, Okla.

ED admissions for heart failure outpace non-ED admissions.(Data Trends)(emergency department)
October 1, 2003... Admissions to U.S. hospitals for heart failure increased by 1.2 percent from 2000 to 200l, and they remained essentially unchanged from 2001 to 2002. At face value, these statistics may seem inconsequential, yet a closer look discloses a...

The future is--: fill in the blanks: "for hospitals, the future is--.".(From the President)
October 1, 2003... How you fill in that blank may depend on your specific organization, on your market, on your latest P&L statement, or on the traffic you encountered driving to work this morning. Too often, we fill in that blank with words like "bleak."...