Healthcare Financial Management articles from September 2006

Healthcare Financial Management archives from September 2006

Parkland Hospital pursuing patients who allegedly defrauded it.(investigations on fraudulent)(Brief article)
September 1, 2006... On July 27, The Dallas Morning News reported that Parkland Memorial Hospital in Dallas, along with the district attorney's office, was investigating 142 patients alleged to have lied about where they live and how much they earn in order to...

Healthcare disparities continue despite awareness.(National Healthcare Disparities Report)(Brief article)
September 1, 2006... Three years ago, the first National Healthcare Disparities Report was published. Mandated by Congress, that report addressed many of the challenges inherent in measuring disparities. The 2004 report summarized the status of U.S. healthcare...

Managed by whom?(NEWS WATCH)(physicians who do not participate in any managed care plans)(Brief article)
September 1, 2006... MANAGED BY WHOM?: The percentage of U.S. physicians who do not participate in any managed care plans rose to 11.5% in 2004-05, up from 9.2% in 2000-02, according to a report from the Center for Studying Health System Change. The study was based...

Hispanic and black adults are uninsured at rates up to 3 times higher than white adults ...(NEWS WATCH)(Brief article)
September 1, 2006... Hispanic and black working-age adults in the United States are at greater risk of experiencing gaps in insurance coverage, lacking access to health care, and facing medical debt than white working-age adults, according to an August report from...

CMS.(Centers for Medicare and Medicaid Services)
September 1, 2006... ... CMS has issued the Medicare Part A skilled nursing facilities pricer update for FY07. The update methodology is identical to that used in the previous year and will include the Medicare Modernization Act reimbursement for beneficiaries with...

Why we need transparency.(NEWS WATCH)(Brief article)
September 1, 2006... WHY WE NEED TRANSPARENCY: In a recent Harris poll, consumers guessed the price of a new Honda Accord within $300, but were off by $8,100 when asked to estimate the cost of a four-day hospital stay. Of those who had received medical care in the...

... And experience preventable hospitalizations up to 5 times more often than whites.(NEWS WATCH)(Brief article)
September 1, 2006... Blacks and Hispanics are hospitalized more often than non-Hispanic whites for diabetes and other chronic conditions that good primary care can help prevent and control, according to a statistical brief issued in July by the Agency for...

Part D benefits?(insurance usage)(Brief article)
September 1, 2006... PART D BENEFITS? Pharmaceutical industry profits are on the upswing, as drugmakers benefit from new prescriptions and somewhat higher prices for medicines, according to The New York Times. The number of prescriptions has risen at least 3% this...

Immigrants in New York City face challenges in healthcare access.(NEWS WATCH)(Brief article)
September 1, 2006... Many foreign-born New Yorkers, particularly Spanish-speakers, face difficulties accessing health services, and their health may decline after living in the United States, according to a report supported by The Commonwealth Fund and the Fund for...

Supersize me.(NEWS WATCH)(Brief article)
September 1, 2006... SUPERSIZE ME: Medicaid now covers 59 million Americans--one in six-according to the National Association of State Budget Officers. It pays for 37% of all U.S. births, helps pay for more than 60% of all patients in nursing homes, and accounts...

Federal register.(NEWS WATCH)(Brief article)
September 1, 2006... ... Home health agencies would receive a 3.1 percent increase in Medicare payment rates for CY07--an additional $460 million in payments--under a proposed rule released by the Centers for Medicare and Medicaid Services (Federal Register, Aug....

Hmmm ...(Medicare Part D stand-alone prescription drug plans)(Brief article)
September 1, 2006... HMMM... The average monthly premium charged by Medicare Part D stand-alone prescription drug plans is $37, according to Health Affairs--well above the $19 average monthly drug premium charged by local Medicare Advantage HMOs and the $22...

Medicare coverage of colonoscopy has not reduced disparities in cancer screening among the elderly: study.(Brief article)
September 1, 2006... Although Medicare has been covering colonoscopy for average-risk beneficiaries since July 2001, a study reported in the July-August issue of Health Affairs has found that fewer than half of the elderly are screened. Researchers examined the...

Many states taking a point-and-click approach to transparency.(State Watch)
September 1, 2006... Since March, when the Bush administration publicly announced a goal of seeking to make more healthcare price and quality information available to consumers, transparency has become synonymous with good business. As Mike Leavitt, secretary of...

CMS announces final rule for inpatient PPS reforms.(Quick Hits: Top News Stories of the Month)(prospective payment system)(Centers for Medicare and Medicaid Services)(Brief article)
September 1, 2006... The Centers for Medicare and Medicaid Services has issued a final rule for Medicare's inpatient prospective payment system reforms, effective for discharges on or after Oct. 1, 2006. The changes will be phased in over three years instead of...

HHS issues final rules on exceptions and safe harbors for health IT.(Quick Hits: Top News Stories of the Month)(Department of Health and Human Services )(Brief article)
September 1, 2006... The Department of Health and Human Services has announced final regulations supporting physician adoption of electronic prescribing and electronic health records technology with exceptions to the physician self-referral law. The final rules...

CMS proposes 3% average increase for hospital outpatient services.(Quick Hits: Top News Stories of the Month)(Centers for Medicare and Medicaid Services)(Brief article)
September 1, 2006... CMS has issued a proposed rule for payments to hospital outpatient services designed to make them more accurate and to promote higher quality and for ambulatory surgical centers to better align payments with hospital outpatient departments. The...

CMS proposes 5.1% drop in physician service payments, CY07.(Quick Hits: Top News Stories of the Month)(Centers for Medicare and Medicaid Services)(Brief article)
September 1, 2006... CMS's proposed rule revising payment rates and policies under the Medicare physician fee schedule includes the statutory formula that requires CMS to implement an expected--5.1 percent update in payment rates for physician-related services. The...

CMS reports to congress on strategic plan for specialty hospitals.(Quick Hits: Top News Stories of the Month)(Centers for Medicare and Medicaid Services)(Brief article)
September 1, 2006... On Aug. 8, CMS announced a "strategic and implementing plan" as part of a report to address issues regarding physician investment in specialty hospitals. The moratorium on payments to certain specialty hospitals for services furnished to...

Final rule for inpatient rehab facilities payment.(Quick Hits: Top News Stories of the Month)(Centers for Medicare and Medicaid Services)(Brief article)
September 1, 2006... Inpatient rehabilitation facilities are projected to receive approximately $7 billion in payments from the Medicare program in FY07 under a final rule announced Aug. 1 by CMS. The rule updates payment rates and modifies payment policies for...

Stretching herself.(Terry Kelly of Healthcare Financial Management Association)
September 1, 2006... HFMA Member Terry Kelly teaches yoga. Some people start their day with a cup of coffee to get going. Terry Kelly starts hers with yoga--and picks up a cup of coffee afterward. Kelly, clinical liaison for the patient financial services...

Voices from our forums.(Healthcare Financial Management Association)
September 1, 2006... Recently, members of HFMA's patient financial services forum discussed a bill passed by the California Senate Health Committee that tightens hospital billing and collections policies in all state hospitals. Here is a sample of what members had...

Research: multitasking puts stress on the brain.(Strange, but True)(Brief article)
September 1, 2006... New research shows that if we're multitasking while trying to learn something new, it can affect our ability to apply what we've learned. A study published in the Proceedings of the National Academy of Sciences demonstrates what happens to...

In the battle to control costs, power struggles prevail.(2 Years Ago in hfm)
September 1, 2006... In hfm's September 1986 cover story, "Money, Morals and Medicine: Managers and Physicians Co Head to Head," author Keith Berndtson, a family physician, described the challenges healthcare financial managers faced in working with physicians to...

Site seeing.(ETCETERA)
September 1, 2006... When was the last time you visited www.hfma.org? You could be missing out on some of the latest additions to HFMA's web site, including: HFMA Roundtable: Today's Top Revenue Cycle Trends. Revenue cycle processes must be efficiently managed...

Dewey Defeats Truman!(Letters to the Editor)(Letter to the editor)
September 1, 2006... As the author of the article "DRG Do-Over: The Need for a Service- Line Strategy" in the August issue of hfm, I must admit that I feel somewhat like the newspaper editor who prematurely (and inaccurately) ran the headline, "Dewey Defeats...

Overheard.(ETCETERA)(Centers for Medicare and Medicaid Services announcing new steps to provide consumer-directed health plans )(Brief article)
September 1, 2006... "Many features of Medicare were developed before consumer-directed health plans became widely used to lower healthcare costs for millions of Americans. We are now providing some needed flexibility to make the increasingly popular...

U.S. and U.K.: so similar, yet so different: the annual US/UK Exchange allows us to compare healthcare issues while learning about--and enjoying--each other's culture.(Courage IN LEADERSHIP)
September 1, 2006... I enjoyed helping to host the annual HFMA US/UK Exchange this year. This annual event allows us to not only exchange information about each other's healthcare system, but also gain insight into each other's culture and everyday life. Our U.K....

Newt Gingrich: healthcare transformation advocate.(interview with Newt Gingrich)(Interview)
September 1, 2006... Since retiring from Congress in 1999, former Speaker of the House Newt Gingrich has devoted much of his time to the transformation of health and health care. In 2003, he authored the book Saving Lives and Saving Morley and founded the Center...

Chipping away at the impossible.(electronic confirmation of individual patients insurance coverage)
September 1, 2006... The topic of discussion was price transparency, and one staff person reported that a healthcare finance professional recently called it "impossible." That's a rational response. It's rational if you mean that posting average prices on a...

Back to school--with health insurance.(HFMA NEWS)(Children's Health Insurance )(Brief article)
September 1, 2006... A back-to-school campaign is linking thousands of eligible students with healthcare coverage through Medicaid or the State Children's Health Insurance Program. The campaign is a project of the Robert Wood Johnson Foundation's Covering Kids &...

Goldstein joins HFMA board.(Lisa Goldstein appointed as member of Healthcare Financial Management Association)(Brief article)
September 1, 2006... HFMA announces the election of Lisa Goldstein, senior vice president, Moody's Investors Service, to the Association's Board of Directors, effective July 1, 2006. Goldstein's term on the 12-member board of directors continues through May...

HFMA celebrates its 60th anniversary.(Healthcare Financial Management Association)(Brief article)
September 1, 2006... This month, HFMA commemorates its 60th anniversary--and to celebrate, hfm has put together a timeline of some of HFMA's many accomplishments. HFMA began as the American Association of Hospital Accountants in 1946. Today, HFMA has more than...

Milestones in HFMA's history.(Healthcare Financial Management Association)(Chronology)
September 1, 2006... 2006 > HFMA releases PATIENT FRIENDLY BILLING[R] report Consumerism in Health Care. * HFMA releases research report Overcoming Barriers to Electronic Health Record Adoption. 2005 * HFMA's Annual National Institute achieves...

Let's talk about health savings accounts ... there's little doubt that Americans will soon learn a lot about what it means to own a health savings account.
September 1, 2006... President Bush, attempting to address rising healthcare costs and growing numbers of Americans without health insurance, has put most of his eggs into an HSA basket. HSAs, according to the Bush White House, will give individuals greater control...

Weathering a financial storm.(BUSINESS)
September 1, 2006... The 2005 Atlantic hurricane season was long and destructive, breaking previous records. One academic medical center in Texas felt the effects of the hurricanes, suffering a loss in revenue and operational challenges. The First Storm ...

ERISA and hospital charges granting an inch, not a mile.(MANAGED CARE)(Employee Retirement Income Security Act of 1974)
September 1, 2006... The Employee Retirement Income Security Act of 1974 is a confusing part of the complex web of statutes, regulations, and case law that regulate the healthcare industry. The statute is regularly a subject of U.S. Supreme Court opinions that...

The value of consulting in revenue cycle transformations an analysis: an objective study of providers' experiences with revenue cycle consulting engagements discloses many of the benefits and pitfalls associated with such engagements.
September 1, 2006... Revenue cycle consulting firms in the healthcare industry offer services that may be attractive to providers facing tight margins and huge receivables. A provider typically engages a revenue cycle consultant with the expectation that the...

Good documentation: what it means for your physicians--and your revenue cycle: the complexity of E/M coding bedevils medical practices to this day. But educating physicians and providing them with customized tools can significantly improve documentation accuracy.
September 1, 2006... Many medical groups continue to struggle with generating accurate records of what physicians do during office visits, consultations, hospital care, and other evaluation and management patient encounters. This widespread underdocumentation of...

Revenue cycle staff education: 3 views: creating and submitting a bill is not easy. It may be time to rethink the way your organization prepares the people who make payment happen.(FEATURE STORY)
September 1, 2006... "Education is the most powerful weapon which you can use to change the world." --Nelson Mandela Attracting and keeping good employees does not rest solely on the compensation plan. In fact, one important factor is staff education. ...

Is your claim editor really working? Complete, unquestioning reliance on an internal claim editor to ensure clean claims can be a costly mistake.(Drug Administration)
September 1, 2006... Many hospital financial leaders have a lot at stake in the accuracy of clinical claim editors. The purpose of these editors, also called scrubbers, is to analyze and ensure the technical and coding accuracy of patient bills before they are...

An ounce of (pre-bill) prevention is worth a pound of (claims) cure: fine-tuning pre-bill processes is the financial equivalent of practicing preventive medicine.(FEATURE STORY)
September 1, 2006... Effective management of pre-bill processes can prevent many of the signs and symptoms of fiscal illness such as adjustment headaches, denial nausea, bad-debt hypertrophy, collection inflammation, and patient irritation. As the saying goes. "An...

Battling bad debt: for an increasing number of hospitals, new automated technology is helping to reduce write-offs and increase self-pay revenue.(FEATURE STORY)
September 1, 2006... A new concept is changing the way hospitals view bad debt--and their response, on both the front end and the back end of the revenue cycle, could significantly boost their organizations' bottom lines. The concept is controllable versus...

Retrospective review: the good, the bad, and the ugly: rigorous retrospective review of managed care accounts should be mandatory for hospitals.(FEATURE STORY)
September 1, 2006... Do you know the terms and rates for each of your managed care contracts? Do you know whether your organization has received all of the payment it is entitled to and not a dime more? You should. Managed care contracts can account for 30...

All in a day's work: changes in the Medicare program over time not only have altered the significance and use of patient days in determining Medicare payments, but also have muddied the waters somewhat as to what exactly is a patient day.(FEATURE STORY)
September 1, 2006... Patient-day statistics are a significant component of several Medicare payment calculations, including graduate medical education payments and disproportionate share hospital payments. The Centers for Medicare and Medicaid Services' rules...

Adapting customer service to consumer-directed health care: by implementing new tools that provide greater transparency in billing, hospitals can decrease collection costs while improving consumer satisfaction.(FEATURE STORY)
September 1, 2006... "... become a patient, and you enter a world of paperwork so surreal that it belongs in one of Kafka's tales of the triumph of faceless bureaucracies. And although some insurers and hospitals are attempting to streamline and simplify bills, the...

Gainsharing: past, present, and future: for a while, it seemed that the OIG was predisposed to disapprove of hospital-physician gainsharing. Now, the OIG appears to be more open to such arrangements.(FEATURE STORY)(Office of Inspector General)
September 1, 2006... Early last year, the Office of Inspector General of the Department of Health and Human Services issued six advisory opinions approving hospital-physician gainsharing arrangements--arrangements between a hospital and physicians under which the...

Collection service evaluation checklist.(hfm TOOLBOX: American Medical Association Cash Flow Solutions, Inc.)
September 1, 2006... The collection service evaluation checklist is designed to help providers prepare a request for proposal, ensure that the collection service meets their requirements and cost allocations, and provide criteria to compare collection services. The...

Assessing management and leadership in the hospital industry: what does your hospital's credit rating say about your management?(LEADERSHIP AND MANAGEMENT)
September 1, 2006... Moody's is frequently asked how we assess management as a credit factor when assigning a debt rating on a not-for-profit hospital's bonds. From our discussions with hundreds of hospitals and health systems across the country, we believe that...

Information-based transformation: the need for integrated, enterprisewide informatics: it has often been said that health care is "data rich and information poor.".(clinical information systems electronic health records)
September 1, 2006... There are lots of transactional systems collecting lots and lots of data, but it is often hard to mine the data to identify trends and opportunities. Executives and administrators in healthcare organizations are often frustrated when they know...

Reader feedback suggests market mess; two things hospitals seem to crave most in marketing: competitive information and benchmarking. I will attempt to address both with one bullet.(NEW REVENUE GROWTH)(Letter to the editor)
September 1, 2006... My company, SILK, recently completed an online survey among readers of our bimonthly e-newsletter, Take 2. As best we could, we wanted to see what the trends are on marketing priorities, spending allocation, and product line strategies so we...

Inflation: safeguarding your portfolio from the contagion: relatively dormant for the past few years, the inflation bug is again taking a bite out of investment portfolios. Although there's no absolute antidote, there is plenty that you can do to protect your organization's investment funds.(CAPITAL FINANCE)
September 1, 2006... Perhaps more than any other sector of the American economy, the healthcare sector has had reason to be concerned about inflation over the years, given the constantly rising cost of health care. Even in periods when inflation was quiet for the...

Calendar.(calendar for seminars on financial management)(Calendar)
September 1, 2006... NATIONAL September 25-28 Sixteen seminars are offered in Nashville Fall Seminars covering the topic areas of financial Nashville, Tenn. management, revenue cycle, and managed care...

Ronald R. Long, FHFMA, CPA (Southwestern Ohio Chapter).(appointment of Ronald R. Long as executive vice president and chief financial officer of Texas Health Resources)(Brief article)
September 1, 2006... Mr. Long, a former Chairman of the Board of HFMA, has been named executive vice president and CFO, Texas Health Resources, Arlington, Texas. He previously held this title with the Health Alliance of Greater Cincinnati.

Jay Burkett, CPA (First Illinois Chapter).(promotion of Jay Burkett as service line leader for the revenue management practice in Ernst and Young L.L.P.)(Brief article)
September 1, 2006... Mr. Burkett has been promoted from geographic practice leader to service line leader for the revenue management practice, Ernst & Young, LLP, Health Sciences Advisory Services, Chicago.

Andrea D. Ethridge (Oklahoma Chapter).(PEOPLE)
September 1, 2006... Ms. Ethridge has been appointed director of corporate internal audit, St. John Health System, Tulsa, Okla. Formerly, she was senior audit manager, KPMG, Tulsa.

Bruce Hallowell (Virginia Chapter).(PEOPLE)
September 1, 2006... Mr. Hallowell has been promoted from partner to national director of healthcare revenue cycle management services, Computer Sciences Corporation, Falls Church, Va.

Michael Hartnett (South Carolina Chapter).(PEOPLE)
September 1, 2006... Mr. Hartnett has joined Phoenix Health Systems, Montgomery Village, Md., as manager, consulting services. He had been manager, commercial Healthcare Practice, BearingPoint, Inc., Chicago.

Jordan Melick (Lone Star Chapter).(appointment of Jordan Melick as managing director in Morgan Keegan and Company Inc)(Brief article)
September 1, 2006... Mr. Melick has been named managing director, fixed income banking group, Morgan Keegan & Company, Inc., Dallas. Formerly, he was managing director, health care finance, Piper Jaffray, Houston.

Trahan H. Whitten (Southern California Chapter).(Ernst & Young, LLP promoted Trahan H. Whitten)(Brief article)
September 1, 2006... Mr. Whitten has been promoted from geographic practice leader for the Pacific South West, to leader of the regulatory reporting and compliance service line, Ernst & Young, LLP. Health Sciences Advisory Services, Irvine, Calif.

Craig Williams (Massachusetts Chapter).(appointed at Feeley & Driscoll, P. C.)(Brief article)
September 1, 2006... Mr. Williams has been appointed manager, Feeley & Driscoll, P. C., Boston. Previously, he was director, administration and finance, departments of neurology and neurosurgery, Brigham & Women's Hospital, Boston.

Deborah J. Wilson (Massachusetts Chapter).(PEOPLE)
September 1, 2006... Ms. Wilson has been promoted from executive vice president, finance and operations, to CEO, Bridgewater Goddard Park Medical Associates, Brockton, Mass.

George K. Adams (Northern California Chapter).(appointed at The Raymond James Healtheare Finance Group)(Brief article)
September 1, 2006... Mr. Adams has joined The Raymond James Healtheare Finance Group, Chicago, as director of healtheare finance. Previously, he was founder and president, Tarpon Fund Advisors, San Francisco.

Kathleen M. Beriau, CHFP, CPA (Massachusetts Chapter).(appointed at Cape Cod HealthCare, Inc.)(Brief article)
September 1, 2006... Ms. Beriau has been appointed internal auditor, Cape Cod HealthCare, Inc. Hyannis, Mass. Formerly, she was controller. Rehabilitation Hospital of the Cape and Islands. East Sandwich, Mass.

Keith E. Bull (McMahon-Illini Chapter).(appointed at Medical Recovery Specialists, Inc.)(Brief article)
September 1, 2006... Mr. Bull has joined Medical Recovery Specialists, Inc., Des Haines, Ill., as vice president, sales and marketing. Previously, he was regional sales manager, The Audit Group, Labadie, Mo.

Nate Dondanville (Georgia Chapter).(PEOPLE)
September 1, 2006... Mr. Dondanville has been promoted from director, healthcare staffing, to president, healthcare and finance division, Prestige Staffing, Atlanta.

Brad Girsch (Wisconsin Chapter).(PEOPLE)
September 1, 2006... Mr. Girsch has joined Zimmerman, LLC, New Berlin, Wis., as national account director. Formerly, he was membership director, The Academy of Healthcare Revenue, Madison, Wis.

Debra G. Lowe (Northeast Ohio Chapter).(appointed at The Ohio State University Medical Center)(Brief article)
September 1, 2006... Ms. Lowe has joined The Ohio State University Medical Center, Columbus, Ohio, as director of patient financial services. She had been regional director, patient financial services, Humility of Mary Health Partners, Youngstown, Ohio.

Outlier payments not as prevalent as headlines may suggest.(DATA TRENDS)
September 1, 2006... The U.S. Department of Justice recently announced settlements with two major hospital systems relating to alleged overpayments received by member hospitals from the improper use of outlier payments. Intended to provide an incentive for...

Courage to lead in the revenue cycle: courage in leadership, the theme of HFMA Chairman Joe Fifer, involves having the courage to speak up when things are going wrong, and the courage to do the right thing for the right reasons.(Healthcare Financial Management Association )
September 1, 2006... Lisa Goldstein, Moody's team manager for healthcare ratings, writes in this issue of hfm that "Successful leaders demonstrate a willingness to make and execute difficult decisions." She notes that successful management teams establish strong...