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Oct 15, 2015 10:00:00 AM

5 Steps to Realizing Value in a Clinical Co-Management Agreement

Healthcare reform has undoubtedly created more integrated delivery and payment models based on a culture of quality-focused and cost-efficient clinical management. In one example, many healthcare systems have begun implementing clinical co-management arrangements (“CCMAs”) to accomplish the physician alignment and integration required to achieve these goals. 

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Topics: Healthcare, Hospital Management, Clinical Integration, CCMA

May 1, 2014 11:30:00 AM

Shift Happens – What the Revenue Shift From FFS to Outcomes Means to Hospital Valuations

The consequences of a shift in the Fee-for-Service (FFS) revenue model to outcomes-based compensation is creating a tsunami of change for hospitals. Let’s look at how this shift is affecting the valuation of hospitals in a buy or sell situation. 

In an FFS revenue model, valuations were based on how much revenue generated was attributed to volume. That is all changing with the Affordable Care Act (ACA). Today, hospitals face a variety of issues that impact day-to-day operations and the bottom-line:

  • Declining inpatient volumes
  • Lower reimbursement rates  per patient from Medicaid and Medicare with private payors starting to follow the trend
  • The advent of high deductible plans in private pay
  • Changing diagnosis codes
  • Enhanced regulatory vigilance 

These factors contribute to a financial model where  operating expenses are outpacing revenue.

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Topics: Hospital Management

Apr 24, 2014 3:28:00 PM

Health Care Round-up: Alzheimer’s Strain on Workforce, Medical Crowdsourcing, and More

Here is a round-up of health care stories that are catching our interest this week.

Is the Health Care Workforce Prepared for an Increase in Alzheimer Patients?

The April issue of Health Affairs is devoted to the latest research and thinking about Alzheimer’s disease. Alzheimer’s cases already overwhelm health care facilities and families. The challenge is expected to worsen with an increase from 5 million cases in 2013 to 13.8 million cases in 2050. Here is detailed look at how to increase and train a work force that is prepared for the challenge. 

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Topics: Healthcare, Hospital Management

Mar 6, 2014 9:30:00 AM

Theft Causes Most PHI Breaches & It’s Not Just Laptops

A recent report released by IT Security firm Redspin says hospitals and facilities are most vulnerable for Patient Health Information (PHI) breaches from negligent insiders and from the theft or loss of unencrypted portable computing devices (laptops). Theft, according to the report, is responsible for 83% of all large HIPPAA privacy and security breaches, with hacking accounting for 6% of breaches. 

Let’s take a closer look at the numbers (we are accountants after all). The report shows that more than 29 million patient health records have been compromised since 2009, with a whopping 137.7% increase in the number of records breached in 2012-2013. The most recent figures should be put in context. 

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Topics: Hospital Management, PHI Security

Feb 13, 2014 9:56:00 AM

Chasing Cost Reductions Isn’t the Answer for Hospitals to Balance the Budget

Cutting administrative costs has traditionally been the first strategy hospitals use to make up a budget deficit. But in today’s health care environment, it will take more than reducing personnel and operational expenses to make up the shortfall that is on its way, if not already here. There are a variety of reasons why cutting administrative spending won’t balance the budget – but in a nutshell, it’s not enough and it does not drive better patient care. 

Many hospitals already lose money on Medicare and Medicaid and those reimbursement amounts continue to drop. It is also anticipated that private payers will reduce their rates in proportion to the federally funded programs.  Medicare Fee-for-Service (FFS) reimbursement models are on their way out. Physicians and health care systems will be forced to adapt to changing models in order to stay in business. 

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Topics: Healthcare, Hospital Management