Study: No link between offering price transparency tool and lower healthcare spending

http://www.beckershospitalreview.com/finance/study-no-link-between-offering-price-transparency-tool-and-lower-healthcare-spending.html

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Offering a price transparency tool to a large insured population in California did not result in decreased healthcare spending, according to a study published in Health Affairs.

For the study, researchers analyzed the experience of beneficiaries of the self-insured California Public Employees’ Retirement System, a benefit manager for the state’s public employees, their dependents and retirees. CalPERS offered beneficiaries enrolled in an Anthem Blue Cross preferred provider organization a commercial price transparency tool called Castlight. Castlight was introduced to beneficiaries on July 1, 2014, and researchers conducted the study from July 1, 2012, to Sept. 30, 2015. Researchers said they specifically focused on “shoppable” services such as lab tests, office visits and advanced imaging services.

The study found no link between shoppable services spending and Castlight. Researchers said only 12.3 percent of beneficiaries offered the price transparency tool used it to conduct a price search at least once in the 15 months after it was introduced. Only 2.4 percent of beneficiaries used it at least three times during the 15 months, and 3.9 percent used it at least twice for searches with at least 30 days between searches.

The study found beneficiaries that did a price search prior to receiving imaging services on average paid 14 percent less than those who did not do a price search prior to those services. Researchers said only 1 percent of beneficiaries who received advanced imaging conducted a price search.

“We did not find evidence that offering a price transparency tool was associated with a reduction in spending on shoppable services. Patients’ use of the tool was associated with lower-price imaging services, but because use of the tool was so limited, this result did not translate into meaningful spending reductions among the population offered the tool,” the study’s authors concluded.

Former healthcare CFO sentenced to more than 3 years in prison for fraud

http://www.beckershospitalreview.com/legal-regulatory-issues/former-healthcare-cfo-sentenced-to-more-than-3-years-in-prison-for-fraud.html

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U.S. District Judge Malcolm J. Howard sentenced William Canupp, former CFO of Beulaville, N.C.-based Eastpointe Human Services, to 3 1/2 years for wire fraud, tax fraud and conspiracy to commit federal program fraud, according to The Wilson Times.

Mr. Canupp served as Eastpointe’s CFO from March 2010 to April 2013. Eastpointe manages the public sector behavioral health system for several counties in eastern North Carolina.

On May 24, 2016, a federal grand jury returned a 47-count indictment against Mr. Canupp, charging him with conspiracy, bribery, organization fraud, wire fraud and money laundering. The indictment was issued nearly one year after a state audit found Mr. Canupp had facilitated kickbacks from two Eastpointe contractors. The audit revealed Eastpointe paid two contractors more than $1 million for renovations from 2010 to 2013. Each time a check was received from Eastpointe, the contractor wrote a personal check to Mr. Canupp. The contractors paid the former CFO a total of $547,595.

Mr. Canupp pleaded guilty in March to conspiracy to commit federal program fraud, wire fraud and tax fraud, according to The Wilson Times.

 

Auditor: 15-bed Missouri hospital at heart of $90M billing fraud scheme

http://www.beckershospitalreview.com/finance/auditor-15-bed-missouri-hospital-at-heart-of-90m-billing-fraud-scheme.html

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Putnam County Memorial Hospital, a 15-bed hospital in Unionville, Mo., received $90 million in insurance payments in less than a year for lab services that were performed at other facilities across the country, according to The St. Louis Post-Dispatch, which cited a report released Wednesday by Missouri State Auditor Nicole Galloway.

According to Ms. Galloway’s report, Putnam County Memorial Hospital contracted with Hospital Laboratory Partners in September 2016 to operate a clinical laboratory on behalf of the hospital.

“Immediately upon signing the management contract with the hospital, the CEO and his associates began billing significant amounts of out-of-state lab activity through the hospital,” according to the auditor’s report.

Putnam County Hospital allegedly acted as a shell company by submitting claims for other labs and funneling the insurance payments through the hospital.

“Based on our review of hospital accounts, the vast majority of laboratory billings are for out-of-state lab activity for individuals who are not patients of hospital physicians,” states the auditor’s report.

Ms. Galloway has turned her findings over to the Missouri attorney general, the FBI and the Putnam County prosecuting attorney, according to KCUR.

On Thursday, Hospital Laboratory Partners said the auditor’s report mischaracterizes the payments. The company said Putnam County Hospital, a critical access hospital, is authorized to bill for off-site lab work.

“The assignment of non-patient lab specimens has been standard practice for rural and critical access hospitals for many years,” Hospital Laboratory Partners attorney Mark Thomas said in a statement to The Kansas City Star“The purpose of the rural/critical access exceptions is to give rural healthcare facilities a fighting chance to survive and serve their local communities.”

 

Bon Secours Richmond CEO orders managers, others to take paid leave to reduce expenses

http://www.beckershospitalreview.com/finance/bon-secours-richmond-ceo-orders-managers-others-to-take-paid-leave-to-reduce-expenses.html

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Bon Secours Richmond (Va.) Health System CEO Toni Ardabell, BSN, issued an order July 19 mandating select salaried workers at the health system take five paid days off to reduce the health system’s expenses by the end of its fiscal year Aug. 31, according to the Richmond Times-Dispatch.

A health system spokesperson said in a written statement to the Times-Dispatch Aug. 10 the order applies only to salaried management and professional personnel who accrued a large number of paid vacation days but had not used them during the first 10 and a half months of the fiscal year. The rule does not apply to employees who “have little or no accrued PTO … [or] those who have just returned from a leave of absence or those who may be getting ready to take one,” the spokesperson said.

Ms. Ardabell’s memorandum, obtained by the Times-Dispatch, called for “full compliance with these instructions,” provided the stipulation does not affect patient care or reduce patient volume. She also wrote management should not attempt to replace employees on leave with “other workers in a way that adds incremental expense.”

“Replacing a salaried employee with an hourly employee you have to pay doesn’t help,” Ms. Ardabell wrote. “However, if another salaried employee who is being paid anyway simply stretches to cover the work of two people for a few days, then we realize the savings.”

The spokesperson said the order does not reflect any financial distress at the health system. Bon Secours is “a financially strong and fiscally sound organization with consistently high bond ratings and financial performance,” she told the Times-Dispatch.

Healthcare Triage News: The Trump Administration Has Many Options to Undermine Obamacare

Healthcare Triage News: The Trump Administration Has Many Options to Undermine Obamacare

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While the Senate and the House haven’t been very effective in passing a repeal of Obamacare, the ACA’s provisions are still at risk. There’s a lot that Donald Trump’s administration can do (or not do) to undermine Obamacare’s provisions and marketplaces.

7 QUESTIONS THAT ANSWER THE ULTIMATE OPPORTUNITY OF LEADERSHIP

7 Questions that Answer the Ultimate Opportunity of Leadership

The easiest thing leaders do is get things done. The hard part is the people.

Leaders are ineffective if all they do is get things done.

The true focus of leadership:

Leaders focus on people while getting things done.

The greatest opportunity of leadership is developing other leaders.

If you don’t get things done, you won’t be a leader very long. But ultimately leaders enable others to get things done. Now the question is, “What things?”

Leaders advance the welfare of others.

You earn the right to lead by advancing the welfare of others. But serving the greater good is only the first level of leadership. The hard part is next.

Leadership expands when the people you serve become leaders who enable others to serve.

The 3 Levels of Leadership:

Level 1: Advance the welfare of others.

Level 2: Influence others to advance the welfare of others.

Level 3: Influence others who influence others to advance the welfare of others.

How to serve those who serve others:

  1. Honor humility. Won’t honoring humility inspire pride? Not if you think of humility as behaviors and practices.
  2. Break isolation. Establish and strengthen connections.
  3. Clarify ‘good’. People must know what ‘good’ is, if they plan to advance it.
  4. Recognize service.
  5. Celebrate openness.
  6. Show enthusiasm, more than criticism, for others.
  7. Address tough issues with candor, empathy, and compassion.

7 Questions that develop leadership in others:

  1. If you were to exemplify humility today, what might you do?
  2. How might you help others establish and strengthen connections today?
  3. How might you advance the welfare of others today?
  4. Who might you recognize today?
  5. How might you be open to the suggestions and ideas of others today?
  6. How might you pass your enthusism on to others today?
  7. How will you acknowledge emotions and deal with tough issues at the same time?

How might leaders focus on people while getting things done at the same time?