Tag Archives: Hospital

CMS launches voluntary bundled payments model, first since spiking mandatory bundles

Posted on by • Posted in Uncategorized • Tagged , , , , , , • Leave a comment

http://www.healthcarefinancenews.com/news/cms-launches-voluntary-bundled-payments-model-first-spiking-mandatory-bundles?mkt_tok=eyJpIjoiT1RCaE1tTmtOekZpTldReSIsInQiOiJjMlNuWlpqbDRDblZyMHJ3N3lDRDk3MlFLQWh4dmxUc3hCZjRNVWt3SnhwRUVNQ3pDUURMbUNqcGdHejFhSHU4bjM5M01Fd1VpN3lTT2NLSHpBejQydVYyUlJ0RDRkamNWWCtKLzNMZnJrUms3aSs2bkRTQURZQzRySnByajU3ayJ9

The agency’s Innovation Center said the new Bundled Payments for Care Improvement Advanced model is the first APM that would qualify under MACRA.

The Centers for Medicare and Medicaid Innovation Center has launched a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced — which CMS Administrator Seema Verma said is the first Advanced APM.

The current Bundled Payments for Care Improvement Initiative, or BPCI, is scheduled to end on Sept. 30. BPCI Advanced starts on Oct. 1 and runs through Dec.  31, 2023.

The BPCI will qualify as an an advanced alternative payment model under the quality payment program for MACRA. With advanced APMs, providers take financial risk, but can also reap an incentive payment reward.

The model gives incentive payments if all expenditures for an episode of care are under a spending target that factors in quality.

“BPCI Advanced builds on the earlier success of bundled payment models and is an important step in the move away from fee-for-service and towards paying for value,” Verma said.

BPCI Advanced participants may receive payment for performance based on 32 different clinical episodes. The clinical episodes in BPCI Advanced add outpatient episodes to the inpatient episodes that were offered in the previous BPCI model, including percutaneous coronary intervention, cardiac defibrillator, and back and neck except spinal fusion.

Last year, the Centers for Medicare and Medicaid Services cancelled or scaled back on mandatory bundled models for joint replacement, hip fractures and cardiac care, but promised to release new voluntary models.

CMS cancelled the episode payment model and the cardiac rehabilitation incentive payment model, which were scheduled to begin on Jan. 1.

The agency also reduced the number of mandatory geographic areas participating in the comprehensive care for joint replacement model, from 67 to 34. Participants in the 33 remaining areas could take part on a voluntary basis.

In BPCI Advanced, participants will be expected to redesign care delivery to keep Medicare expenditures within a defined budget while maintaining or improving performance on specific quality measures. Participant bear financial risk, have payments tied to quality performance, and are required to use certified electronic health record technology.

Like all models tested by CMS, there will be a formal, independent evaluation to assess the quality of care and changes in spending under the model.

Remedy Partners, which works with providers in the current BPCI program, reported in June 2017 that bundles resulted in a $500 million reduction in the cost of unnecessary medical expense over that past year for more than 1,000 providers. In addition, hospital readmissions decreased by 6.1 percent and a patient’s length of stay at a skilled nursing facility decreased by 6.3 percent, Remedy said.

 

Cost reduction tops list of 5 top CFO priorities for 2018

Posted on by • Posted in Uncategorized • Tagged , , , , , , • Leave a comment

http://www.healthcarefinancenews.com/news/health-execs-top-5-priorities-2018?mkt_tok=eyJpIjoiTlRkbE5qa3hPR0pqTURJNCIsInQiOiJxS28rUmdlMUxJV2hHOTF6WVNiYm1IUklXZFA4ZWI1MmZsY25GYkVRdEN3QTNFWnBsMG83MzRTOU5rQ1B5NXVqMTJxYXcxMEdiVkdWcU1aQ0RGeE52T1FtSlNtd1RiZGRhWHdncEpyS1dUM2lCdlAwbVVPYzlcL1BDa3NZa1ZyVVAifQ%3D%3D

CFOs rank cost reduction opportunities as most important for year ahead, though most expressed limited confidence in their ability to do it.

CFOs rated cost reduction as the most important performance management activity for 2018, according to a new Kaufman Hall survey of senior finance professionals.

Nearly 30 percent chose “identifying and managing cost-reduction initiatives” as the most important performance management function for their organizations, from a list of five choices, according to the 2018 CFO Outlook: Performance Management Trends and Priorities in Healthcare.

The other four priorities, in order, are improving performance reporting to operational leaders (25.8 percent); predicting and managing the impact of changing payment models (18.1 percent); developing more integrated and planning processes across financial planning and strategic capital allocation (16.3 percent); and leveraging rolling forecasting as part of a more continuous planning and financial performance monitoring process (10.7 percent).

Most CFOs, however, also said they have limited confidence in their organization’s ability to manage the financial impact of evolving business conditions. Only 15 percent said their organizations are “very prepared” to manage evolving payment and delivery models with current financial planning processes and tools.

Seventy-percent said they have cost measurement tools that are too simplistic or provide inaccurate data that can’t be trusted or have no tools in place at all, according to the survey of senior finance executives at 350-plus hospitals and health systems.

Fifty-six percent of CFOs and executives said their organizations lack

access to clean, consistent, and trusted data, while ninety-percent think their hospitals should be doing more to leverage financial and operational data to inform strategic decisions.

CFOs said long budgeting cycles are preventing value-added analysis by finance teams. Sixty-nine percent have a budget process that takes more than three months from initial rollout to board presentation. For 9 percent of these organizations, the process takes more than six months.

The survey addresses the rapidly changing healthcare business environment, and the growing role and importance of the CFO function to inform strategic business decisions that will impact long-term success, according to consulting firm Kaufman Hall.

The health care industry’s bubble

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://www.axios.com/the-health-care-industrys-bubble-1515720779-70510df9-9809-42f3-b981-c621db68cbd2.html

Image result for The health care industry's bubble

Health care companies at this year’s J.P. Morgan Healthcare Conference celebrated the Republican tax overhaul and trumpeted optimistic views of their future financial power. But as more Americans become unable to afford drug prices, hospital bills, deductibles and copays — and as they voice their anger — there is sentiment brewing in the industry that a day of reckoning will come.

Key quote: “We are in the middle of a bubble in all health care asset classes,” said Bijan Salehizadeh, a health care investor at NaviMed Capital. “Everyone knows it, but no one knows how it will end.”

What we’re hearing: The one part of health care that multiple people at the conference said desperately needed to change was pharmaceuticals.

  • Many companies continue to hike list prices on generics and brand-name drugs, game the system by extending old drug patents, and are coming out with relatively fewer breakthroughs compared with a much higher number of “me-too” drugs that provide limited benefits over existing drugs.
  • Firms that are developing innovative treatments are commanding prices that surpass many estimates of what is reasonable.
  • Drug companies looking to get bought out are expecting high takeout prices based on the assumption current pricing tactics will remain the status quo.

Yes, but: As many presentations from the J.P. Morgan event confirmed, problems aren’t confined to the pharmaceutical industry.

  • Hospital profits and cash reserves are hovering near historic highs.
  • Premium rates reflect the high cost of health care services and drugs, but observers have raised questions about whether insurers are getting the best deals possible, and whether narrow networks have been helpful.
  • Independent Medicare policymakers continue to push for regulatory changes to nursing homes, home health companies and other non-hospital providers that are earning sizable profit margins from the government.

“Providers are part of it,” Rod Hochman, CEO of Providence St. Joseph Health, a large not-for-profit hospital system based on the West Coast, acknowledged in an interview. “But also pharma has to be part of the solution. Insurers have to be part of the solution.”

Spencer Perlman, a health care analyst at Veda Partners who wasn’t at the J.P. Morgan meeting, has long said companies that obstruct competition or play with regulatory loopholes have been playing with fire.

“So much of current health care valuations are based on revenue and earnings projections that are generated by reimbursement arbitrage, legal maneuvering and/or rent-seeking behaviors,” Perlman said.

Get smart: Health care eats up almost one-fifth of the U.S. economy. The companies that get a slice of that pie don’t have incentives to give it up. Even if Congress or federal agencies intervene with new policies, look for many players to point fingers at industries they believe are bigger abusers — like the current fight between drug companies and pharmacy benefit managers.

 

Top 10 challenges for healthcare executives in 2018

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , • Leave a comment

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-10-challenges-healthcare-executives-2018?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=10012018

 

 

 

12 takeaways from the 2018 JP Morgan Healthcare Conference

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , , , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/hospital-management-administration/12-things-you-need-to-know-from-the-2018-jp-morgan-healthcare-conference-while-the-destination-is-uncertain-the-direction-is-clear.html

Related image

 

The recent breathtaking flurry of mega-mergers coupled with increasingly challenging market forces and an ever shifting political landscape has cast a cloud of confusion regarding where the U.S. healthcare delivery system is heading.

So, where do you go to find the map?

Every year, the JP Morgan Healthcare Conference provides an incredibly efficient snapshot of the strategies for large healthcare delivery systems, the hub for healthcare in the U.S. Most of these organizations are also the largest employers in their respective states. The conference took place this week in San Francisco with over 20 healthcare systems presenting, including Advocate Health Care, Aurora Health Care, Baylor Scott & White Health, Catholic Health Initiatives, Cleveland Clinic, Geisinger Health System, Hospital for Special Surgery, Intermountain Healthcare, Mercy Health in Ohio, Northwell Health, Northwestern Medicine, Partners HealthCare System, WakeMed Health & Hospitals and many of the other big name brands in the market. Each provided their strategic roadmap in a series of 25-minute presentations from their “C” suite. If you’re looking for the GPS on strategy and a gauge on the health of healthcare, this is it.

How do their strategies differ? What direction are they heading in? There is a great line from Alice in Wonderland that goes, “If you don’t know where you’re going, any road will take you there.” You would think that line applies perfectly to the U.S healthcare system, but the good news is it actually doesn’t.

While the exact destination for everyone is TBD, the direction they are heading in is actually pretty clear and consistent. It turns out that they are all using a very similar compass, which is sending them down a similar path.

So, what are the roadside stops health systems consider absolutely necessary to be part of their journey to creating a more viable and sustainable value-based business model?

Based on the travel plans for over 20 of the largest and most prestigious healthcare delivery systems in the country, here’s your GPS and list of 12 things you “must do” on your journey.

1. You Must Scale

Clearly the headline at #JPM18 was the flurry of major announcements regarding major mergers. With that said, two of the mergers were front and center: teams were there to present from Downers Grove, Ill.-based Advocate and Milwaukee-based Aurora, which will be a $10 billion organization with 70,000 employees, as well as San Francisco-based Dignity Health and Englewood, Colo.-based Catholic Health Initiatives, which will be a $28 billion organization with 160,000 employees. The size and scale of these mergers is pretty stunning. While the announcement of these and the other recent mega-mergers has forced many into their board room to determine what the deals mean to them, the consensus at the conference was this: There are a number of different paths forward to achieve scale. Some, like Baylor Scott & White in Texas, have aggressive regional expansion plans. Others are betting on partnerships to provide the same or even more value. Taking a pulse of the room, two things were clear. The first is there is no definition of scale any more in this market. The second is that, despite this flurry of mergers, “getting really big” is not the only destination.

2. You Must Pursue “Smart Growth” and Find New Revenue Streams

Running counter to the merger narrative in the market, Salt Lake City-based Intermountain provided a good overview of the movement to what is called an “asset light” strategy of “smart growth.” This is a radically contrarian approach to the industry norm, which is the capital intensive bricks and mortar playbook of buying and building. As part of their strategy, Intermountain will open a “virtual hospital” delivering provider consultations and remote patient monitoring via telehealth. The system will also launch a number of healthcare companies every year, leveraging their considerable resources in a manner they believe will produce a higher yield. Other health systems outlined a similar stream of initiatives they have in motion to diversify their revenue streams and expand their business model into higher margin, higher growth businesses. One example is Cincinnati-based Mercy Health, which achieved strong growth and leverage via their investment in a revenue cycle management company. Advocate in Illinois formed a partnership with Walgreens. Together, they now operating 56 retail clinics and Advocate has made a significant impact on driving new patients and downstream revenue to their system. The bottom line is all now recognize that they must think and act differently to be able to continue to fund their clinical mission and serve their community.

3. You Must Measure and Manage Cost and Margins

While some are moving aggressively to get scale, everyone is looking to more effectively use the resources they have and get more operating leverage. Margin compression was a consistent theme, with many systems now moving into consistent, stable operating models around managing margins versus launching reactionary initiatives when they find a budget gap. What is emerging is a new discipline and continuous process around managing cost and margins that is starting to look similar to the level of sophistication we have seen in the past for revenue cycle management. To that end, there has been major movement in the market to implement advanced cost accounting systems, often referred to as financial decision support, which provide accurate and actionable information on cost and help organizations understand their true margins as they take on risk-based, capitated contracts. Some during the conference referred to it as the “killer app” for the financial side of driving value. Regardless of what you call it, all are moving aggressively to understand the denominator of their value equation.

4. You Must Become a Brand

Investing in and better leveraging their brand has become a strategic must for health systems. The level of sophistication is growing here as providers shift their mental model to viewing patients as “consumers.” Aurorain Wisconsin cited their dedicated Consumer Insights Group and outlined their “best people, best brand, best value” approach that has been incredibly effective both internally and externally. At the same time, the bigger investments for many health systems relative to brand are more on brand experience than brand image, with a focus on understanding and radically rethinking the consumer experience. As an example, at Danville, Pa.-based Geisinger, close to 50 percent of ambulatory appointments are scheduled and seen on the same day. And every health system is making meaningful investments in their “digital handshake” with consumer, creating and leveraging it via telehealth as well as mobile applications to enhance the customer experience.

5. You Must Operate as a System, Not Just Call Yourself One

One clear theme at #JPM18 is different organizations were at different points along the continuum of truly operating as a system vs. merely sharing a name and a logo. There are a number of reasons for this, but you are increasingly seeing tough decisions actually being made vs. just kicking the can down the road. There has been a great deal of acquisitions over the last few years coupled with a new wave of thinking relative to integration that is more aggressive and more forward-looking. This mental shift is actually a very big deal and perhaps the most important new trend. Many health systems are heavily investing in leadership development deep into their organization to drive changes much faster.

6. You Must Act Small

The word “agile” is quickly becoming part of everyone’s narrative with health systems looking to adopt the principles and processes leveraged in high tech. Chicago-based Northwestern Medicine is an example of an organization that has grown dramatically in the last five years, now approaching $5 billion in revenue. At the same time, they have still found a way to operate small, leveraging daily huddles across the organization to drive their results. The team at Raleigh, N.C.-based WakeMed has achieved a dramatic financial turnaround over the last few years, applying a similar level of rigor yielding major operational improvements in surgical, pharmacy and emergency services that have translated into better bottom line results.

7. You Must Engage Your Physicians

Employee engagement was a major theme in many of the presentations. With the level of change required both now and in the future, a true focus on culture is now clearly top of mind and a strategic must for high-performing health systems. That said, only a handful articulated a focus on monitoring and measuring physician engagement. This appears to be a major miss, given that physicians make roughly 80 percent of the decisions on care that take place and, therefore, control 80 percent of the spend. One data point that stood out was a 117 percent improvement in physician engagement at Northwestern. Major improvements will require clinical leadership and a true partnership with physicians.

8. You Must Leverage Analytics

Many have reached their initial destination of deploying a single clinical record, only to find that their journey isn’t over. While health systems have made major investments big data, machine learning and artificial intelligence, there was a consistent theme regarding the need to bring clinical and financial data together to truly understand value. Part of this path is the consolidation of systems that is now needed on the financial side of the house with a focus on deploying a single platform for financial planning, analytics and performance. The primary focus is to translate analytics not just into insights, but action.

9. You Must Protect Yourself

As organizations move deeper into data, there is increased recognition that cybersecurity is a major risk. Over 40 percent of all data breaches that occur happen in healthcare. During the keynote, JP Morgan Chase CEO Jamie Dimon shared that his organization will spend $700 million protecting itself and their customers this year. Investments in cybersecurity will continue to ramp up due to both the operational and reputational risk involved. Cybersecurity has become a board room issue and a top-of-mind initiative for executive teams at every health delivery system.

10. You Must Manage Social Determinants of Health in the Communities You Serve

Perhaps the most encouraging theme for healthcare provider organizations was the need to engage the community they serve and focus on social determinants of health. As Intermountain shared: “Zip code is more important than genetic code.” To that end, Geisinger refers to their focus on “ZNA.” They have deployed community health assistants, non-licensed workers who work on social determinants of health and have implemented a “Fresh Food Farmacy,” yielding a 20 percent decrease in hemoglobin A1c levels along with a 78 percent decrease in cost. Organizations like ProMedica Health System in Ohio have seen similar results with their focus on hunger in Toledo. WakeMed has an initiative focused on vulnerable populations in underserved communities that has resulted in a significant decrease in ER visits and admissions and over $6 million in savings.

11. You Must Help Solve the Opioid Epidemic

The opioid issue is one that healthcare professionals take very personally and feel responsible for solving. It came up in virtually in every presentation, and it’s an emotional issue for the leaders of each organization. This is good news, but the better news is that they are taking action. As an example, Geisinger invested in a CleanState Medicaid member pilot that resulted in a 23 percent decrease in ER visits and 35 percent decrease in medical spending, breaking even on their investment in less than 10 months. While many would rightly argue that the economic rationalization isn’t needed for something this important, the fact that it’s there should eliminate any excuse for anyone not taking action.

12. You Must Deliver Value

The Hospital for Special Surgery in New York is the largest orthopedics shop in the U.S. and a great example of how value-based care delivery is taking shape. Perhaps the most revealing stat they shared is that 36 percent of the time, patients receive a non-surgical recommendation when they are referred to one of their providers for a second opinion. This is exactly the type of value-based counseling and decision-making that will help flip the model of healthcare. Some systems are farther along than others. Northwestern currently has 25 percent of its patients in value-based agreements, but other systems have less. As the team from Intermountain re-stated to this audience this year, “You can’t time the market on value, you should always do the right thing, right now.” Well said.

It’s time to get started or get moving even faster.

As the saying goes, “It’s the journey, not the destination.”

Happy trails.

Done deal: Princeton HealthCare joins Penn Medicine

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

https://www.bizjournals.com/philadelphia/news/2018/01/09/penn-medicine-merges-with-princeton-healthcare.html

Image result for Done deal: Princeton HealthCare joins Penn Medicine

The University of Pennsylvania Health System’s biggest push ever into New Jersey became official Tuesday with its addition of Princeton HealthCare System.

“The joining together of Princeton HealthCare System and Penn Medicine represents an exciting new chapter in Penn Medicine’s growth,” said Ralph W. Muller, CEO of the Penn Health System. “[Princeton Healthcare] has an impressive reputation for providing high-quality care to patients close to home, and innovating in many types of community-based health and wellness initiatives. Now, we can offer a powerful partnership to patients throughout the region [Princeton HealthCare] serves, continuing the services they already depend on, coupled with access to world-class care for complex conditions and innovative clinical trials available at Penn Medicine.”

Princeton Healthcare — which operates the 319-bed University Medical Center of Princeton at Plainsboro, the 110-bed Princeton House Behavioral Health facility in Princeton, a home care division and a physician network — first reached a tentative agreement to join the Penn Health System in 2016. The two organizations spent more than a year going through the now-completed regulatory review process, which included getting the support of the state Attorney General’s Office and state Department of Health, and the approval of state Superior Court’s Chancery Division.

“This is a significant day in our history, and we look forward to being an even stronger organization, clinically and financially, as we continue to fulfill our almost century-old mission of serving this community,” said Princeton HealthCare President and CEO Barry S. Rabner. “We could not ask for a better partner than Penn Medicine.”

Rabner repeated the community members will continue to receive high-quality care locally, and added they also “will benefit from easier access to the latest medical breakthroughs, cutting-edge technologies and specialized clinical expertise—both here and elsewhere in the Penn Medicine system.”

Princeton Healthcare, which employs about 3,000 workers and has an active medical staff of more than 1,100 physicians, is based about 40 miles north of Philadelphia. As part of the transaction, the names of the health system and its affiliates will change. The system will be Penn Medicine Princeton Health. The hospital’s new name will be Penn Medicine Princeton Medical Center.

“Our trustees engaged community members, physicians and employees in a thorough, two-year process to evaluate and select a partner,” said Kim Pimley, Princeon HealthCare’s board chairwoman. “In Penn Medicine, we found a partner that shares our values. Together, we can make world-class care more accessible to the people in the communities we serve.”

Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise. The Penn Health System’s patient care facilities include: The Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Pennsylvania Hospital, Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital. It also operates Good Shepherd Penn Partners, a long-term hospital and rehabilitation care provider created through a partnership between Good Shepherd Rehabilitation Network and Penn Medicine. The health system also operates a network of outpatient and physician practice sites throughout the region, including Penn Medicine Cherry Hill and Penn Medicine Woodbury Heights in South Jersey.

Court records associated with the transaction provided the following narrative about how the two health systems came together.

Princeton HealthCare spent several years evaluating potential strategic options and partners before signing its deal with Penn. Its first step was initiating a competitive process of evaluating potential partners and partnership structures during the summer of 2015. Wells Fargo was brought in as a consultant and the firm identified 19 potential strategic partners, initiated contact with 17, and, sent a confidential draft and non-disclosure agreement to 11 organizations that expressed an interest in a fully-integrated strategic partnership.

By the end of 2015, Wells Fargo sent a formal request for proposal to nine potential strategic partners that best satisfied Princeton HealthCare’s “guiding principles.” Six potential partners provided a written response to the formal request for a proposal by February 2016.  Princeton HealthCare narrowed the field to three “preferred partners” – Penn Medicine, a second Pennsylvania health system and a New Jersey-based health system. The identities of the other potential partners were not disclosed.

After more detailed proposals were submitted by the three potential partners, Princeton HealthCare’s strategic planning committee voted in May 2016 to recommend that the system enter into exclusive negotiations with the Penn Health System for three key reasons:

  • “Penn Medicine has the human, scientific, educational, financial and clinical resources necessary to enable Princeton HealthCare to provide the highest level of accessible care to the communities it serves long into the future. Penn Medicine has demonstrated that it shares Princeton Healthcare’s values;
  • “A partnership with Penn Medicine will enhance Princeton HealthCare’s ability to expand its clinical programs, care coordination and information technology and to provide its patients with better access to medical breakthroughs, clinical trials, cutting edge technologies and more specialized clinical expertise; and
  • “For more than two centuries, Penn Medicine has been committed to the highest standards of patient care, education and research. Penn Medicine’s commitment has been recognized across the nation.”

Princeton HealthCare entered into a non-binding letter of intent to join the Penn Health System in July 2016. A former affiliation agreement was signed in December 2016.

According to court records, the proposed transaction will not result in the payment of any purchase price or the sale of assets. Penn Health System has committed to spending a minimum of $200 million to fund “strategic capital projects for the benefit of the residents of the communities served by Princeton HealthCare and to improve the financial performance of Princeton HealthCare and its affiliates during the five-year period after the deal closes. Penn Health System has also committed to spend at least $12 million per year for “routine capital expenditures” on the University Medical Center’s campus.

The deal, according to court records, also involves Penn Health system assuming financial responsibility for Princeton HealthCare’s outstanding debt and pension obligations. All donor-restricted gifts made to Princeton HealthCare and its foundation will continue to be held and used for purposes consistent with the donor’s intent. In addition, after the closing, any gifts received by Princeton HealthCare through local fund-raising efforts will be used locally for the benefit of Princeton Healthcare and its affiliates. The deal stipulates Princeton HealthCare’s governing board will retain the right to approve any closure or relocation of any licensed health care facilities for six years following the closing of the proposed transaction.

 

Hospital CFOs: 3 things demanding your attention in 2018

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/finance/hospital-cfos-3-things-demanding-your-attention-in-2018.html

Image result for hospital CFO concerns

From managing new risk-based payment models to navigating an uncertain regulatory environment, healthcare industry finance leaders face many challenges this year, making it difficult to determine which initiatives to prioritize.

To simplify and focus, below are three areas hospital and health system CFOs should prioritize in 2018, according to a new study from Kaufman Hall. For the study, Kaufman Hall surveyed CFOs and other senior finance executives from more than 350 hospitals, health systems and other healthcare organizations across the nation from Oct. 2 to Oct. 27, 2017. Of the respondents, 69 percent were from multihospital health systems, 19 percent were from standalone hospitals, 4 percent were from medical groups and 8 percent were from health plans or other organization types.

1. Cost reduction initiatives. Nearly 30 percent of the respondents said identifying and managing cost reduction initiatives is the most important performance management activity for their organizations. “CFOs recognize the urgency of generating cost improvements, but are struggling with data, processes, and tools due to their lack of structure, transparency, accuracy, and hence, creditability,” according to Kaufman Hall. Seventy percent of survey respondents said their organizations do not use cost measurement tools, or use tools that are too simplistic or provide inaccurate data.

A reliable cost accounting solution can help healthcare organizations manage cost-reduction initiatives. “It must provide flexibility and transparency of costing model elements and a fluid ability to support strategic and financial planning,” according to Kaufman Hall. “A trusted cost accounting tool enables modeling and forecasting of utilization, labor and other costs, and insights into current costs at a patient or service line level.”

2. Financial planning. More than 50 percent of respondents said operational budgeting and forecasting, cost management and efficiency, and reporting and analysis to support decision-making as top initiatives. To improve in these areas, hospital leaders need to have clear goals that are communicated across the organization, according to Kaufman Hall. However, further improvement is needed to ensure transparency and accountability, as nearly half of respondents said their organizations do not closely track targets across the organization to help achieve financial goals.

“Progress is being made in improving financial planning processes, analytics, and tools in order to ensure best-possible organizational performance,” according to Kaufman Hall. “But CFOs and other finance leaders must focus on the areas that will generate the most significant returns.” Kaufman Hall recommends hospitals and health systems examine whether they have the financial resources and talent to successfully implement and operate clinical and administrative tools; support ongoing data collection and management; drive data analytics; and integrate the results with broader organizational plans.

3. Budget processes. The budget process at most healthcare organizations is time consuming, and budget assumptions are often outdated by the time they are published. Although the majority of respondents (69 percent) said their organization’s budget process takes more than three months from initial rollout to board presentation, CFOs recognize there is room for improvement in this area. Forty-seven percent of respondents said their budget cycles do not leave ample time for value-added analysis that can inform strategic decisions.

“Finance leaders are and should be considering different approaches to budgeting, not just simple tweaks to the existing process,” according to Kaufman Hall, and many healthcare organizations are doing just that. Thirty-one percent of respondents said their organizations plan to start using rolling forecasting in the near future to give them the ability to adjust projections and strategies to remain in sync with long-term financial plans.

Access the full Kaufman Hall report here.

Ex-director of finance accused of embezzling $3M from North Carolina hospital

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-director-of-finance-accused-of-embezzling-3m-from-north-carolina-hospital.html

Image result for federal indictment

 

High Point (N.C.) Regional Hospital’s former director of finance is accused of stealing more than $3 million from the hospital between Jan. 1, 2003, and Aug. 15, 2017, according to WXII 12 News.

According to a federal indictment, Kimberly Russell Hobson defrauded the hospital by issuing unauthorized and forged checks payable to herself and relatives. She’s also accused of using the hospital’s credit cards for personal expenses.

Ms. Hobson used money embezzled from the hospital to purchase luxury vehicles, a motorcycle and other items for personal use, according to court documents.

Ms. Hobson is charged with seven counts of wire fraud, two counts of bank fraud, five counts of aggravated identity theft, and one count of possessing and uttering counterfeit securities, according to the report.

A spokesperson for High Point Regional Hospital told WXII 12 News Ms. Hobson was removed from her position at the hospital last summer.

 

Federal lawsuit: Duke, UNC agreed not to hire each other’s physicians

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/legal-regulatory-issues/federal-lawsuit-duke-unc-agreed-not-to-hire-each-other-s-physicians.html

Image result for federal lawsuit

Arguments are expected to begin Thursday in a federal lawsuit brought by a radiologist who claims North Carolina’s two largest academic medical centers agreed not to hire each other’s faculty.

A former Duke University radiology professor, Danielle Seaman, MD, filed the antitrust lawsuit in 2015. She alleges the University of North Carolina’s chief of cardiothoracic imaging told her she was passed over for a job as a radiology professor at UNC due to an agreement between the two medical schools not to hire each other’s faculty.

“The intended and actual effect of this agreement is to suppress employee compensation, and to impose unlawful restrictions on employee mobility,” according to Dr. Seaman’s amended complaint.

According to the amended complaint, the defendants agreed the only exception to their no-hire agreement would be for faculty who were granted a promotion simultaneous to their hiring. “Under the agreement entered into between defendants and their co-conspirators, an assistant professor at Duke cannot be hired by UNC unless she is hired into a position at the associate professor rank or higher, and vice versa,” states the amended complaint. The highest faculty rank at both UNC and Duke is professor; therefore, there is no possibility for promotion above that rank.

On Thursday, U.S. District Judge Catherine Eagles will hear arguments on whether the lawsuit should include all skilled medical workers employed between 2012 and 2017 at Duke’s medical school; Durham, N.C.-based Duke University Health System; UNC-Chapel Hill’s medical school; and UNC Health Care in Chapel Hill.

The judge will also consider a proposed settlement between UNC and Dr. Seaman. Under the settlement, UNC would promise not to participate in any unlawful restraints on competition and cooperate by providing witnesses, documents and data in the ongoing lawsuit against Duke’s medical school and Duke University Health System.

Both Duke and UNC deny the existence of the no-hire agreement.

 

 

These 6 healthcare leaders say quality improvement is an organizationwide effort and a cultural imperative

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , • Leave a comment

https://www.fiercehealthcare.com/healthcare/6-inspiring-quotes-improving-quality-from-6-healthcare-leaders?mkt_tok=eyJpIjoiWVRNeE1HSTFPREkwTmpsbSIsInQiOiJtcHFUTmw4bU5UWE0rbE44Q0ExcUc5cEI5SSt0UVdcL0ZYVDllbUhMN3VNXC9ab2JTTlwvKzVYOXMyTmVmRlwvZjJ2VzNZWmp5Z2VJeERzVytyWUZOdkVyRmdnVWNWSEV6SVhkSWVHSFljSkhRV05rMUt5WFwvemVvM2dsMEpUeW1rYUx2In0%3D&mrkid=959610

Executive looking out window

Despite recent uncertainty about the government’s commitment to value-based care, healthcare organizations remain focused on efforts to improve quality, patient care and employee engagement.

In 2017 the Centers for Medicare & Medicaid Services cancelled mandatory bundled payment models for hip fractures and cardiac care and also asked providers for feedback on other value-based payment models.

But healthcare organizations seem committed to the initiatives they have already put in place to improve quality. Indeed, last year healthcare leaders shared their successes, challenges and lessons learned as they worked to improve quality and patient outcomes. We’ve rounded up the most memorable quotes from these healthcare thought leaders about quality, the importance of physician engagement and how to achieve a culture of patient safety.

Here are six of our favorite quotes from our interviews and industry news and event coverage over the past 12 months:

1. “We had to challenge our old paradigms. Physicians are instrumental in setting the tone, and unless the physicians believe we’re on the right path we don’t have the kind of alignment that will help us move forward.”

Gary Kaplan, M.D., chairman and CEO of Virginia Mason Health System, explained in a webinar this fall how the Seattle system improved patient safety using a patient-centered approach. Virginia Mason’s safety culture transformation began in 2001, Kaplan said, when system leaders realized that a physician-centered approach alone would not improve patient care.

2. “You need to start with the early adopters. You can’t start with folks who will fight you tooth and nail. You want to start with early successes and then evolve from there.”

Felipe Osorno, an executive administrator at Keck Medicine of the University of Southern California, spoke at the Institute for Healthcare Improvement’s annual quality forum about strategies to engage physicians in improvement initiatives. The secret was designing a program in which physicians were respected for their competency and skills, their opinions were valued, they had good relationships with their medical colleagues, they had a broader sense of meaning in their work and they had a voice in clinical operations and processes, he said.

3. “We really want to attract folks who believe at their core, not just intellectually but in their heart, that kindness can heal. … If we do it right the first time and we assess candidates based on the fit of the organization, ideally we will have more engaged employees who deliver care in a way that is patient-centered.”

Wanda Cole-Frieman, vice president of talent acquisition at Dignity Health, talked to FierceHealthcare this summer after the California system was named by an online job platform as the best place to interview in 2017. Among its techniques: It assesses candidates’ behavioral competencies for human kindness, compassion and the human experience.

4. “To create a true culture of safety and reliability we need to engage everyone, and it can only be driven when we have strong alignment. Everyone can play a role in safety.”

Gary Yates, M.D., a partner in strategic consulting at Press Ganey, explained in an interview that building and promoting a culture of safety at healthcare organizations is important to retain current staff members, but is also an especially effective recruiting tool for millennials, who will make up half of the workforce by the year 2020.

“People talk, and people ask about the culture inside different organizations,” Yates said. Putting the spotlight on safety and quality could “tip the scales” for young people.

5. “Our focus is safety, to fundamentally be a safe hospital. If we start there or if any hospital starts there, patient experience will take care of itself, quality metrics will take care of itself as will employee morale.”

FierceHealthcare caught up with Nicholas “Nico” R. Tejeda, CEO of The Hospitals of Providence Transmountain Campus in El Paso, Texas, at an American College of Healthcare Executives event. He talked about opening a new teaching hospital and establishing the culture of the organization from the beginning and with every hire.

There are no acceptable levels of errors, he said. And while it may be nearly impossible to achieve zero incidents, he still wants the organization he leads to strive for perfection.

6. “We don’t see quality as just a clinical goal. It’s an enterprisewide priority that encompasses customer service, compliance and wellness.”

A few years ago, Anthem decided to make a “rigorous” effort to boost the quality of its plans. And it’s demonstrating results, Anthem’s then-CEO Joseph Swedish said during the 2017 AHIP Institute & Expo. Now, more than half of the insurer’s Medicare Advantage enrollees reside in 4-star plans, compared to just 22% the year before.