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Bending the healthcare cost curve requires a proactive approach by stakeholders across the industry, including providers, payers, patients, and federal and state governments. Even with the recent stabilization of national healthcare spending growth, national health expenditures reached $2.7 trillion in 2011 and constituted about 18 percent of the nation’s gross domestic product (GDP). The latest statistics from the Centers for Medicare & Medicaid Services show GDP growth rose from a negative 2.2 percent to 4 percent from 2009 to 2011, while national health expenditure growth held steady at 3.9 percent (CMS Office of the Actuary, National Health Expenditures 1960-2011, Table 1).Hospitals, health systems, and other healthcare providers can help move the country toward sustainable healthcare and national fiscal health by reining-in organizational costs and learning to operate with lower rates of annual revenue growth.
Massachusetts mandated such action with a 2012 law meant to constrain per capita healthcare spending that continued to trend above national averages after the state extended health coverage to nearly all residents in 2006. Last summer’s law restricts healthcare spending growth through 2017 to no higher than growth in the potential gross state product. For 2018 to 2022, the limit will be tightened to potential gross state product minus 0.5 percent. Entities, including insurers, hospitals, and physicians, that don’t comply are subject to civil penalties.Our October 2012 analysis of Congressional Budget Office estimates, which we conducted with the not-for-profit Altarum Institute, found that similar restrictions on spending growth would have a profound and positive effect on the federal deficit and solvency of the Medicare Hospital Insurance Trust Fund (Kaufman, K., Roehrig, C., “GDP+0: Prospects And Challenges Of Bending The Health Care Cost Curve,” Health Affairs Blog, October 16, 2012). It also found that achieving NHE growth of GDP+0 actually requires per capita cost trends to be held at GDP minus 0.6 percent, due to increased demand from a growing Medicare population and expansion of health coverage under the Affordable Care Act. In other words, “just GDP+0” is not enough. This Kaufman Hall-Altarum Institute analysis suggests that healthcare providers could make a significant contribution to solving the country’s financial challenges by limiting revenue growth in their institutions to GDP+0 or lower. A January report by The Commonwealth Fund also recommends setting targets for healthcare spending growth at no more than long-term GDP growth per capita. The report proposes a series of policies to meet those goals and reduce projected health spending by $2 trillion through 2023, including payment reforms, empowering patients to make value-based care decisions, and other improvements (Confronting Costs: Stabilizing U.S. Health Spending While Moving Toward a High Performance Health Care System, The Commonwealth Fund, January 2013).
Proactive providers around the country are working to reduce spending through initiatives such as redesigning care processes to increase efficiency, removing service duplication, and eliminating inappropriate tests and procedures. Normal cost-management efforts will not be enough; cost transformation will be required. The work providers do now to reduce costs is, and will continue to be, critical for health care and the nation’s long-term economic health.
Kenneth Kaufman is chair, Kaufman, Hall & Associates, Inc., Skokie, Ill., and a member of HFMA’s First Illinois Chapter (firstname.lastname@example.org).
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Publication Date: Wednesday, February 13, 2013
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
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