Browse by Topic
More than 40,000 members value HFMA's thought leadership and practical strategies. HFMA is where you need to be.
Get acquainted with the
healthcare finance industry's leading professional association. Find out why our
members rely on HFMA as their go-to source for insight and
Members have many
options for helping them advance their careers. Conferences, seminars,
eLearning, certification, and more -- our education and events will keep you
Connect the dots on today's big issues, explore collaborations, get career-boosting tips, and network with colleagues nationwide at the leading finance conference. Save $150 off the full conference rate when you register by Feb 27.
Real-time presentations with nationally recognized experts, networking opportunities, and industry solutions—no travel required!
Get the latest, practical education in key areas of healthcare finance over 1, 2, or 3 days. Choose Essentials Programs or Master Sessions in DC or Seattle. Register early and save $100.
If you're a subscriber to any of our three newsletters, you have access to online education. Learn more or subscribe.
Get the perspectives of leading healthcare finance professionals on today's hottest issues.
Information about leading vendors helps your buying decisions.
Forum members can network during live webinars or access a library of past webinars on topics such as bundled payment, charity care, and ICD-10.
An ever-expanding collection of spreadsheets, policies, job
descriptions, checklists, and more that you can adopt and adapt.
Forum members can submit vexing questions to a panel of experts
using our Ask the Expert service.
Your source for employment solutions.
Find new employment opportunities or
reach out to qualified candidates.
Distinguish yourself as a
leader among your peers and advance your career by earning certification in our
healthcare finance programs.
Get an objective third-party evaluation of products and services used in the healthcare finance workplace.
MAP App is a web-based application that helps organizations improve revenue cycle performance based on industry-standard metrics called MAP Keys.
Find suppliers and products in this comprehensive vendor directory for healthcare finance professionals.
Guidance for understanding and communicating about the price of health care.
Guidelines on how to make it easier for consumers to get information about healthcare prices.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
The various problems that have plagued implementation of the Affordable Care Act (ACA) and the responses to these problems have received widespread coverage in the media. Hospitals and other medical facilities can draw both positive and negative lessons from these occurrences.
As passed by Congress, the ACA was a political document, and there seems to have been relatively little attention given to the need for a carefully crafted implementation plan. Many of the resulting problems may be traced back to this lack of foresight, and it is here that hospitals can learn some important lessons.a
The first lesson is that a good plan, based on a clear analysis of actual circumstances, can help hospitals get off on the right foot, whereas a bad plan, based on wishful thinking, can place hospitals at a disadvantage from the start.
During the early years of implementation of the ACA, there appears to have been insufficient effort devoted to setting up meaningful lines of communication with all affected individuals and organizations. The consequences underscore the second important lesson for hospitals: For new hospital programs, it is important to open up numerous lines of communications with all affected individuals and organizations and support the exchange of information throughout. Implementation activities that are directed only toward the inner organization can fail to elicit the needed outside engagement.
Last-minute ACA communications efforts have tended to be ad hoc and underfunded. The lesson for hospitals and other medical facilities is to make sure sufficient attention is given to sound advance planning to avoid crisis responses to communications issues. It is critical to assemble and define realistic tasks, costs, and schedules from the start.
The ACA difficulties illustrate the danger of rushing any initiative that will bring major change into effect. Hospital managers should stick to their own assessments regarding the pace of change that is viable, and not allow themselves to be pressured into more rapid action.
ACA implementation seems to have been focused on rushing to meet its ambitious deadlines and on acceptance of delayed decision making. As a result, technical problems now threaten the implementation, and late fixes are being accepted. By all appearances, the Department of Health and Human Services (HHS) failed to bring together the most experienced persons and organizations in the field and to give them the management structure and support to make sure they could do the job.
Another insight is that, once program implementation is under way, special emphasis should be placed on avoiding last-minute changes in specifications. Think of what happens if an architect is asked to redesign a facility in midstream: frustration, a cost explosion, and chaos.
Most recently, HHS has taken new steps to manage the technology crisis, which can serve as a useful model for hospital managers.
The primary positive lesson—which applies to virtually all program implementation efforts today, given that they all are likely to involve technology—is for hospital managers to recognize that they will often need help to supervise programs with technical components. A high-profile technical leader may be appointed to represent and guide the technical tasks and advise the manager. An outside team of experts may be assembled to analyze the development process and advise the technical leader and hospital manager. A formal process should be put in place for budgeting, scheduling, and supervising all technology-related tasks.
Experience has shown that managers often cannot adequately integrate all implementation activities without such support. Relying on the technical teams alone usually does not assure accountability. A technical leader and team of outside experts can provide essential information that is needed to allow nontechnical managers to effectively supervise technical tasks.
These moves should be taken at the start of implementation. It is often too late to try to step in and impose order on a project once it has started to unravel.
a. See also the recent blog posting “The Obamacare Report (#17) / Political Drama — Good or Bad for ACA Implementation Efforts?” for additional discussion by the authors of the impact of the ACA program failures and their implications.
Cheryl Mitchell is an attorney, Mitchell Law Office, Spokane, Wash.
Publication Date: Friday, November 08, 2013
Is it constitutionally legal for President Obama to "fix" a law passed by Congress on his authority alone?Doesn't this undermine the authority of Congress to make laws?
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
©2015 Copyright Healthcare Financial Management Association
HFMA.org is best viewed using IE9 or the latest versions of Chrome, Firefox, and Safari.
Join HFMA today and enjoy: