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 $100 off the full conference rate when you register by May 8.
Real-time presentations with nationally recognized experts, networking opportunities, and industry solutions—no travel required!
Learn about timely healthcare finance topics and earn CPEs. Most live webinars are free for HFMA members and $99 for non-members. View the latest schedule.
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.
Transformation toward value-based healthcare is reshaping the delivery of care, patient expectations, and payment structures.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
Any new health business must demonstrate three basic functions:
Only if budgeting and marketing, technology, and customer relationships are established can other new-business activities be successful. As implementation of the Affordable Care Act (ACA) nears its moment of truth, when open enrollment in the healthcare insurance marketplaces begins on Oct. 1, 2013, the status of these functions can shed light on progress and problems.
The new Health Insurance marketplaces, or exchanges, have already displayed inadequacy in budgeting and initial marketing. The Department of Health and Human Services (HHS) has announced that program budgeting has not included an adequate setting aside of funds to pay for required education and outreach for the new Health Exchanges.
This explanation has come after three years during which HHS has neither taken any clear actions toward mounting a major outreach effort to explain the ACA nor acknowledged the need for such action. We are not aware of any mailings to the public, TV public service programs, to recruitment of providers to distribute brochures.
HHS has now been reduced to seeking last-minute donations to support outreach efforts, demonstrating that initial budgeting failed to adequately prepare for this predictable need. (See Kliff, S., "Budget request denied, Sebelius turns to health executives to finance Obamacare," The Washington Post, May 10, 2013.)
Any testing of technology has been well hidden. Each marketplace must link to insurance companies that are to offer insurance policies for sale, and provide individuals and small-business employers with an easy-to-use and easy-to-understand software interface so that policies may be scanned and purchases made. Demonstration efforts should be common today across the country.
And each marketplace must illustrate seamless communications with the IRS so that income information supplied by individuals may be sent to the agency, and it can calculate and communicate back the amount of any subsidy to be received.
All of this must happen in a timely manner, or individuals will give up on the effort and blame the technology.
Finally, any new health business must show that it understands potential customers, and must demonstrate this connection in a way that customers will recognize. To date, the marketplaces have not addressed this issue. There has been no recruitment of representatives who can be recognized by and speak effectively to those who will be seeking insurance coverage through an marketplace. There is no "image" for these businesses.
The status of the marketplace at this point indicates more than "growing pains." Rather, there seems to be a basic lack of understanding about the requirements for setting up and implementing successful "marketplace" businesses.
Healthcare organizations should not sit idly by and placidly contemplate this situation. Get-well plans are urgently needed. It may be time for those who are experienced in the development of successful healthcare organizations to voice their concerns—and even lend a hand. The ACA agencies are far afield from their usual tasks, and could use insight and assistance. But they may not yet understand the nature of the need, or show a willingness to ask for help.
Healthcare leaders can respond to this situation in several ways. In the very least, they may want to consider appropriate internal actions within their own organizations to adjust to the expected outcomes of the problems being encountered by the Exchanges.
Other managers may decide that direct intervention strategies are possible, by attempting to set up lines of communication to help steer the marketplaces in directions that will not only make them more effective with consumers but also reduce internal problems for the organizations managing the marketplaces. This approach will depend on healthcare leaders’ ingenuity and ability in making their voices heard.
Enlisting third parties for communications may have potential in some cases. Healthcare leaders can cultivate an indirect relationship with a third party that already has a relationship with a marketplace, and with the manager’s organization. There might be greater receptivity on the part of the marketplace manager, as efforts could achieve changes that will benefit all three organizations.
Ferd H. Mitchell is an attorney, Mitchell Law Office, Spokane, Wash., and a member of HFMA’s Washington-Alaska Chapter.
Cheryl Mitchell is an attorney, Mitchell Law Office, Spokane, Wash.
Publication Date: Friday, June 21, 2013
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Dale Hockel, senior vice president of operations, and Jim Fanelli, CFO, TriMedx, share strategies for elevating clinical engineering through innovative management programs.
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.
HFMA's print, email, online, and mobile opportunities provide you maximum reach and impact. We will work with you to build a plan that meets your needs. Contact a sales rep.
HFMA’s Buyer’s Resource Guide is a comprehensive vendor directory that helps healthcare finance professionals find products and services.
Access all the tools and resources you need to develop your personal skills. Organized into distinct career levels, this tool creates a career plan specific to your career goals.
...with HFMA’s Certified Healthcare Financial Professional (CHFP).
©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: