November 2016 hfm CoverCover Story

Building a Fee-For-Service Bridge to Population Health
Initiatives that generate fee-for-service revenue can be helpful to hospitals seeking population health strategies.
By Erin Mastagni, John Redding, and Michele Le


From the President's Desk

November 2016: From the President's Desk: Joe Fifer on the Patient Experience Expanding on thoughts in his November 2016 column in hfm, HFMA President and CEO Joe Fifer talks about the patient experience—firsthand. 

HFMA Video Spotlight

What Hospitals Can Do to be in Compliance With 501(r) and Other Regulations
Ellen Stewart, MSHA, JD, FHFMA, partner at Berenbaum Weinshienk, discusses what hospitals can do to make sure they are in compliance with 501(r) and other regulations.


Early Edition

Hospital M&A Activity: A Window of Opportunity to Tackle the Talent Conundrum 
M&A presents an opportunity for healthcare organizations to attract and retain talent.

By Scott Boyd, MBA

Improved Quality of Health Care Does Equate to Lower Costs 
Using lean methods, hospitals can develop standard care protocols that can effectively improve quality of care and reduce costs. 
By Jennifer Ittner and Jami Eddington

Historical and Projected National Average Spending per Enrollee by Payer, 2009-25 
Healthcare spending per enrollee in Medicare, Medicaid, and private health insurance plans is projected to continue increasing through 2025.


Features

Case Study
Pioneering a Rolling Forecast
One health system found a rolling forecast method of budgeting has resulted in a more agile organization.
By Larry E. Hill, MHS

Translating Risk into Revenue: Strategies for Risk-Adjusted Markets
To effectively negotiate a risk-adjusted contract, a health system must demonstrate that it is fully capable of documenting and coding the patient care it delivers.
By Brandon Solomon and Brad Helfand, MPH, FACHE

Case Study
Reaping the Benefits of an Innovative Pharmacy Business Model
One health system improved the margins on its pharmacy services by establishing the area as a business within a business within the larger organization.
By James Jorgenson, RPh, MS, FASHP, William Shaw, RPh, Keith E. Kilgore, and Dawn Moore Jefferson,PharmD, MS

Medicare’s Site-Neutral Payment: Impact on Hospital Outpatient Services
Hospitals should prepare for the impact of Section 603 of the Bipartisan Budget Act of 2015 on payment to new off-campus hospital outpatient departments.
By Jim Price, Rick Buchsbaum, and Kyle Price

Case Study
Improving Health Outcomes by Reducing Unwarranted Variation in Surgical Care
Physicians, hospitals, and patients all benefit from a standardized approach to treatment throughout surgical episodes of care. This article includes an example of how a management service organization (MSO) is helping to make this standardization happen at St. Luke’s Regional Medical Center in Boise, Idaho.
By Kenneth M. Little, MD, FAANS, Jeffrey S. Taylor, and Michael Schlosser, MD


Advertising

Business Profiles
Taking Data Analytics to the Next Level
Sponsored by Deloitte

A Patient-Centered Financial Experience
Sponsored by PatientMatters


Focus Areas

Payment
BCPI Year Two Results: Findings and Implications
Results of year two of the Bundled Payments for Care Improvement initiative have implications regarding the future direction of such initiatives.
By Chad Mulvany, FHFMA

Revenue Cycle
The Future of the Revenue Cycle: Modern, Analytics-Based Self-Pay Investigation
Analytics can help identify which patients will be unable to pay, allowing a healthcare organization to provide resources to them.
By David Figueredo


Columns

From the Chair
Plan to Thrive
For healthcare organizations, an effective strategic planning process involves five key choices.
By Mary Mirabelli, FHFMA

From the President
My Turn to Be the Patient: What I Learned
What’s routine for healthcare professionals is anything but routine for patients. Every interaction matters.
By Joseph J. Fifer, FHFMA, CPA

From the Editor 
Healthcare Consumerism: Employers Could Change Everything 
A recent HFMA Health Care 2020 report on consumerism notes that the combination of increased cost sharing and value-based payment models is profoundly changing the dynamic among consumers, providers, and health plans.      
By Daniel R. Verdon

Eye on Washington
Healthcare Reform Challenges Continue for a New Administration and Congress
After the presidential election, the new administration faces an important decision about what should happen in the next round of healthcare payment reform.
By Gail R. Wilensky, PhD

Healthcare Reform
The Travails of the ACA Health Insurance Exchanges
Health plans’ challenges with the ACA will inevitably spread to hospitals and physician practices.
By Ken Perez

Etcetera: Member Profile
Trail Time
Director of health care enjoys trail riding in the Desert Southwest.

Data Trends
Analyzing Patterns in Outpatient Long-Stay Observation Claims Analysis
Hospitals can benefit from analyzing the extent to which their utilization patterns for observation services are in line with those of peers.
By William Shoemaker