M&A Basics: How to Avoid a Broken Deal
Hospital leaders involved in merger and acquisition discussions need to understand some fundamentals about these transactions to ensure a successful outcome.
An Antitrust Primer
It may be helpful to remember certain basic principles of antitrust law when contemplating mergers and acquisitions.
A KPI Primer: 5 Steps for Creating Meaningful Revenue Cycle Metrics
Healthcare revenue cycle KPIs that have a defined purpose and are actionable can raise staff performance and improve processes.
NY Rural Providers Turn Medical Homes into an ACO
What makes this medical home project different from many others around the country is that it is an all-payer pilot. After lengthy negotiations between providers and payers, the health plans agreed to pay the medical homes $7 per member per month to care for some 100,000 patients during the first year.
CY15 Medicare Physician Fee Schedule Proposed Rule Fact Sheet
This document summarizes the revised policies pertaining to payment policies under the Medicare physician fee schedule for calendar year 2015 (CY15).
Acquisition and Affiliation Toolkit – Home
Introduction This toolkit is a companion to HFMA’s Value Project report on Acquisition and Affiliation Strategies. Consolidation is a rapidly evolving strategic focus for health care organizations. As the report suggests, new forms are continually appearing. This toolkit offers tools for assessing your organization’s situation, determining acquisition and affiliation options, and moving toward finalizing an agreement with an acquisition or affiliation partner. It also provides three examples scenarios to illustrate how these tools might be put to use in setting a course for your organization. Toolkit Directory We encourage first-time users of this toolkit to review the sections in the order listed below. You can then use this directory to navigate to particular sections of interest. Assessing Your Situation Organizational assessment Market assessment Common acquisition and affiliation goals Determining Your Options Common acquisition and affiliation approaches Identifying potential partners Educating your board Moving Forward Communicating your strategy internally Key steps in finalizing an agreement Example Scenarios A stand-alone hospital determines its consolidation approach An academic medical center aims for long-term sustainability A multihospital pursues a regional strategy and system-wide economies of scale
Forum Webinar: Tackling Two CAH Financial Challenges
Listen to the recording and view the slides and attendee polling answers for this Forum Networking Webinar on two specific challenges that CAHs face.
What Does Financial Success Look Like in the CAH World?
CFO Bryce K. Betke credits four key factors for Crete Area Medical Center’s success: affiliation, payer mix, physician employment, and population health.
Price Transparency Task Force
The American Hospital Association fully supports the recommendations of the HFMA Price Transparency Task Force. The AHA has long supported the need to provide patients with healthcare price and quality information and has worked with stakeholders, including HFMA, to provide useful information that will help patients make healthcare decisions. We believe that it will take everyone—providers, insurers, employers and government—working together to provide patients with the information they need. Hospitals are committed to improving how consumers get information on the amount they will be expected to pay for care. This includes helping patients understand their hospital bills by finding better ways to explain them in user-friendly terms. Providing understandable and useful information about the price of hospital care is one of the ways America’s hospitals are working to improve the health of their communities. Rich Umbdenstock President and CEO American Hospital Association Ensuring consumers have the support and information they need to maximize the value of their healthcare dollars has been a longstanding priority for health plans. These recommendations build on health plans’ innovative tools that empower consumers in their decision-making. Increased transparency also shines a spotlight on the need for all stakeholders to address the underlying drivers of healthcare costs. Karen Ignagni President and CEO America's Health Insurance Plans Transparency in price information is a reflection of our commitment to respect the dignity of the persons we serve. Patients and their families deserve complete information about their care and price information is an important component of what they need to make decisions about that care. Sister Carol Keehan, DC President and CEO Catholic Health Association of the United States The American College of Physician Executives, representing more than 11,000 high-level physician leaders in all types of healthcare organizations across the U.S. and 46 countries, is pleased to offer its support for the policy recommendations included in this important new study on price transparency. The implementation of reform, including the Affordable Care Act, shined a bright light on this increasingly difficult issue, and the time for change is now. As patients assume greater responsibility for their healthcare needs, the demand for accurate, reliable information will continue to grow. The healthcare industry has an obligation to all citizens—the insured and the uninsured—to make the procurement of care as simple and accessible as possible. To continue along the current path would risk creating prolonged and greater mistrust of the medical community as a whole. As an organization dedicated to the lifelong development and support of physician leaders, ACPE is all too aware of the challenges involved in creating greater price transparency. We believe the recommendations included in this report are an important first step toward meaningful reform. ACPE stands ready to assist in any way necessary as you move forward. Peter Angood, MD, MD, FRCS(C), FACS, MCCM, President and CEO, ACPE Mark Werner, MD, CPE, FACPE, Chairman, ACPE Board of Directors Engaging patients in their healthcare decisions is a top priority for physicians. MGMA is pleased to be part of the Price Transparency Task Force and join with key stakeholders to determine ways that patients can better access price information to help guide healthcare decisions. Readily available price and quality information is crucial to helping patients make informed choices about their care Susan L. Turney, MD, MS, FACP, FACMPE President and CEO Medical Group Management Association As the U.S. healthcare industry continues to evolve into a more open and transparent care system, it has been rewarding to represent a major teaching safety net health system in the recent work related to pricing transparency. The HFMA Price Transparency Task Force has included representation from health systems, hospitals, insurance plans, and the consumer in its work to develop guidelines for all constituents affected by healthcare pricing. The discussions were thoughtful and energetic; the final product establishes the initial baselines to create transparency. I endorse the findings and recommendations in this report. Mary Lee DeCoster Vice President, Revenue Cycle Maricopa Integrated Health System Most Americans agree healthcare pricing is opaque. HFMA has provided a great service by convening diverse organizational stakeholders who comprised the task force that developed this report. It establishes a common language and puts forth sensible principles, both necessary to achieve price transparency. This HFMA report is likely to become a must-have resource for anyone mounting an effort to establish clear healthcare pricing. Mark Rukavina Community Health Advisors, LLC The ability for consumers, whether insured or not, to have easy access to meaningful information about the price of healthcare services and the total expected price of medical episodes or events, has become a national priority for good reasons. The share of medical expenses paid by individual consumers is at an all-time high and projected to increase. Consumers should be able to know the price of any service or product purchased before becoming liable to pay the bill. The HFMA has taken a bold and important step to lay out the fundamental principles that all industry stakeholders should abide by to get consumers the pricing information they need and deserve. HCI3 was privileged to be a part of the team that developed this report and supports its conclusions and calls to action. François de Brantes Executive Director Health Care Incentives Improvement Institute Price transparency is important to all of us as healthcare consumers and in our roles as providers or payers of care. It has been a pleasure to work with HFMA’s Price Transparency Task Force in developing practical solutions for improving price transparency. By following these recommendations, we can help demystify consumers’ financial responsibility for their care and equip them to make better-informed healthcare decisions. Robert Galvin, MD Chief Executive Officer, Equity Healthcare Operating Partner, The Blackstone Group
Examples of Price Transparency Tools
A number of health plans, provider organizations, state hospital associations, and other groups have already developed transparency tools.