May 2018

Cover Story

Trend | Capital Finance

Healthcare Capital Markets Outlook: Short-Term Opportunities Versus Long-Term Uncertainty

Although today’s healthcare capital markets support continuation of their investment strategies, hospital and health system’s current should be prepared for changes that may require a shift in focus.

From the President's Desk

Expanding on thoughts in his May 2018 column in hfm, HFMA President and CEO Joseph J. Fifer, FHFMA, CPA, offers perspectives on new research showing that value-based payment has yet to reduce the total cost of care.

Video: Denials and the Revenue Cycle

David Dyke, former vice president of product management for Change Healthcare, discusses how to reduce denials that disrupt the revenue cycle and how to keep up with changing rules around claims.

Early Edition

How To | Population Health Management

To Succeed at Managing Population Health, Adopt a Health Plan Mindset

To be successful with population health management, healthcare provider organizations should take a lesson from the strategies health plans use to improve the quality of population-level outcomes and performance around costs. 

How To | Physician Relationships

Optimizing a Health System’s Post-Acute Care Network

Health systems should develop strong networks of post-acute care providers as part of strategic efforts to deliver high-quality service across the care continuum, from wellness to end-of-life care.

How To | Staff Development

Value-Based Employee Compensation in an Inpatient Rehabilitation Facility

Tying employee compensation directly to performance, rather than experience, can encourage better job performance.

How To | Value-Based Payment

Ensuring a High-Performing Referral Network

To be able to ensure patients receive high-quality care under value-base payment arrangements, primary care physicians require well-developed specialty networks for patient referrals.

Features

How To | Facilities

Why Age Is Not Enough: A Better Approach to Equipment Replacement

By considering maintenance and other costs, hospitals and health systems can work more efficiently to replace equipment.

Trend | Capital Sources and Allocation

The Rise, Fall, and Possible Return of Variable-Rate Demand Bonds

Variable rate demand bonds, created in an inflationary environment, have waned in popularity but remain a viable credit source for hospitals and health systems.

How To | Partnerships and Value

Health System Integration: Prescription for Success

Health systems that are pursuing a merger or acquisition require a structured planning process to achieve full integration across the merged organizations’ clinical, administrative, and operational areas.

Case Study | Payment Models

Creating APMs for Specialty Care: A Provider-Led Initiative for Delivering Value

The experiences of a large urology group practice can provide finance leaders with insight into key considerations involved with developing an advanced alternative payment model (APM) for a healthcare specialty area.

Research & Reports | Cost of Care

What Is Driving Total Cost of Care?

A recent study identifies key factors that may be influencing total cost of care in the United States and provides recommendations for addressing those factors.

Focus Area

How To | Technology

Revenue Cycle Software: A Practical Guide for Purchase

The purchase of new revenue cycle technology should include stakeholders from across the organization to ensure the needs of each group are met.

How To | Partnerships and Value

Best Practices for Affiliation Agreements Between Health Systems and Universities

A well-structured affiliation agreement between university and health system partners will enable the parties to execute joint strategic priorities and advance the shared goals of the academic medical center.

Columns

Trend | Telemedicine

Responding to a Changing Healthcare Environment

Aligning incentives among providers and exploring telehealth opportunities are two ways in which hospitals and health systems can respond and adapt to a changing environment.

Column | Healthcare Business Trends

Pursuing Your Passion: Advice for Healthcare Finance Leaders

Carol Friesen, FHFMA, MPH, reminisces about her experiences as 2017-18 Chair of HFMA and shares ideas and insights gleaned from her “HFMA leadership journey.”

Column | CMS and MedPAC Guidelines and Trends

MA Ruling May Signal Industry Readiness to Integrate SDH into Traditional Medical Care

In addressing social determinants of health and social services, a recent Medicare Advantage ruling by CMS may have taken the first steps toward providing more integrated and comprehensive care to the nation’s aging population.

How To | Accountable Care Organizations

How Provider-Led ACOs Can Generate Long-Term Savings

Providers with concerns about the elusive success of ACOs should adopt some key strategies for implementation.

Column | Healthcare Reform

The Current Outlook for Value-Based Care Under the Trump Administration

Value initiatives introduced by the Affordable Care Act have met with varied success. Under the Trump administration, the future of these initiatives is uncertain.

Column | Value-Based Payment

Value: The Way Forward

Value-based payment won’t bend the cost curve unless healthcare organizations commit to fundamental change. Not everyone will come out whole. 

News Watch Data Analysis 

Top Ambulatory Surgical Center Procedures by Volume, 2015

This bar chart shows "cataract surgery with intraocular lens insert, 1 stage" holding the highest percentage by volume of ambulatory surgical center procedures at 18.6 percent, while "carpal tunnel surgery" is at the bottom of the chart with 0.7 percent.

Supplements

Executive Roundtable | Analytics

HFMA Executive Roundtable: Interoperability: Driving or Impeding Value-Based Care?

Poor data interoperability is limiting healthcare organizations’ progress with value-based models. In this roundtable, several healthcare financial and IT leaders discuss the challenges of poor interoperability and how organizations can overcome them.

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Trendsetter | Care Management

Trendsetter: Reimagining Cross-Continuum Relationships

This article examines how DHG Healthcare partnered with a health system to improve care coordination for hip replacements due to fracture.