Posted by Mark Brousseau
As hospitals seek to survive and thrive in the new world of bundled payments, ACO and medical home programs, many are actively seeking to employ more physicians and acquire community practices. In fact, a recent survey by the Medical Group Management Association (MGMA) shows a nearly 75 percent increase in the number of active doctors employed by hospitals since 2000.
This shift has intensified the perennial challenge of making employed providers revenue positive for the organization. A recent study published in The New England Journal of Medicine estimated that hospitals lose between $150,000 and $250,000 per year over the first three years of employing a physician (Kochner and Sahni; "Hospitals' Race to Employ Physicians" – March 30, 2011).
Against this backdrop, hospitals must establish a corporate chargemaster file to standardize aspects of physician charging for greater operational efficiency, optimal reimbursement and reduced compliance risks, says Keith Neilson, CEO of Craneware, which is exhibiting at HFMA's ANI Conference this week in Orlando.
To this end, Craneware is launching its Physician Revenue Toolkit to help hospitals manage multiple physician operations.
What do you think?
Showing posts with label healthcare technology. Show all posts
Showing posts with label healthcare technology. Show all posts
Monday, June 27, 2011
Healthcare reform boosts importance of business process improvement
Posted by Mark Brousseau
Health reform-mandated revisions, productivity adjustments, and proposed documentation and coding offsets pose a huge challenge for hospitals, says Ken Perez, senior vice president of marketing for MedeAnalytics.
MedeAnalytics is exhibiting at HFMA's ANI Conference this week in Orlando.
“Our research and economic models indicate that a 300-bed hospital will be required to reduce costs by more than $6 million in the year ahead to avoid erosion of its Medicare margins," Perez says. "The sheer magnitude of the financial impact of these multiple, complex and mounting reductions indicates that hospitals should focus even more attention on improving the efficiency and effectiveness of their core activity—the process and delivery of care.”
“Many hospitals are dealing with complex internal processes and financial pressures,” adds MedeAnalytics Associate Vice President of Product Marketing Cole Hooper. “It’s evident that hospitals will need to focus on process workflow and key performance indicators to improve cash flow and identify areas of loss."
What do you think?
Health reform-mandated revisions, productivity adjustments, and proposed documentation and coding offsets pose a huge challenge for hospitals, says Ken Perez, senior vice president of marketing for MedeAnalytics.
MedeAnalytics is exhibiting at HFMA's ANI Conference this week in Orlando.
“Our research and economic models indicate that a 300-bed hospital will be required to reduce costs by more than $6 million in the year ahead to avoid erosion of its Medicare margins," Perez says. "The sheer magnitude of the financial impact of these multiple, complex and mounting reductions indicates that hospitals should focus even more attention on improving the efficiency and effectiveness of their core activity—the process and delivery of care.”
“Many hospitals are dealing with complex internal processes and financial pressures,” adds MedeAnalytics Associate Vice President of Product Marketing Cole Hooper. “It’s evident that hospitals will need to focus on process workflow and key performance indicators to improve cash flow and identify areas of loss."
What do you think?
Thursday, September 30, 2010
Healthcare Payables: From Bad to Worse?
By Amer Khan (akhan@egisticsinc.com) of eGistics (www.egisticsinc.com)
Effectively managing the payables process is a big job for most companies, but for healthcare organizations, it is a particularly tall order -- and it's about to get a lot more challenging.
The problem in managing healthcare payables stems from the byzantine network of buyer and seller relationships employed by most healthcare organizations, combined with the increasingly complex procurement processes and contracts that healthcare organizations use to purchase goods and services. Every day, the typical healthcare organization receives a mountain of invoices from many different suppliers, most under different contracts with potentially different payment arrangements.
When you mix in the unusually high number of suppliers that most healthcare organizations use -- a hospital might have thousands of suppliers compared to a few dozen for a big law firm -- you can see how the payables process can quickly become complicated. For instance, on a given day, a hospital might receive invoices for everything from Band-Aids to the pricey cardiology equipment it leases.
The healthcare industry's attempts to address the inefficiencies of the payables continuum have delivered mixed results. Several years ago, group purchasing organizations (GPOs) started sprouting up, allowing healthcare organizations to buy a range of goods and services from a single entity, rather than dealing with multiple vendors. While GPOs have enabled their customers to maximize discounts and reduce the number of vendors they do business with, there are still many cases where healthcare providers must source goods and services directly (such as buying from local suppliers), meaning they still must maintain a high number of supplier relationships.
Here's the scary part: the problem is likely to get worse. Every innovation in the healthcare industry -- whether it's new technologies, new devices or new drugs -- may create more suppliers, generating more invoices, contracts, payment arrangements, and, in some cases, acquisition channels. With our nation focusing like never before on innovations in healthcare, providers have no time to waste.
And while healthcare organizations are focusing tremendous amounts of time and resources on "big issues" such as meeting new requirements for electronic health records (EHRs) and ICD-10, driving down the costs associated with payables can deliver significant benefits as well, and in short order.
So, how can healthcare organizations accomplish this?
Since manual processes don't scale, the healthcare industry will need to rethink its approach to payables. The answer starts with eliminating paper at the earliest point possible in the process.
Whether it's converting paper invoices to electronic images, or convincing business partners to provide electronic invoices in the first place, eliminating paper simplifies and automates the payables process. It allows healthcare providers to apply automated rules for processing, and to initiate an electronic payment with detailed remittance information so the supplier can automatically post the receivables. With these types of solutions, providers can solve their current business challenges and lay a solid foundation to manage the increasingly complex payable environment that is sure to come.
What do you think?
Effectively managing the payables process is a big job for most companies, but for healthcare organizations, it is a particularly tall order -- and it's about to get a lot more challenging.
The problem in managing healthcare payables stems from the byzantine network of buyer and seller relationships employed by most healthcare organizations, combined with the increasingly complex procurement processes and contracts that healthcare organizations use to purchase goods and services. Every day, the typical healthcare organization receives a mountain of invoices from many different suppliers, most under different contracts with potentially different payment arrangements.
When you mix in the unusually high number of suppliers that most healthcare organizations use -- a hospital might have thousands of suppliers compared to a few dozen for a big law firm -- you can see how the payables process can quickly become complicated. For instance, on a given day, a hospital might receive invoices for everything from Band-Aids to the pricey cardiology equipment it leases.
The healthcare industry's attempts to address the inefficiencies of the payables continuum have delivered mixed results. Several years ago, group purchasing organizations (GPOs) started sprouting up, allowing healthcare organizations to buy a range of goods and services from a single entity, rather than dealing with multiple vendors. While GPOs have enabled their customers to maximize discounts and reduce the number of vendors they do business with, there are still many cases where healthcare providers must source goods and services directly (such as buying from local suppliers), meaning they still must maintain a high number of supplier relationships.
Here's the scary part: the problem is likely to get worse. Every innovation in the healthcare industry -- whether it's new technologies, new devices or new drugs -- may create more suppliers, generating more invoices, contracts, payment arrangements, and, in some cases, acquisition channels. With our nation focusing like never before on innovations in healthcare, providers have no time to waste.
And while healthcare organizations are focusing tremendous amounts of time and resources on "big issues" such as meeting new requirements for electronic health records (EHRs) and ICD-10, driving down the costs associated with payables can deliver significant benefits as well, and in short order.
So, how can healthcare organizations accomplish this?
Since manual processes don't scale, the healthcare industry will need to rethink its approach to payables. The answer starts with eliminating paper at the earliest point possible in the process.
Whether it's converting paper invoices to electronic images, or convincing business partners to provide electronic invoices in the first place, eliminating paper simplifies and automates the payables process. It allows healthcare providers to apply automated rules for processing, and to initiate an electronic payment with detailed remittance information so the supplier can automatically post the receivables. With these types of solutions, providers can solve their current business challenges and lay a solid foundation to manage the increasingly complex payable environment that is sure to come.
What do you think?
Monday, June 15, 2009
The Minnesota Mandate: What Does It Mean?
By Mark Brousseau
When HIPAA was passed in 1996 it looked like an electronic future for healthcare was upon us. As it turned out, the lack of enforcement for the new law combined with the ability to “opt-out” of electronic claim and remittance processes altogether allowed payers to delay their adoption of electronic file capabilities.
This was extremely counter-productive to the healthcare industry as a whole, notes Jim Ribelin, CEO, HERAE, LLC (www.herae.com). How could payers take the laws seriously when Medicare has only recently made the move to all electronic remittance data, and there are still US Military hospitals that as of today require paper-based processing as ‘standard procedure?’
It took Tim Pawlenty, Governor of Minnesota, to enact a state law requiring all insurance payers that do business in the state of Minnesota to conduct all claim and payment transactions electronically by December 19, 2009. This time there is no ability to “opt-out” of the electronic mandate. Furthermore, there are stiff penalties waiting for any payer that does not comply, Ribelin points out.
“This presents a very different situation than we’ve seen with HIPAA enforcement,” Ribelin says. “There is the law, but now there is enforcement and penalties, and a relatively tight deadline, at a state level.”
Ribelin adds that Minnesota is home to some of the top, internationally-recognized healthcare facilities. “This new law will require quick and decisive action on the part of large and small payers to provide electronic files across the board,” he says. “It will also create a level of ‘fear and uncertainty’ in the provider market, as every one of them is finally confronted with the inescapable requirement to accept and process electronic remittance information.”
The good news is that the healthcare remittance market has matured since HIPAA and there are solutions available that provide flexible online workflow, payer connections and electronic funds transfer (EFT) data re-association with electronic remittance advice (ERA) data, Ribelin says. The bad news is that there are also very limited solutions out there that do the bare minimum, and often create more work and headaches for the healthcare provider in their quest to adopt electronic payment solutions.
“The challenge is to educate the market on what they should look for in a remittance partner,” Ribelin says. “Sending a scanned image of an explanation of benefit (EOB) can be considered an electronic solution – but it’s a far cry from obtaining a fully HIPAA-compliant 835 data file complete with claim, patient and procedure information that can be searched and reported upon.”
The optimum solution deals with the data right at the source, by direct-connecting to payers, Ribelin claims. This provides many advantages, including standardized online presentation of claim information regardless of the payer, the ability to receive the most robust remittance data before it is modified/tainted by clearinghouses or accidently by the providers themselves, he says. There are also longer-term benefits, Ribelin adds, including significant advantages in terms of reporting to improve back-office processes and collections, contract management to monitor and improve accuracy of insurance payer payments and much more.
What do you think? Post your comments below.
When HIPAA was passed in 1996 it looked like an electronic future for healthcare was upon us. As it turned out, the lack of enforcement for the new law combined with the ability to “opt-out” of electronic claim and remittance processes altogether allowed payers to delay their adoption of electronic file capabilities.
This was extremely counter-productive to the healthcare industry as a whole, notes Jim Ribelin, CEO, HERAE, LLC (www.herae.com). How could payers take the laws seriously when Medicare has only recently made the move to all electronic remittance data, and there are still US Military hospitals that as of today require paper-based processing as ‘standard procedure?’
It took Tim Pawlenty, Governor of Minnesota, to enact a state law requiring all insurance payers that do business in the state of Minnesota to conduct all claim and payment transactions electronically by December 19, 2009. This time there is no ability to “opt-out” of the electronic mandate. Furthermore, there are stiff penalties waiting for any payer that does not comply, Ribelin points out.
“This presents a very different situation than we’ve seen with HIPAA enforcement,” Ribelin says. “There is the law, but now there is enforcement and penalties, and a relatively tight deadline, at a state level.”
Ribelin adds that Minnesota is home to some of the top, internationally-recognized healthcare facilities. “This new law will require quick and decisive action on the part of large and small payers to provide electronic files across the board,” he says. “It will also create a level of ‘fear and uncertainty’ in the provider market, as every one of them is finally confronted with the inescapable requirement to accept and process electronic remittance information.”
The good news is that the healthcare remittance market has matured since HIPAA and there are solutions available that provide flexible online workflow, payer connections and electronic funds transfer (EFT) data re-association with electronic remittance advice (ERA) data, Ribelin says. The bad news is that there are also very limited solutions out there that do the bare minimum, and often create more work and headaches for the healthcare provider in their quest to adopt electronic payment solutions.
“The challenge is to educate the market on what they should look for in a remittance partner,” Ribelin says. “Sending a scanned image of an explanation of benefit (EOB) can be considered an electronic solution – but it’s a far cry from obtaining a fully HIPAA-compliant 835 data file complete with claim, patient and procedure information that can be searched and reported upon.”
The optimum solution deals with the data right at the source, by direct-connecting to payers, Ribelin claims. This provides many advantages, including standardized online presentation of claim information regardless of the payer, the ability to receive the most robust remittance data before it is modified/tainted by clearinghouses or accidently by the providers themselves, he says. There are also longer-term benefits, Ribelin adds, including significant advantages in terms of reporting to improve back-office processes and collections, contract management to monitor and improve accuracy of insurance payer payments and much more.
What do you think? Post your comments below.
Wednesday, March 11, 2009
Saving Healthcare Dollars Through IT
Posted by Mark Brousseau
Approximately 64 percent of physicians say healthcare technology does save their patients money, according to a recent survey of 705 U.S. physicians by Epocrates. The areas of technology where the most savings occur include: electronic formulary reference tools, e-health records, and e-prescribing.
What do you think? Post your comments below.
Approximately 64 percent of physicians say healthcare technology does save their patients money, according to a recent survey of 705 U.S. physicians by Epocrates. The areas of technology where the most savings occur include: electronic formulary reference tools, e-health records, and e-prescribing.
What do you think? Post your comments below.
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