HFMA SOUTH TEXAS LEADERSHIP FORUM January 20, 2017 at the Blanton Museum of the Art, The University of Texas at Austin HFMA South Texas at the Western Region Conference in Las Vegas
For the approximately 16,000 nursing home operators across the country, increased scrutiny and constant realignment have become a way of life. And if trying to prepare for a new administration that is likely to enact significant regulatory and reimbursement changes in the near future wasn’t enough, long-term care providers also end 2016 with a new 700-page rule from the Centers for Medicare & Medicaid Services (CMS). The new rule, commonly referred to as either “The Final Rule” or the “Rules of Participation,” is a series of guidelines and requirements for long-term care facilities that receive Medicare or Medicaid funding. The guidelines will be implemented in three phases. The first phase was initiated on Nov. 28, 2016, phase two will be implemented by Nov. 28, 2017, and phase three will be implemented by Nov. 28, 2019 (Figure 1). The goal of the new regulations is to continue the advancement of service delivery and safety that has occurred over the past several years, as well as put in place a series of mechanisms designed to achieve improvements in quality of care while simultaneously attempting to reduce burdens on providers. The new regulations represent the most comprehensive update in decades. The first time Medicare and Medicaid requirements were published by CMS was in 1989, and although there have been periodic revisions since then, this is the most thorough overhaul since 1991. Clearly, the health care industry has experienced substantial changes in care delivery in the past decades, so the Final Rule’s arrival has…
Survey finds top drivers of healthcare IT investment are improving patient experience and engagement In an era of digital natives, new technological solutions to healthcare challenges appear almost daily. Not surprisingly, two-thirds of hospitals report increased tech budgets for this fiscal year. Additionally, over a quarter of hospitals have seen more than a 5 percent increase. A recent survey* by First American Healthcare Finance, in partnership with the American Hospital Association, identified this rise in budgeting for hospital and health system information technology. Where Are Healthcare Organizations Investing? With endless possibilities, where are providers investing IT? In 2016, First American met with over 700 unique healthcare organizations to learn about their top investment priorities. Out of 900+ projects, top IT investments fell into four buckets: Infrastructure to run operations and keep data safe with server, software, and wireless infrastructure upgrades. Communication to make verbal and digital flow of information more efficient, using tablets, iPhone, nurse call systems, EMR upgrades, and telehealth. Patient monitoring devices to boost preventative care using heart failure prevention devices (necklaces, wristbands, and watches), nutrition tracking devices and apps, and food scanners. Revenue generating items such as da Vinci robots, hybrid operating rooms, cutting-edge ultrasound and imaging equipment, artificial intelligence in robots, and 3D bio-printing. In the past, technology in healthcare organizations meant a handful of computers, some digital monitoring equipment, and a few pieces of imaging equipment. In today’s healthcare environment, technology has never been more aligned with every aspect of the patient experience. Additionally, as…
Abstract Swing-beds are one approach to addressing two problems in rural communities: the shortage of nursing home beds and the decline in rural hospital occupancy. In the past, swing-bed demonstration hospitals have shown the greatest potential for quality improvement compared to nursing homes in providing a continuum of care. Background A national swing-bed program was first authorized in the 1980 Omnibus Budget Reconciliation Act allowing Medicare reimbursement of swing-bed care in rural hospitals with fewer than 100 beds. The term “swing bed” is used to describe the level of care hospitalized patients receive once they are no longer in need of acute care. Swing bed admissions are limited to patients who require some level of skilled nursing care and are currently in a hospital acute care bed. Patients cannot be admitted to a swing bed from either the community or a skilled nursing facility unless they have spent three days in an acute care hospital bed for related needs within the past 30 days. Swing beds are generally limited to 40 days per patient under state law . Rural hospital leaders may be quick to blame Medicare and federal regulations for their collective financial crisis, but the biggest reasons so many rural hospitals are in danger of closing is because they simply do not have enough inpatients . Since the passage of ACA there has been a further downward utilization trend and subsequent cash flows issues in small rural hospitals. Increased out of pocket expenses for healthcare, associated with…
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By: Med A/Rx Under the Telephone Consumer Protection Act (TCPA), calling cell phone numbers using an “automatic telephone dialing system” can cause legal problems for providers and revenue cycle companies trying to contact patients to pay their outstanding account balance. The TCPA (47 U.S.C. 227, 47 CFR 64.1200) prohibits the use of an “automatic telephone dialing system” to contact “any telephone number assigned to a …cellular telephone service” without “express prior consent” from the party being called. More than two-fifths of American homes (45.4%) had cell phones and no landline phones in the 2nd half of 2014 – a 4.4% increase from a year prior, and double since 2008. About 44.1% of all adults (106 million) lived in wireless only homes — and the same for 54.1% of all children (40 million children). In addition, a sixth of American homes (14.9%) still had a landline, but received all or almost all calls on their cell phones.1 To reduce the risk of legal fees associated with calling cell phones, we suggest adding the following language to your current MEDICAL TREATMENT AUTHORIZATION AND CONSENT FORM: You agree, in order for us to collect any amounts you may owe, we or an associated third party may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or e-mails, using any e-mail address you provide to us. Methods of contact may include…
In seemingly every presidential election, we are told by pundits and politicos that this particular contest represents the starkest choice between two vastly opposed ideologies that we’ve seen in decades. The future, your kid’s future and your grandchildren’s future, depends on its outcome. Some may argue that such hyperbole is an understatement this year, and, whether that’s true or not, one thing is clear—this election gives voters the choice between the known and the unknown. If Secretary Hillary Clinton wins, the nation will likely stay on its current path—a pursuit of incremental change shaded by Democratic ideologies. If Donald Trump wins, no one is quite sure what will happen, although a look at his proposals and the GOP’s 2016 platform provides some insight. Health Care Clinton has made it clear she believes in upholding and improving the Affordable Care Act (ACA). Her website lists several other health care policies including: • Expanding Medicare by lowering eligibility age from 65 to 55 • Lower prescription drug costs by requiring drug companies to invest in research and development in order to receive taxpayer support • Incentivize states to expand Medicaid (no specifics given) • Allow families to buy insurance on the health exchanges regardless of immigration status • Identify ways to make providers eligible for telehealth reimbursement under Medicare • Expand federally qualified health centers and rural health clinics • Double funding for primary-care community health centers All this amounts to what would be a hefty expansion of the ACA and would…
Where patient satisfaction was once solely measured from a clinical standpoint, patients are increasingly judging and rating their satisfaction with healthcare organizations by the amount of repeat business and referrals they bring. Since 1992, ClearBalance has partnered with health systems to provide consumer-centric affordable care while improving net recovery of patient pay and overall financial performance. We recently conducted a study to measure awareness, loyalty and satisfaction with that program. The second annual Healthcare Consumerism Study was sent out in August, completed by nearly 2,700 patients. Of those survey respondents, healthcare cost was undeniably a concern: 79 percent stated that it was a factor when selecting a physician, and 81 percent stated the same when choosing a healthcare provider. Relative to their cost concerns, one out of every three consumers stated they would delay care if a loan program wasn’t made available to them. So, while cost is a factor for patients when selecting a specific physician or healthcare provider, the availability of a loan program is still critical in the decision-making process. One survey respondent said, “It’s helpful not to have to pay a large, unexpected medical bill all at once.” This seemed to be a common opinion amongst respondents, as an overwhelming 91 percent stated that healthcare was an expense that required financing of more than 12 months. Of those who use the ClearBalance program, more than half reported their annual insurance deductible to be $3,000 or less. Seventy-two percent of respondents depended on their employer-provided insurance to…
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