October 14th, 2013
by: Bill Deane
“Patient Care Medical Home” is a term that coincides with the Patient Protection and Affordable Care Act’s (ACA) emphasis on enhancing the role of primary care.
Clinics such as Federally Qualified Health Centers (FQHC), rural health clinics (RHC), and some hospital outpatient departments (such as 1206-d clinics), frequently function as safety net providers and the medical access point for their communities. As a result, they evolve into the base “medical home” for local residents. This initial access point of care makes them an ideal starting point for developing a patient relationship that can be expanded to other areas of care.
By obtaining more information about each patient at the initial point of contact, asking the right questions, and entering the information into a now required electronic medical records system, clinics have opportunities for improving how they coordinate patient care. This data becomes a key component in understanding the needs of each patient, assisting in better care planning and allows for future sharing of information with other providers as needed. Read the rest of this entry »
October 3rd, 2013
by: Anthony Taddey
In the past, most nonprofit providers’ capital plans were basically oriented towards the acquisition or maintenance of physical assets including physical plant, clinical and diagnostic equipment, medical office buildings and related structures. Today’s more difficult operating environment has forced health system management to similarly consider other capital intensive needs to augment their existing patient service offering or expand into new markets. These would include mergers, acquisitions or other types of institutional affiliations, physician practice acquisition, increasing IT investment and the movement toward more ambulatory modalities of patient care.
A well designed and timely capital planning process is a key management tool to assist health system leaders and boards of directors to make these necessary and difficult capital resource acquisition and allocation choices. Read the rest of this entry »
September 25th, 2013
by: John Pfeiffer
A few weeks ago, DHCS emailed* public DPNFs a package enabling them to file DPNF supplemental Medi-Cal claims for the period from 6/1/11 to present. This email shows the state’s recognition that all public DPNFs qualify for this program due to the AB97 rate freeze/cut, even those with rates below the statewide maximum. This program enables public DPNFs to recoup 50% or more of the AB97 rate freeze/cut, including any eventual retroactive “clawback” if and when it occurs.
HFS Can Assist with DPNF Claim Submittal
HFS has been assisting several public DPNFs by preparing the claims for supplemental payment. Our professionals can provide a range of assistance depending on your organization’s specific needs, from simply providing education, to reviewing facility-prepared claims submissions, all the way to preparing the actual claims and following through to final payment.
For more information please contact John Pfeiffer, 510-867-1314, or email@example.com.
* If you did not receive the email package, contact John Pfeiffer: firstname.lastname@example.org.
September 24th, 2013
by: Teresa Jacques
A little noticed provision in the Patient Protection and Affordable Care Act (ACA) requires ALL employers to notify their employees of the health insurance options they have available to them as a result of enactment of the ACA. According to the Department of Labor, all employers covered by the Fair Labor Standards Act (FSLA) are obligated to make the health insurance notification by OCTOBER 1, 2013. An FSLA covered employer is one with at least one employee and $500,000 in revenue.
This notification MUST occur whether the employer provides health insurance to the company’s employees or not. The Department of Labor has provided information about this mandatory notification and made model forms available for employers to use. Read the rest of this entry »
September 18th, 2013
by: Trahan Whitten
Hospital pricing practices are under scrutiny as never before. Inspired by the activities of the Office of the Inspector General for the Medicare program, the House Energy and Commerce Committee, numerous class action lawsuits, legislation regarding pricing transparency, and, of course, the media, the hospital industry is under the microscope for an array of exaggerated and imagined offenses. Recent headlines include:
- Affordable Care Act ruling (June 28, 2012)
- Time magazine’s ‘Bitter Pill: Why Medical Bills are Killing Us’ (March 4, 2013)
- Medicare data releases – inpatient (May 8, 2013) outpatient (June 3, 2013)
- California Hospital Association press release states desire to move away from the chargemaster (May 8, 2013)
- HFMA announces creation of a price transparency task force (June 18, 2013) Read the rest of this entry »
August 26th, 2013
by: Carlos Jimenez
The Middle Class Tax Relief and Job Creation Act of 2012 (the “Act”) delayed the implementation of significant reductions to Medicare physician payments that would have occurred in federal fiscal year (FFY) 2013. In the budget neutral environment that now defines the Medicare and Medicaid programs, “funding” for this delay has to come from somewhere else within the system. Thus, the Act also included several revisions to Medicare bad debt policy, some of them significant. These changes will have varying impacts on Medicare bad debt reimbursement for hospitals, critical access hospitals, FQHCs and RHCs, and skilled nursing facilities. In total, Medicare bad debt reimbursement for these types of providers is projected to decrease by almost $7 billion through FFY 2022.
Read the rest of this entry »