The Lincolnton (NC) planning board has recommended a rezoning request that would allow Carolinas HealthCare System to build an $85 million hospital in Lincoln County. State officials approved the plan for a 101-bed hospital in February, after CHS provided details and population estimates that demonstrated the need for the facility. CHS officials hope that the facility could be open by late 2010 or early 2011.
Medical price inflation cooled for the fourth consecutive year in 2007, but experts say the stage is set for health costs to rebound with a vengeance. In 2007, premiums for family coverage increased 6.1 percent, the slowest growth rate since 1999. Premiums rose an average of 7.7 percent in 2006. A return to double digit inflation would be jarring--affordability already troubles many families and business.
Several medical groups in Oregon continue to construct or remodel buildings, as well as implement technology to change how patients receive treatment. For example, Legacy Health System in Portland will construct a new, seven-story tower to expand the Legacy Emanuel Children's Hospital and provide a new Children's Emergency Department. Emanuel's west wing and patient tower will also be remodeled for additional adult intensive care and acute care beds. Also, Providence Portland Medical Center is expanding its computer system so it can carry more than half the orders for patient care at the hospital.
Medical malpractice cases can drag on for years, exacting an emotional toll on both sides when in the end neither side really feels like the winner. About three-fourths of cases that go to trial end in the doctor's favor, but lawsuits are costly and physicians blame their patients' propensity to sue for changing how they practice. In response to a flurry of medical malpractice cases, the Florida Legislature in 2003 capped "pain-and-suffering" damages at $150,000 for emergency room patients and $500,000 for all others. Since then, one-third fewer cases have been filed, several insurance companies have returned to Florida and premiums have decreased.
In very few, if any, other businesses do we hear so much about the “revenue cycle.” Maximizing the revenue cycle. Transforming the revenue cycle. Massaging the revenue cycle?
Maybe not. But all I know from the amount of noise on the matter is that the revenue cycle is darn important. You CFOs know that too.
I had a lot of trouble when I first started covering healthcare figuring out why the “revenue cycle” held such an exalted place in the business (judged from the incessant marketing about it in trade shows) when in other businesses, it was so prosaic that it didn’t even have a sexy and exotic name like revenue cycle. Revenue and expense or profit and loss seemed to cover things.
But in healthcare, those two words are all I hear about some days. What do they even mean? Accounts payable and accounts receivable do the trick of describing what you’re talking about just fine, but don’t cover it in healthcare. Collect the money you’re owed (as quickly as possible) and pay the money you owe (as slowly as possible) and you have a thriving business. Not so in healthcare.
In healthcare, it’s complicated. You know, third-party payment system and all that. Rare is the day that I don’t get a pitch (or six) from some consultant or company that claims their clients, which are usually hospitals, have realized huge gains from “transformation of the revenue cycle.” The message I get loud and clear is that getting paid what you’re owed for providing healthcare is complicated, and you—CFOs, directors of finance, and other leaders in the department that brings the money into hospitals—need help.
I have no problem with that. Revenue cycle companies and consultants pay the freight for much of this magazine and many of the sponsored ads you see on the finance pillar of HealthLeaders Media. And sometimes their results are impressive. Many of these companies boast sophisticated computer programs that are easy to use. Many of them can lend you an excellent consultant (or group of consultants, if necessary) who work on engagements for short or long terms, helping hospitals train new employees and retrain old ones on how to bring in the cash your institution is owed for goods and services rendered.
But why is it so complicated? Isn’t a lot of money wasted in administration? Absolutely. Between 15% and 30%, depending on whom you believe, of the healthcare dollar is spent on often-redundant administration of payment from payers to providers.
Many are calling for reform of the payment system so that both government and commercial payers pay based on a continuum of care rather than for individual procedures. It’s an interesting idea that has lots of moving parts that could fail and derail the whole machine. But if it ever comes to pass, it will be great for the simplification of payment and for a lot of other, health-related reasons—which, after all, is why we’re all here, right?
It might not be so great for the revenue cycle industry. In the meantime, anyone for a revenue cycle massage?
In recent years, the CFO's role has become increasingly complex, with new responsibilities such as direct accountability for corporate performance, say representatives from McKinsey & Co. To help new CFOs better understand how to balance the multiple demands, McKinsey surveyed and interviewed current CFOs of many different tenures. The executives shed light on what it takes to succeed in the role-and identified activities that ought to make the short list of nearly all new CFOs.
General Electric shocked Wall Street with its first disappointing earnings report in years, and some say GE Healthcare's 17% drop in first quarter profits on a slight revenue decline should be giving investors in medical device companies pause. GE's explanation is that "Healthcare earnings were impacted by a difficult U.S. environment and continued regulatory shipping restrictions on the surgical supplies business."
South Carolina-based Companion Global Healthcare added three Singapore hospitals to its network. The deal now allows Americans access to medical and surgical services at ParkwayHealth operated hospitals at pre-negotiated, in-network rates lower than those of U.S. hospitals.
The deal between ParkwayHealth and Companion Global Healthcare is a step in the maturation of the medical travel industry, notes David Williams, consultant and cofounder of MedPharma Partners LLC.
“Conceptually, hospitals halfway around the world will now have the same status to members as those just down the street, so that’s a big step,” he said. “It may be a bit of a wake-up call to the local hospitals in South Carolina, putting them on notice that they are facing a broader set of competitors.”
More than one million members of Blue Cross Blue Shield and BlueChoice HealthPlan of South Carolina now have access to the three Singapore hospitals—Mount Elizabeth, Gleneagles, and East Shore—at preferred network rates. The hospitals are accredited by the Joint Commission International, the affiliate of The Joint Commission.
“Patients in increasing numbers are crossing international borders seeking top-quality care at affordable prices,” said Dan Snyder, ParkwayHealth group executive vice president and chief operating officer, in a prepared statement.
Williams points out that the network expansion will aid Companion Global Healthcare’s growth and bolsters the reputation of ParkwayHealth and Singapore as a destination for global healthcare, but he doesn’t expect that this deal will open the floodgates of medical travel to Singapore.
“This marks a significant milestone in the global reach of Singapore’s healthcare,” said Jason CH Yap, director of healthcare services for the Singapore Tourism Board, in prepared remarks. “Singapore has long been the leading medical hub and healthcare destination of choice in Asia.”
Florida budget restraints have slowed development of an electronic system, leaving regional organizations to fend for themselves. After a push to offer grants totaling $9 million was killed, Rep. Denise Grimsley returned with a bill providing matching grants and no-interest loans to help develop a statewide health information exchange. The bill was approved 109-0 by the House, but it has not been funded.
The Third District Court of Appeals has ruled that Blue Cross Blue Shield of Florida must pay pathologists for their professional services. The decision could affect 11 similar cases, and affirms a jury's decision to award $1.5 million to the South Florida doctors who make up Palmetto Pathology Services. Blue Cross Blue Shield had paid pathologists a professional fee until 1999 when it decided it would pay for only lab services, but the pathologists insisted that they are entitled to a fee for analyzing results.
