Well, the summer has flown by once again leaving us with good memories (maybe with the exception of that one week with the earthquake and hurricane) while at the same time pushing us to look forward to budgets and planning for 2012. Not an easy task for anyone these days as the economy continues to linger in the danger zone and providers face new cutbacks and potential reimbursement reductions as healthcare reform initiatives go into effect. There are some positives, though, in that the state maintained most of its healthcare subsidies for this fiscal year and there is the potential for a good dose of Meaningful Use dollars to flow to individual providers that qualify. Nonetheless, we are all challenged to position ourselves for future success while preparing for dramatic changes in the business of healthcare.
BESLER Consulting is no different. As the industry changes and new opportunities arise, we are constantly adapting to ensure we are in the best possible position to provide true value-added services to our clients. We are not resting on our laurels as we celebrate our 25th year of bringing innovative solutions and results to you. Did you know BESLER Consulting has recovered nearly $50M for our clients over the last two years with our Medicare Advantage IME, Transfer DRG and Section 1011 offerings alone? These are just two components of a much broader array of revenue recovery services, with extensive compliance features built in, that we provide and are constantly expanding. We encourage you to compare us to our competitors: we typically recover an additional 30% of revenue when we conduct a second sweep after another vendor has completed its work. BESLER wants to be your revenue recovery partner as we develop more consulting and software solutions to bring you even greater ROI.
In this month’s issue you will find some excellent articles that addressing the issues you are facing that are possibly ripe with the potential for additional revenue recovery. These include IME and DSH, where BESLER has been an industry leader for years.
Revenue integrity and recovery must be a key focus for all healthcare providers. As reimbursement continues to be squeezed, you must be certain that you are collecting every dollar to which you are entitled. The flip side is equally important, however. Expenses must be assessed in light of the stagnation in reimbursement. There are opportunities out there to improve your bottom line without the sting of deep cuts and layoffs. For example, if you are a 340B program “covered entity” are you certain that you are taking full advantage of the program to save every dollar possible? See the accompanying article to get a sense of what you should be taking into consideration to get the best possible savings.
Another area where providers have seen incredible increases in cost is medical necessity and admission determinations. While this is a subject of significant focus for both insurers and providers, it is not something that requires costly outsourcing. BESLER Consulting sees this as an area where providers can make an investment in their own staff (i.e. case management, physician advisor, etc.) through positioning, training and education to eliminate the need to have to rely on outside resources indefinitely. Chances are that you have adequate resources already on staff to make this happen. Working with your internal resources, we can move you toward self-sufficiency and reduced costs while ensuring patients are appropriately classified.
As always, I wish you the best as we (yes, I am going to say it) move into the holiday season. I hope to have the opportunity to see you around the industry over the coming months. Take care and never hesitate to reach out.
Brian P. Sherin, FHFMA