Summer is here and it already seems that it is going by toofast. Wasn’t it just yesterday that wewere lamenting the snow and cold?
In these difficult and uncertain times in healthcare, we areall working harder than ever to improve our margins while preparing to avoidthe negative consequences of healthcare “reform”. Unfortunately, much of the cost of theinitiatives contained in the Affordable Care Act (ACA) of 2010 is borne on thebacks of healthcare providers in the form of potential reduced reimbursementrelated to readmissions, hospital acquired conditions and value-basedpurchasing. On top of these, providersare facing additional uncertainty in terms of a new DSH/Uncompensated Care fundsdistribution methodology and substantial reductions on Medicaid DSH allotments,both beginning in FFY 2014. While we maynot view this as appropriate, the fact is that these are the cards that havebeen dealt and we have to prepare in the best way we can. It is one thing to estimate what the impact will be to your organization but the morepragmatic approach is to do all that you can to minimize the potential fornegative impacts to your bottom line.
How is your organization preparing to avoid, or at leastminimize, reimbursement reductions as a result of healthcare reform? The Besler team is prepared to discuss yourunique situation with you and strategize as to how your hospital can begin totake action now to address the many areas of concern.
Another major aspect of reform will be the increase in theinsured population, Medicaid or otherwise, and the impact this will have on yourEmergency Department (ED) volume. As weall know, the ED is a unique clinical environment that presents unusual anddifficult challenges when it comes to patient throughput and management. As volumes grow, effective management of theED patient from the Case Management standpoint (observation vs. inpatient status,social admissions, patient throughput, etc.) will be essential to ensuring thata key source of your hospital’s revenue is validated and reimbursable. Relying on outside resources to make thesedeterminations results in a recurring high dollar expense line item on your budgetand is not a long term solution. Beslerhas a team of individuals with both clinical and business management experiencein the ED that can assist your ownstaff in becoming self-sufficient in optimizing patient classification, managementand satisfaction.
Besler continues to offer a number of reimbursement recoveryopportunities that may be suited to your needs. Our success with finding millions of dollars of uncollected revenue forour clients is well-documented. Now weare taking things to the next level with the development of our BVerified web-based tools that help youto achieve compliance and identify revenue recovery potential using edits basedon our extensive years of revenue cycle consulting. We would be happy to discuss both ourconsulting and web-based offerings with you so that you can be confident thatno dollar goes uncollected.
As the healthcare environment becomes more and more complex,please take some time this summer to enjoy the simple pleasures of spendingtime with family and friends. It will dous all good to put things in perspective. Have a wonderful summer.
Brian P. Sherin, FHFMA