Before I provide my industry comments, I wanted to extend a “thank you” to all of our clients and readers out there. For those of you who can remember back that far, BESLER Consulting was founded in 1986 and we’ve since grown in our mission and service offerings. Last year we added 34 new relationships to the BESLER client roster and I wanted to take a quick moment to thank those of you who have given us the trust to help your facility with your mission. It’s humbling to speak with our clients who express gratitude for bringing in additional revenue, or assistance in achieving compliance with a coding or documentation issue or settling Medicare appeal issues on a timely basis. It’s a great feeling to know that our assistance is helping you achieve results. Our success has been built on your success, and for that we’re grateful.
As you’ll read further in the articles in this edition of the BEACON, we continue to focus our attention and support to providers on accurate and optimal reimbursement and compliance. At a point not too long ago, “the auditors” referred to only a few groups: the financial statement auditors and Medicare. Today, “the auditors” can mean a whole host of groups coming in to inspect a healthcare provider’s books and records. These groups are finding increased success by attacking areas that are not core to a hospital’s mission of providing the best care possible to its patients. They focus on the fringe, find an area of weakness and can erode the foundation of your mission. That’s not to say that improvements can’t be made; nothing is perfect and opportunities to do better are everywhere. Will we have the resources to make improvements ourselves, or will our diminished resources force us to abandon the mission? I sincerely hope it’s the former.
As we see payment reductions made across the board and seemingly daily multi-million dollar scandals hit the healthcare industry, it’s evident that changes need to be made. Provider-lead audits, proactive monitoring and increased operational enhancements are all things that the hospital is in the best position to identify and address. No one can deny that investing in our future is a cause worth supporting. However, as it stands now, recent changes to reimbursement models and audits serve little more than to pull resources away from the industry. The penalties and reductions aren’t pumped back into the system to create or research new delivery models, or care quality measures, or even to update outdated technologies that are still in use at some facilities. If the government wants to invest our future, it can’t simply take money off the table. It can, however, select what it will and will not pay for. Not paying for medical errors makes sense, but increasing payments for teaching programs and other initiatives that will secure our long term success should also occur.
As providers deal with increased scrutiny from the “the auditors”, we remain steadfast in our belief that an honest and proactive dialogue will mitigate future errors and resource waste. Providers have a mission unlike any other industry; treating patients from cradle to grave and all of the challenges in between. Providers need the right combination of support and resources to continue to carry out their mission and sustain themselves for generations to come.
Jonathan H. Besler, CPA
President and CEO