REVENUE CYCLE EFFICIENCY

Most of the 8,700 layoffs this year were non-clinical jobs. The Bureau of Labor Statistics leads to dire projections as we move into 2013. As revenue cycle professionals, we have always been challenged to streamline revenue cycle operations, reduce revenue cycle labor cost and become more efficient. I submit that the challenge is now a mandate. Check this out.......

News in brief - Nov. 5, 2012

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Hospital mass layoffs for 2012 expected to match 2011’s numbers -At-risk teens interested in seeing their medical records online

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Hospital mass layoffs for 2012 expected to match 2011’s numbers

Thirteen mass layoffs occurred in hospitals in September, affecting 817 people, according to a monthly report released Oct. 23 by the U.S. Bureau of Labor Statistics. If numbers hold steady for the remainder of 2012, the industry is on track to have a similar annual count of mass layoffs as it did in 2011.
Ninety-three layoff incidents occurred in the first nine months of 2012, leading 6,529 people to claim unemployment benefits. At this rate, the year would end with about 124 mass layoff incidents with roughly 8,700 people affected. This is comparable to the totals for 2011, which had 121 mass layoffs with 8,098 people losing their jobs.
The BLS does not break numbers down by occupation, but people who hire health workers say administrative rather than clinical staff tend to be most at risk of losing their jobs during mass layoffs.A mass layoff is defined as a minimum of 50 people losing their jobs from one company at the same time. Smaller incidents are not counted. is startling as we consider mass layoff statistics for hospitals in 2011 and 2012.
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At Nearterm, we specialize in assisting provider organizations toward more effective revenue cycle practices through revenue cycle process improvement, better use of revenue cycle technology and revenue cycle management practices.Our revenue cycle consultants, HIM Professionals and interim leaders deliver results. If we can help as you brace for future revenue cycle mandates or if you simply want to share speculation about how the revenue cycle will "morph" in the future, let's talk.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

 

EMR EFFICACY

A practical observation presented in this article and the cited study is that whether medical records are maintained hard copy or electronically, the source is still the same - people. In either environment, providers will continue to be challenged toward improving accuracy and the consequences are far reaching . Check it out;

http://medcitynews.com/2012/12/electronic-medical-records-not-a-panacea-for-patient-safety-problems/

If you are a CFO, HIM Professional or have a role in Health Information Management, you may find this snippet insightful. If you would like assistance with process innovation supporting your HIM, EMR or related revenue cycle objectives, let's talk.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

AFFORDABLE CARE ACT

Here is some information about the impact of the Affordable Care Act. While we have known the "rules" for some time, hospitals are now beginning to feel the impact in the form of revenue penalties and the demand to provide care differently than in the past. Re-admission penalties are a current target and most thought leaders expect more to come.

http://www.kaiserhealthnews.org/Stories/2012/November/27/medicare-spending-hospital-readmissions.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+khn%2Ffulltext+%28All+Kaiser+Health+News+%28Full+Text%29%29

If you have innovative thoughts about how hospital chief financial officers, revenue cycle professionals and others can mitigate or minimize the impact of ACA mandates, please share.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330
jmatthews@nearterm.com

DRESS FOR SUCCESS

For a lot of hospital employees, dress code is a matter of policy. However, in revenue cycle operations, HIM, hospital finance and other non-clinical work environments, there is greater flexibility regarding attire. Read the article below and think about how your appearance may impact your career.

http://under30ceo.com/4-ways-dress-success-increasingly-casual-workplace/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Under30CEOAll+%28Under30CEO%29

Jim Matthews
Principal; Nearterm Corporation
jmatthews@nearterm.com

MANAGEMENT TIPS

Below is a link to an easy read that I found to be provocative. Check it out and see how these tips might help you be a stronger leader. At Nearterm, we specialize in assisting healthcare provider organizations to reach their revenue cycle, health information management and other financial goals with the support of our expertise and human capital. As such, we are always interested in articles like this one as we continue to advance together with our national client/partner base.

http://www.howdesign.com/design-business/design-management/how-to-be-a-good-manager/?utm_source=twitterfeed&utm_medium=linkedin

Feel free to call or email if you have comments or would like to learn more.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330
jmatthews@nearterm.com

The Impact Of Healthcare Reform

I found this article insightful.

http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/how-will-obamas-re-election-impact-healthcare-4-asc-industry-leaders-respond.html

If you are a revenue cycle professional interested in specific impacts on revenue cycle performance or if you have thoughts about how it will impact your organization, let's talk. www.nearterm.com

EAST COAST HOSPITALS ARE PREPARED FOR THE STORM

At NEARTERM, we work hand in hand with provider organizations to help them "prepare for the storm" as we brace for the imminent changes that impact revenue cycle performance. We support our clients with expertise, human capital and thought leadership.

 

But this time, we salute our clients on the east coast as they prepare for a very different storm - HURRICANE SANDY. Here is a recent track;

 

http://www.cnn.com/2012/10/25/world/americas/tropical-weather-sandy/index.html?eref=mrss_igoogle_cnn

 

But after SANDY is long gone, keep us in mind as you prepare for that "other storm".

 

Jim Matthews

Principal; Nearterm Corporation

jmatthews@nearterm.com

HOW WILL REFORM IMPACT ME-AN EXERCISE TO HELP YOU FIND OUT

The media bombards us with spin on the impact of healthcare reform. I read through the following article as though I recently moved to America and had reason to better understand impacts on me personally. See what you think........ http://www.healthcare.gov/

If you read this publication and have thoughts or interpretations you would like to share, please weigh in. As a revenue cycle professional, I found this interesting and hope you will too. If you are a chief financial officer, revenue cycle director, revenue cycle consultant or otherwise involved with healthcare financial management, I submit that contemporary knowledge about changes that effect patient financial services is important.

Jim Matthews
Principal; Nearterm Corporation
www.nearterm.com

THE CUSTOMER IS NOT ALWAYS RIGHT

We often hear "the customer is always right" as a moniker supporting customer service training and related service management initiatives. Here is a modified version that I think makes more sense; "THE CUSTOMER IS NOT ALWAYS RIGHT BUT THE CUSTOMER IS ALWAYS THE CUSTOMER".

Our patients are not always right and we are not helping them by treating as if they are. Here are a few common examples:

"you have to take my insurance"
"you cannot deny service under any circumstance"
"you cannot come after me for payment as long as I am making payments"

There are many more examples. The point is we have an obligation to educate patients about patient financial services and that means tactfully addressing misunderstandings they may have. The best way to do that is by addressing them as the valued customers they are.

I could and may write a book on this topic but please feel free to contact me if you would like to contribute your ideas.

Affordable Care Act - Going right to the source......

We are constantly bombarded with opinions about contemporary issues. Often, we depend on the interpretations of others or "cliff's notes" in order to keep up with our changing environment. I thought you might find it interesting to see the actual ruling on ACA.....no wonder we rely on interpretations! http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

Please call me if you can explain this in 100 words or less.

Jim Matthews
jmatthews@nearterm.com
(281) 646-1330

Healthcare Innovation Symposium

The HFMA Healthcare Innovation Symposium in Galveston last week was a great educational and networking opportunity. If you missed us, please call and get acquainted. We offer cutting edge revenue cycle consulting, interim management and search resources.

Gulf Coast Chapter

Patient Satisfaction Myths

We have all  struggled with customer satisfaction measurement initiatives. Patient satisfaction has become increasingly important as patients have greater influence on their care choices over recent years. I read this article recently (see link) and recommend that it is a good read if you are considering this topic.http://www.hospitalimpact.org/index.php/2012/10/17/title_70

HFMA ANI - A great experience!

If you attended the ANI this year, I hope your experience was as rewarding as ours. And speaking of "rewarding", congratulations to Seth Bohrer of Dosher Memorial Hospital. Seth won an iPad at our event drawing!

HOSPITAL BENCHMARKS

A senior healthcare executive who recently transitioned from a successful career in another industry made an interesting comment after being part of a major health system for a few months. She asked, "Why is it that hospitals insist on comparing benchmark performance data only with other hospitals?" "Let's face it" she added, "The service management system is broken so why compare our performance against other broken entities?"

To be clear, our healthcare delivery system per se is among the best in the world. We are leaders in cutting edge research, technology and clinical outcome. However, this was a provocative and maybe even profound snippet aimed at customer service management. At Nearterm, we understand the prevailing conventional wisdom that requires benchmarking comparisons to "like" healthcare facilities. It does have value. However, our patients compare us to all of the other service providers they interact with when considering customer service. They compare us to delivery companies, department stores, contractors, banks, utility companies and many others. Next time you are focused on benchmarking your organization, see how you compare to non-healthcare providers. Do not stop at being the best among what some consider to be a a "service management system that is broken". Instead, be the best among all service providers, all industries. What a great way to build patient and community loyalty!

Nearterm's revenue cycle team can help you develop a patient financial services strategy that will enable your organization to advance from patient satisfaction to patient loyalty. It is patient loyalty that ultimately drives market share and financial success. Call and speak directly with one of our Principals about the process and how it might be of value to you.

Jim Matthews; Principal

PATIENT SATISFACTION OR LOYALTY?

For years, revenue cycle professionals have been concerned with "patient satisfaction". We conduct surveys, measure change and react to it as we design our delivery systems and work with our front line people. This has come about largely because we recognize that patients are progressively more involved in choosing their providers. But have you ever stopped to think about what it means for a customer to be "satisfied"? It means you have "fulfilled their expectations", you have been "sufficient" or perhaps "adequate". Satisfied patients are not usually the ones that are speaking favorably of your services and you are one mistake away from losing them. They are not loyal, just satisfied.

I submit that Patient Satisfaction is not enough in today's competitive market; Patient Loyalty is a more important goal. "Loyal Customers" can be described differently than "Satisfied Customers". Think of loyal customers in terms like "devoted attachment", "steadfast allegiance" and "faithful". These customers will come back to your facility, speak highly of your services and people and help you maintain and grow your share of the market you serve. I am sure you can think of a business or service you are loyal to, differentiating those that have simply met your expectations. Which would you recommend to your friends?

Nearterm can help you advance from having satisfied customers to having loyal patients. The revenue cycle has everything to do with the patient experience. The continuum starts with that first exposure to your organization and leads to patient loyalty. It includes pre-admission, patient access, patient billing, patient accounting, health information management, utilization management and others.  Let us talk with you about a practical approach that will help your hospital amass a loyal patient following.

Jim Matthews; Principal

(281) 646-1330

THE GREAT iPAD2 GIVEAWAY!!!!!!

WIN AN iPad!
 STOP BY BOOTH #307 AND ENTER THE DRAWING

http://www.hfmaconference.org/

iPad GIVEAWAY at the HFMA ANI

Nearterm is giving away another iPad at the 2012 HFMA ANI 
BOOTH #307
Stop by and drop off your business card to win!
http://www.hfmaconference.org/

JOIN US AS WE CELEBRATE 15 YEARS OF SERVICE EXCELLENCE!

This month marks our 15th year of service. We look forward to the next 15 as we continue to deliver expertise and human capital to our prestigious national client base. Nearterm has a reputation as an industry leader in revenue cycle consulting, search, interim management and project staffing.

We would welcome an opportunity to get acquainted and talk about your revenue cycle, cash flow or patient financial service issues. As one of the Principals with the firm, I would be honored to speak with you directly at (281) 646-1330.

Jim Matthews
jmatthews@nearterm.com

ICD 10 - THE CIO PERSPECTIVE

A very interesting survey.....

healthsystemCIO.com Survey Shows Most CIOs Not Sold On ICD-10

03/29/2012 By Kate Gamble Leave a Comment

CIOs Are Happy to Hit Snooze on ICD-10

It comes as little surprise that most CIOs believe the decision to postpone ICD-10 was the right move; what is surprising, however, is that an overwhelming majority don’t see the benefits of converting at all, according to the March healthsystemCIO.com SnapSurvey. Specifically, 80 percent said they do not believe the cost-benefit in the ICD-10 switch warrants moving ahead, with some noting that it will have little effect on patient care.

The survey found that most CIOs (72 percent) felt the postponement was a positive for their organization, as it gives them more time to focus on immediate priorities such as Meaningful Use, and helps to relieve some of the pressure brought on by converging deadlines. Those whose organizations were already on course to meet the target, however, believe the extension will complicate planning and budgetary issues and take focus away from the issue. And while 68 percent of CIOs said they believe the industry overall will benefit from the delay, those in opposition feel that strategically it makes more sense to stay on track, and are concerned that the pushback will ultimately hinder their efforts to obtain funding down the road. Interestingly, the vast majority (84 percent) of CIOs plan to keep pushing forward with plans rather than reallocate resources — at least until a firm deadline is established.
(SnapSurveys are answered by the healthsystemCIO.com CIO Advisory Panel. To see a full-size version of all charts, click here. To go directly to a full-size version of any individual chart, click on that chart)

1. Was the postponement of ICD-10 a good thing for you/your shop?
Yes

• While the value proposition of ICD-10 is clear, it is less clear as to whether that value will be realized. This allows us to focus on revenue cycle and clinical initiatives with clear value (e.g., Meaningful use).
• But we really need a new date. If the date slips three to six months, then it is of no help. If it slips two years and strong consideration is given to appropriate application of ICD-11, then this is a good thing.
• We were running out of runway.
• The challenge of achieving full MU compliance on the timeline established by the government is big enough. Postponing ICD-10 by a year or two will give us some breathing room to focus our finite resources, energy, and leadership bandwidth on this ambitious goal — not to mention figuring out how to truly get value out of all this technology we are implementing above and beyond the compliance requirements.
• We hadn’t hired a project director yet, so the timing was good.
• Some of our vendors were behind in getting us releases that were ICD-10 compliant. We had a train wreck approaching in spring 2013 in slamming in dozens of systems for ICD-10 and Meaningful use all at once.
• Takes the immediate pressure off, but we’re not stopping. Much more expensive to stop and restart than to just keep going!
• We were just beginning planning for it in the middle of a huge EMR implementation. It relieved some immediate organizational pressure.
• We’re currently undergoing a HIS roll-out. This allows more time for preparation.
• Doesn’t change our plans or our priorities, but gives us more time to make sure we are ready.
• It allows us to focus on MU.

No

• It will allow our organizations to remove focus from this issue.
• We were all ready geared up for the deadline, actively training staff and making software purchases to be prepared.
• It is actually a null event for us, just like most other government announcements.
• I wish I could have picked ‘not sure’, as the uncertainty of the new date has caused the biggest issues in scheduling and resourcing.
• We have started our ICD-10 program and this delay complicates our planning and budgeting process.

2. Was the postponement of ICD-10 a good thing for the industry in general?
Yes

• The industry has a whole has competing regulatory initiatives and a need to prepare for different payment models. ICD-10 in terms it its overall value is far down the list.
• The benefits of ICD-10 do not seem to be greater than the costs, and in this intense period of MU and new systems, the timing of ICD-10 was bad.
• The truth is that the industry does not require ICD-10 to make major improvements now in patient care, population health, and control cost. Give us a chance to adopt and Meaningfully Use HIT for achieving these aims before forcing us to go to ICD-10.
• Too much too fast — MU, PPACA, and unrealistic EHR implementation timelines would make for a perfect storm.
• I think vendors had fallen behind on preparations.
• Again, hopeful to those who have procrastinated, but probably not much difference if you were already underway.
• Would like to see us skip ICD-10 and wait for ICD-11.
• Yes, it will allow more overall compliance since the compliance rate is related to the speed of sequential expected compliance dates.
• The answer is really yes and no. The initiative is good but the change to physician documentation is going to be monumental and requires a serious extension of technology to be successful.

No

• We are behind and this kind of action keeps us there.
• I think it will make people even more suspect of any other governmental deadlines and will remove all sense of urgency about meeting them, which is fine until they actually hold fast to one, and then we are toast.
• I don’t think the delay will help most of the industry as the smart money will stay on task.
• Because I think it will only allow everyone to delay the inevitable. ARRA Stage 2 vendor programming resource availability could be a significant factor.
• There is NEVER going to be a good time in healthcare to decide when to do this.

3. Will you keep pushing the project forward as if the original deadline was still in effect, or will you now reallocate human and financial ICD-10-focused resources to issues that need immediate attention?
Keep pushing forward

• For now we will keep pushing forward until a definitive new deadline is in place, at which time we will adjust.
• But if we could get a firm date, then we may consider reallocating time to other projects that would have greater benefit.
• We have too much invested to pull the plug midway through. Investments are already made, so they can’t be unmade.
• We want to get this done. Our real dependency is our system vendor and when they will be ready.
• We will continue pushing forward but will adjust our pacing and resource allocation as needed to reflect a more gradual implementation.
• I believe it will be one-year delay.
• A decision has not been made, but we have recognized that to proceed with current plan with the October 13 deadline will increase the overall costs to some degree by at least one year.
• We hope our vendors do to and we can install ICD-10 system upgrades in a more spread out way and not necessarily associated with Stage 2 MU releases.
• Absolutely, we already budgeted for it, now we can have a little more time for compliance.
• We are continuing to move forward but at a slightly less emphatic pace.

4.
 Will it be more difficult to get organizational buy-in again if/when the new deadline approaches?
Yes

• Why should anyone have a sense of urgency about the deadline when it keeps moving?
• Yes it would be, and it still will be as providers will play that card. Not well of course, but they will play it nonetheless.

No

• No, only because it is a regulatory requirement.
• This is SOP for the government.
• Really? Few people in our organization understand and have bought into ICD-10. So it’s a non-issue to have a delay with respect to organizational buy-in.
• If it’s a year no problem but if it’s longer, then priorities will shift.
• Not really, since we are still going to keep moving.
• It’s a requirement which is already in the clinicians’ minds.

5. Overall, do you see a cost/benefit ratio in the ICD-10 conversion that warrants moving ahead?
Yes

• We will have to do it anyway and we have already put time, effort, and resources into it.
• It helps improve comparisons, but while it improves the “granularity” of the data, it is still claims data, and therefore not as useful as the clinical data from EMRs. We should not lose focus of that fact.

No

• In my opinion, the wise move would be to wait for ICD-11 with a 2017-2018 deadline.
• I am not sure there is a positive cost/benefit ratio, but we need to move on.
• Coding is mostly to support billing requirements and governmental interests in healthcare. I see little direct effect on patient care. It’s only after years of peer-reviewed, “evidence-based” research do changes occur at the bedside. In the short-run, all the coding efforts add cost and inhibit workflow.
• No, the case for ICD-10 has not been made. The folks at CHIME and AHIMA claim that we should do it because there is logically some benefit. But what is the value of the benefit? What is the cost to attain the benefit? We must prioritize the benefit of this thing against the myriad of other opportunities. In my opinion, the value of a new coding system is much less than the value of improved exchanges, better clinical systems, or healthcare reform support. We cannot do it all.
• We need to keep this moving. I hope CMS will seriously consider the positions laid out by CHIME.
• No, as it is going to hurt revenues, but we want to get that past us and get on with the new payment reform (not healthcare reform).
• If you look at the big picture, the risks of moving forward aggressively with ICD-10 far outweigh the benefits, in my opinion. Longer term, however, I can see advantages to adopting a more modern way of coding clinical data that outweigh the costs.
• Probably helps bend the cost curve, but I don’t think this is a winner from a reimbursement standpoint. It will help with a more granular analytics capability though.
• The reimbursement penalties are the issue; 40,000 codes seems a bit excessive, and not terribly useful.
• Not if compliance suffers and there is an overall negative effect on a plan to improve healthcare informatics overall.

Related posts:

1. healthsystemCIO.com Survey Shows CIOs Researching ICD-10 Coding Tools
2. healthsystemCIO.com Survey Shows CIOs Concerned About Staffing Strain
3. healthsystemCIO.com Survey Shows CIOs Struggling With Staffing Challenges
4. healthsystemCIO.com Survey Shows CIOs Frustrated With State Of HIE
5. healthsystemCIO.com Survey Shows Many CIOs Stymied By Broken Governance

Filed Under: ICD-10, Meaningful Use, Prioritization/Resource AllocationTagged With: ICD-10, SnapSurvey

2012 LOOKS LIKE ANOTHER GREAT YEAR!

As we close the first quarter of 2012, we thank all of our clients as well as the many professional colleagues we work with for a great start this year. Our revenue cycle consulting practice has continued to grow as we partner with hospitals in development of state-of the-art process innovation. Since inception, Nearterm has focused on access (admitting and registration), patient accounting, HIM, coding, conversion leadership and assistance, utilization management, interim management, policy and procedure documentation, cash acceleration, denial management and other related targets.

Our revenue cycle strategy and leadership team always welcomes dialogue about current revenue cycle topics - call us anytime at 281-646-1330!

Nearterm wins HAAPC awards again!!!!

It was another awesome year for Nearterm. While our greatest reward always is client satisfaction, we certainly were excited to be recipients of the following professional recognition at the recent HAAPC banquet:

FIRST PLACE Contract/temporary award in the technical professional division
(Team of Randy Bingham, Lori Francis, Shelley Muhs and Gayle Tapps)

$250,000+ Contract/temporary in the technical professional division
(Gayle Tapps and Randy Bingham)

Congratulations to all!