Community Benefit & Transparency Tools
HFMA has compiled these resources for hospitals and health systems to use for compliance when listing standard charges to the public and procedures around charity care.
Tool: Key Question Checklist for CFOs When Evaluating Population Health IT Investments
Hospital and health system CFOs can use this checklist to assist with population health IT investment decisions.
Tool: Sample Revenue Cycle Governance Council Charter
This is a sample tool from HFMA’s CFO Forum. Learn more about the CFO Forum and HFMA’s other Forums here. 1. Purpose To serve as the governing council for the revenue cycle
Moving Forward: Case Studies
As part of its Value Project research, HFMA visits a number of healthcare organizations to learn firsthand how they are moving forward on the transition to value. The following three case studies are composites based on the organizations visited as
Determining the Process
Once an organization has identified its cost reconfiguration opportunities, it must put into place a process to ensure that those opportunities are realized and, once realized, maintained. Who should be involved? The overall
Assessing the Situation
As organizations position themselves for a value based care delivery and payment system, they must be alert both to opportunities for reducing cost structure and to the need to build the capabilities and make the investments needed to engage in
Career Services Launches New Career Strategies Series – NfN Jul2015
HFMA has three “directional” strategies within the healthcare finance industry Policies and Perspectives HFMA has taken a more assertive role in providing our points of view on solutions that drive improvement of the healthcare industry Organizational performance
Determining Your Options: Educating Your Board
It is essential to keep your organization's board of directors up to date on your organization's current situation, capabilities and needs, and potential options for acquisition or affiliation. As you narrow in on the most viable options and partners for your organization, the PowerPoint template tools below outline key elements of your proposed course of action that should be shared with the board. Options are provided for proposals involving both less than fully integrated and fully integrated acquisition and affiliation models. Tool: Educating Your Board: Less than Fully Integrated Models Tool: Educating Your Board: Fully Integrated Models Go to Next Page Home
A Closer Look at a Health System’s Strategic Options
An example of the evolving physician strategy of a health system with a clinically integrated network is shown below: Manage the mix of independent and employed relationships. Rationale: The right mix varies depending on the hospital, market and service, even within a highly aligned, integrated system. Failure to balance and coordinate incentive structures and approaches between independent and employed physicians is a threat to the system. Create financial and non-financial incentives for independent and employed practices to reduce leakage out of the system. Rationale: Keep all elements of the CIN moving forward at roughly the same pace with respect to the journey from fee-for-service to value-based payment. Accept specialty facilities and specialists back into the system. Rationale: It is becoming less attractive for specialty centers to remain independent, and it behooves the system to work out a path for them to move from competitor to ally. Some of these specialists are particularly good, and the system does not want them going to a competitor. Also, since the system’s payments are still significantly fee-for-service, these specialists create profits that can be re-directed to strengthen the financial base. Use changes in physician relationships to manage the physician/patient ratio. Rationale: The greatest cause of “excessive” investments in employed physician practices is a shortage of patients per physician. For example, some employed physicians place restrictions on their schedules that hinder filling them with patients. Also some employed specialists have too few patients because they don’t have enough referrals from independent physicians in their service area. Continue to adjust employed physicians’ compensation packages as the ratio of value-based to fee-for-service revenues changes. Rationale: Relying on leadership is not enough; compensation has to remain aligned.
A Closer Look at a Medical Group’s Strategic Options
The independent medical group has several options regarding its future strategy. Indeed, many groups pursue more than one strategy at once. Here is an example of a single specialty orthopedic group’s strategy: Merge with a (formerly) competing orthopedic group. Rationale: cover more geography, enable the group to support a sports medicine practice, enable the group to have its own rehabilitation group, support more hospitals more effectively, support a stronger professional management team, and support additional orthopedic sub-specialization. Initiate a bundled payment initiative. Rationale: learn (along with a partner health system) to manage all elements of the care process in a value-based payment environment, and gain additional revenues once successful. Integrate IT approaches with as much as possible of the referral base (including EHR, decision-support, and other elements). Rationale: an essential step in accomplishing the other elements of the group’s strategy, with the potential to reduce the group’s total IT costs. Provide leadership in developing a CIN. Rationale: expand and shore up key parts of the group’s referral network, lead the development of an integrated approach to care management for the group’s patients (including total joints, trauma, and other areas), influence the development of the CIN’s funds flow and compensation models, and influence the alliances and other relationships developed by the CIN. Together, the orthopedic group’s strategies seek to make the transition from fee-for-service to value-based payments, to enhance short-term revenues and market position, and to make the group more successful in recruiting.