What steps should a high-performing but small hospital take to assess a possible partnership or merger; should the board bring in a consultant or do this on its own? How can a public hospital secure needed capital when its city owner is disinterested at best, obstructionist at worst? How can a hospital secure the loyalty […]
The flurry of news reports since last week’s election about the fiscal cliff—the budget-cutting initiatives known as “sequestration” combined with automatic tax increases—and the implications for Medicare was led by a report from the Congressional Budget Office that emphasized the need to cut Medicare spending. The National Coalition on Health Care also released a plan […]
The times are such that it makes sense for a board to review its ability to remain independent on a regular basis—every quarter, every six months, for example. Dan Grauman from DGA Partners recommends the use of an independence dashboard for the board’s use. This dashboard serves a tool to evaluate the organization’s position as […]
What is a hospital/health system board’s accountability standard for compliance in the current health reform environment? The board’s oversight responsibility remains the same, said Monte Dube, Esq., at the recent iProtean Symposium. Directors still have two principal obligations with respect to oversight: a duty to attempt in good faith to assure that 1) a corporate […]
Even if the Supreme Court overturned the Affordable Care Act, hospitals would still experience huge cuts in Medicare payment, and there would still be a movement away from traditional fee-for-service, said Marian Jennings at the recent iProtean Symposium in La Jolla, California. “We have put a lot of things into the bucket called “healthcare […]
Governance matters to credit rating agencies, according to Lisa Goldstein of Moody’s Investors Service. At the iProtean Symposium last week, Ms. Goldstein presented the scorecard used by Moody’s to assess governance and management. The five core elements of governance used by Moody’s include: Whether the board and management exhibit leadership capability in stable and […]
The Department of Health and Human Services Office of Inspector General (OIG) conducts audits, investigations and evaluations to ensure compliance with laws and regulations for Medicare, Medicaid and more than 300 other HHS programs. The OIG issues its work plan each year, and the work plan provides significant signs about OIG activity and investigations […]
Two pay-for-performance programs in the Affordable Care Act became effective on Monday—one relating to value-based purchasing and another targeting readmission rates. Both programs enable Medicare to reward hospitals for providing more efficient and higher quality care and penalize those hospitals that don’t measure up. Under the value-based purchasing program, Medicare will pay hospitals based […]
Hospitals that serve a large number of patients who have little or no funds to cover the costs of care, Medicaid patients and Medicare patients on disability have relied on a “disproportionate share” payment from CMS. The Affordable Care Act (ACA) added new provisions to the formula for calculating this payment to hospitals. The recent […]
Under payment reform in the Accountable Care Act (ACA), accountable care organizations (ACO) will receive incentives that reward efficiency and quality care. For the time being, ACOs will be paid based on DRGs, although it is expected there will be elements of capitation involved in the future. However, when determining how the ACO will […]