Potential Challenges to Tax-Exempt Status for NFP Hospitals

“As the Trump administration moves to reform the federal tax code, the country’s tax-exempt hospitals are bracing for potential challenges to their not-for-profit (NFP) status, with billions of dollars in federal taxes at stake,” according to the Healthcare Financial Management Association (HFMA) in an article released last week.   NFP hospitals face increased scrutiny from […]

Hospitals Experience Short-Term Operating Margin Decline after M&A

The finances of acquired hospitals generally suffer for two years after mergers and acquisitions (M&A), according to a recent report from HFMA and the Deloitte Center for Health Solutions.   M&A activity has increased significantly in the past decade, driven by the pursuit of economies of scale and the potential for reducing the cost of […]

Different Financing, Different Risks Between Hospitals and Insurers

Hospital systems and health insurers have very different financing structures. Hospital boards and executive management will want to consider the fundamental differences when considering whether to combine both organizations within the same larger health system.   Briefly, the health system has these fundamental financial structure characteristics: Significant physical plant investment Fewer growth opportunities Higher margins, […]

Moody’s Expects Drug Costs Will Continue to Challenge Hospitals

Hospital inpatient drug costs have been rising and this will continue, but at a moderate pace due to public scrutiny of pharmaceutical companies’ drug pricing practices. Moody’s noted in a recent article that even at a slower rate of growth, “we expect rising drug costs will continue to challenge hospitals’ financial flexibility.” (“Not-for-profit and public […]

Veralon: Call Coverage for Employed vs. Independent Physicians

(The following is an excerpt from “Different Economics, Different Payment: Call Coverage Stipends for Employed vs. Independent Physicians,” Veralon INSIGHTS, September 2017. Dan Grauman, one of our expert presenters, is the Managing Director and CEO of Veralon Healthcare Management Advisors. For the full article, please see the link below.)   “Physician employment agreements now commonly […]

Provider Organizations Should Assess Potential for Additional Revenue Under MIPS

Reporting and collecting data for 2017 for the Merit-based Incentive Payment System (MIPS) should be underway in provider organizations. But some may have decided to wait because of what they perceive as high administrative and labor costs. According to experts, these organizations “are well advised to take a closer look at the potential benefits and […]

OIG Reports on ACO Cost Savings and Quality Gains

Over the first three years of the Medicare Shared Savings Program (2013-2015), 428 Accountable Care Organizations (ACOs) served 9.7 million beneficiaries. Most of these participating ACOs reduced Medicare spending compared to their benchmarks, resulting in a net spending reduction of nearly $1 billion, according to an August report from the Office of the Inspector General […]

Social Determinants of Health Gain Importance Through Population Health

Economists estimate that 80 percent of all the cost of health care relate to social determinants of health. These include everything from exercise and healthy diet and healthy weight, to avoiding substance abuse and/or other self-destructive behaviors, to ensuring that people have adequate nutrition and housing. Those are big social issues that hospitals and health […]

MACRA Made Simple

(The following includes excerpts from our upcoming course, Strategic Issues for Boards, as well as information that didn’t make the cut.)   MACRA creates two different tracks for clinicians to participate in Medicare. One is called the Merit-Based Incentive Payment System, or MIPS. The second is the Advanced Alternative Payment Model (AAPM). Each of these […]