HealthLeaders Media Finance - July 26, 2010 | Berwick’s First Reimbursement Challenge View as a Webpage | Subscribe for Free
Berwick’s First Reimbursement Challenge
Elyas Bakhtiari, for HealthLeaders Media

New CMS Administrator Donald Berwick, MD, has not yet been on the job a month, and he's already finding himself in the middle of one of those reimbursement tugs-of-war that seem to define modern healthcare. How he responds may indicate what hospitals and physicians can expect from CMS during his tenure, particularly when it comes to getting paid. [Read More]
  July 26, 2010

Editor's Picks
MHA Says Bay State Hospitals Cut $3.1B in Expenses
An updated Massachusetts Hospital Association in-house study released this week shows that member hospitals in the Bay State trimmed $3.1 billion in operating expenses in the past two fiscal years. At the same time, payments to hospitals for the last two fiscal years were reduced more than $2.4 billion than they would have been had the FY 2004 ? FY 2008 operational expenses trend continued. Savings were found in the elimination of clinical and administrative positions, programs and services; cuts in compensation and benefits; changes in purchasing strategies, implementation of quality and process engineering techniques, and reduced non-essential spending. [Read More]
Not-For-Profit, Stand-Alone Hospitals See Improvement
After three years of decline, the nation's stand-alone, not-for-profit hospitals stabilized balance sheets in 2009 and saw improvements in other key operating metrics. This results in pre-recession levels similar to 2006. The Standard & Poor's report says the improvement is reflected in fewer credit rating downgrades in the first half of 2010, and nearly as many upgrades as downgrades. [Read More]
Home Visit Programs To Receive Millions
Programs providing home visits that can ultimately reduce pre-term births and the need for emergency room visits are being awarded $88 million from the federal government. The funds, made available from the Affordable Care Act, are issued through the Maternal, Infant and Early Childhood Home Visiting program, and will enable nurses, social workers, and other health professionals to visit at-risk families in their homes. [Read More]
Medicare RAC Focuses on Medicare Advantage, Prescriptions
Medicare Recovery Audit Contracting has made great strides in recovering millions of dollars lost to waste and fraud in the past few years. However, it will face challenges as it expands to include new areas of Medicare Advantage (Part C), Medicaid, and prescription drug coverage (Part D) (as spelled out earlier this year under the new healthcare reform law) according to those testifying last week before a Senate panel. [Read More]
Finance Forum
New Medicare Fraud and Abuse Provisions Under the PPACA
President Obama recently signed off on legislation that very likely will result in a substantial increase in lawsuits against health care providers. Intended to combat fraud in the Medicare & Medicaid programs, several amendments in the Patient Protection and Affordable Care Act significantly change the status quo, and will require greater vigilance by healthcare providers in their dealings with the federal government.

[Read More]
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Finance Headlines
Johns Hopkins Inks Deal With Florida's ACH
John Commins, for HealthLeaders Media, July 20, 2010
CMS Releases SNF PPS Rates for Fiscal Year 2011
Mackenzie Kimball, for HealthLeaders Media, July 26, 2010
Sanford MeritCare Now Sanford Health
Cheryl Clark, for HealthLeaders Media, July 20, 2010
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Money Talk

A look at one hospital's struggles to improve

Mayo Clinic, Rochester, MN
Rating: AA-
Outlook: Positive
Affected Debt: $1.7 billion
Agency: Standard & Poor's Ratings Services
Remarks: S&P revised its rating outlook to positive from stable and affirmed its AA- rating on various issuers' debt issued for Mayo Clinic. At the same time, S&P affirmed its various other ratings on numerous bonds issued on behalf of Mayo Clinic. Offsetting credit factors include liquidity levels that are still below similarly rated organizations. S&P also considers Mayo Clinic's asset allocation aggressive, with approximately 50% of Mayo's long-term fund in alternative assets. S&P also cites its potential exposure to future Medicare and Medicare physician reimbursement reductions.
[Read More]