Monthly Archives: July 2009

Healthcare Finance

Does your health care provider have the cash to survive today?

Survival of the fittest!

It is very well know that in today’s healthcare business, cash flow is the life blood of any business, specifically in the healthcare industry.

The healthcare industry has become much more competitive over the years. Hospitals proclaiming that they have a state of the art cardiology center, with nurses that put the patient first. I am sure that hospitals across the country put their patients first, it’s just that they do it better, the ad claims.

We see the messages on billboards lining the streets, on TV. from shows like Big Medicine and such. Walk thru a mall and see the ad’s from doctors who are specialist in plastic surgery, weight control, and various other procedures.

One would ask why a doctor, hospital does, emergency service need to advertise, don’t they receive their patients from word of mouth, one doctor recommending another?

One would think so, but the game has changed for ever. In the near future the family doctor will no longer be. We will all be seeing a“specialist” for what ill’s us. You may ask yourself “so what’s wrong with that?” well there is nothing wrong, but if you work in the healthcare industry and run a practice, hospital, emergency care center and such, well you need to make sure that your business has steady cash flow and has a competitive edge, and in today’s world the edge is CASH!

Medicaid and Medicare set the stage for what will be paid on claims. As we know, HMO’s and PPO’s and other insurers follow suit and try to under pay claims as well. You the healthcare provider are providing services on a daily basis and do not receive payment on the claim for 45 to 90 plus days, and that is if it is coded correctly.

The point that I am trying to make is that there is much more competition for each dollar that is out there and a lot of energy is spent to collect that dollar. Separating yourself from you competition is important. Having the steady cash flow for working capital to grow is imperative!

The number one key factor in a provider’s fiscal downfall, or lack of growth, is the lack of working capital. A solution to prevent this lies in the provider’s accounts receivable, an asset often wasting away accumulating dust on the balance sheet that becomes lost revenue due to the time value of money.

Many “C-Suite” healthcare executives are choosing medical accounts receivable (MAR) funding as an important tool in their business financing strategies. MAR funding’s flexibility and immediate cash infusion reduces their dependency on debt-incurring bank loans and lines of credit as their sole forms of financing. It provides a predictable and steady cash stream and the amount of medical accounts receivable funding is not limited by a bank’s often under-valued assessment of the provider’s assets

Bank credit lines are often insufficient to meet a provider’s working capital needs and monthly cash flow plans, especially when a conventional bank determines a line based on a significantly “under-valued” valuation of the provider’s assets. Additionally, the bank may be quick to disqualify that collateral once the aging reaches 90 days. This often happens because most conventional banks do not have the deep understanding and working knowledge of the healthcare business, its industry specific regulatory requirements and cash flow challenges.

I challenge you to take a look and see if your business can survive?
How “fit” is your business?
Who are your competitors?
Do you have cash on hand to handle the ups and downs or to expand your business, to be competitive?

Editor’s Note: James Hill is the author of this article and, Vice President at Choice Med Consulting. You can check out his profile on linkedin

Clinical Quality, Emergency Care

Redesigned ER with reduced wait times can save lives

Emergency Room incident at King’s County hospital

The King’s county hospital in Brooklyn, N.Y. has several claims to fame; It was the site of the first open-heart surgery performed in New York State; Kings County physicians invented the world’s first hemodialysis machine, conducted the first studies of HIV infection in women and produced the first human images using magnetic resonance imaging (MRI). In addition, Kings County was named the first Level 1 Trauma Center in the U.S.

It is ironic then, that the hospital became the center of all media attention for a negligence death in their waiting area in the Emergency Room. Esmin Green, a 49 yr old psychiatric patient had been waiting in the emergency room for more than 24 hours before she toppled from her chair and fell on ground. Although the waiting room was occupied by other patients, a security guard, and a staff member, no one cared to help Green until more than an hour after her fall (Check out the Associated Press report for further details on this).

Isolated incident or alarming trend?

HealthCare Management decided to do some research of our own and here is what we came up with.

An archived article in New York times talks about Federal regulators reprimanding cook county for serious flaws in how it decides who should receive emergency care and for treatment delay
The king’s county hospital’s emergency room sees about 116,000 patients a year
In 2007, Kings County hospital deployed, MediKiosk software solution, that automates patient registration and helps emergency department staff prioritize treatment based on medical urgency
According to a recent survey conducted by the American College of Emergency Physicians (ACEP), 80% of the 328 emergency departments surveyed board psychiatric patients
30% of ACEP surey respondents said they board patients between 8 and 24 hours

Before, we conclude it is a dead end, let us look at some other facts that might present solutions

85% of the doctors in the ACEP survey said that wait times for all emergency patients would improve if there were better psychiatric services available.
More than 80 % agreed that regional dedicated emergency psychiatric facilities nationwide would work better than the current system for dealing with psychiatric emergency patients.

Maybe, it is time to redesign the Emergency care ? We rest our case, now you decide!

EHR, Health2.0

Health Records-Now on your iPhone!

In a previous post we talked about electronic health records, and how hospitals and providers are embracing it to improve patient safety. With the introduction of the new iPhone3G, electronic health records are now going beyond the computer and into the iPhones. Hand held devices are always popular with physicians (tablet pcs and pdas). Now, consumers and providers can access health records on their phones.

Some current applications available at the online apple store

Medfile – Developed by Kaplan design lets users create and manage their personal medical records. Information such as blood type, allergies and emergency contact etc can be stored and retrieved.

ADAM – An application that lets the users identify health symptoms.From a simple sprain to fever, and upset stomact, ADAM gives users access to up-to-date medical information that is expert-reviewed. The tool also provides information on what the symptoms mean and when to seek professional medical attention.

These applications are fairly new, and are surely going to generate debate amongst medical professionals within and outside the blogosphere. Also, it remains to be seen, how popular these applications get with consumers.

We at HealthCare Management will keep a tab on this. So keep watching this space.

Health2.0

The Health 2.0 buzz

There has been a lot of activity in the Health 2.0 world recently. There are already two major Health 2.0 related conferences. Atleast a dozen new health 2.0 applications in the first half of this year and the launch of Google Health and Microsoft Health Vault. As usual, we at Healthcare Management will help you keep upto date with what is going on. But like with our previous articles, we intend do our research before we publish. Soon we will be talking with Google Health development team and folks at Aetna to get an understanding of what their Health 2.0 plans are. But before, we get too far ahead let us examine the basics.

What is Health 2.0 ?

Health 2.0 aka Medicine 2.0 aka eHealth, can be broadly defined as ” applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.

The idea is simple. Health 2.0 is about interactive Web services,that, will arm individuals with information, tools and supportive online communities so they can take charge of their own medical care — and in turn transform the U.S. and other healthcare systems by demanding better service and lowering costs.

Watch this space in the future as we profile some emerging health 2.0 applications and services.