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If Sen. Charles Grassley has his way, nonprofit hospitals will have to prove they spend at least 5% of expenses on charity care if they are to keep their tax-exempt status. But a review of what's happened in Maryland suggests such a rule would be unrealistic and largely inappropriate.
That's the conclusion of a report, published recently in the online edition of the journal Health Affairs, which found extremely wide variation in levels of all types of community benefit each hospital reported.
For example, charity care, a subset of community benefit defined generally as that care given to patients without any expectation of payment, varied from 0.05% to 6.33%. Only two hospitals reported contributing 5% or more.
But total community benefit, which included other categories of uncompensated care, such as health professionals' education, community health services, and "mission-driven" programs and research, varied from 1.17% to 14%.
Source: HealthLeaders Media
The last thing you want to learn at your hospital, as a patient sits at your registration desk:
- They can't pay, and no one knew prior to service
- Their insurance changed, and authorization is required
- They recently lost their job and have not paid their COBRA benefits
At this point, you may end up with an unpaid account—and in this economy, that's not good news when hospitals continue to lose reimbursement dollars.
Read the full story by Dom Nicastro.
The patient access team at Skagit Valley Hospital has many goals as it works through this economic recession: Sustain morale, maintain trust, minimize criticism, and acknowledge success.
Michele Hill, CHAM, patient access manager at the Mount Vernon, WA, facility, knows it's not easy considering what the hospital faces:
- Federal and state budget cuts
- Change in payer mix
- Increased charity care requests
- RAC audits
"Our facility, like many others, is facing significant challenges during this time of economic downturn," Hill says.
Read the full story.
Despite a recession and continued crowding, a new study shows that the average wait time in the nation's emergency departments fell by two minutes in 2008 to 4:03. Even with the long waits, Press Ganey's Emergency Department Pulse Report 2009 finds that patient satisfaction rose in 2008, continuing a five-year improvement trend.
Leigh Vinocur, MD, on the emergency physician faculty at the University of Maryland School of Medicine, says she's not surprised that patients leave the ED satisfied.
"First of all, they probably can't get in to see a primary care doctor," says Vinocur, who is also a national spokesperson for the American College of Emergency Physicians. "And when you go to a doctor's office, he decides you could need a CT scan or a neurologist and you're waiting another few weeks for a referral.
"So, even though people are waiting four and five hours in the ER, they have an idea they are going to have a diagnosis when they leave. That doesn't always happen. But we can do a lot of procedures and things while you are there to get closer to the diagnosis," she says.
Read the full story by HealthLeaders Media’s John Commins.
Sometimes, your health information managers need to code. And your patient access managers need to register patients.
In these tough economic times, your hospital staff members should be ready for different roles on any given day. No one is immune to change.
At Albany (NY) Medical Center, managers in the patient access department are prepared to handle staff shortages.
During a recent string of illnesses and consecutives days with short staffs, department leaders took off their managers' hats and got on the frontline to register patients.
"The leadership team are working managers, much like any other patient access area," says Cathy Pallozzi, CHAM, patient access director at Albany Medical, noting the staff recently experienced colds and GI, which sprang the managers to action. "So the managers are on the front end, as well as the associate director. If I am needed, I will be on the front end as well."
Read the full story.
Patients typically arrive at the hospital as planned, urgent, or emergent admissions, and are registered in different ways. Errors made during the registration process can have a negative impact all the way to throughput and discharge planning. For this reason, the hospital may want to consider a performance improvement project to identify if there are registration errors, the types and frequency of these errors, and when they occur. For example, do errors occur more often on emergency admission on the night shift? What types of errors are they? Are they duplicate medical record numbers, errors in Social Security numbers, or the spelling of patient names? Any of these issues will have an impact on patient safety, discharge planning, and even billing or denials.
Editor’s note: This tip comes from HCPro’s newest training resource for hospital case managers—Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes by Beverly Cunningham, MS, RN, and Toni Cesta PhD, RN, FAAN, available now at HCMarketplace.com.
Hospitals can't escape layoffs these days, and they're not adding many jobs any time soon.
Bureau of Labor Statistics data released Friday say hospitals added only 300 payroll jobs across the entire nation, compared to 16,800 jobs in May 2008, and 8,700 jobs in May 2007.
So what are hospitals doing about it, especially on the front end where accurate registrations and upfront collections can mean the difference between a denial and a full return on a patient bill?
They are getting smarter, more technologically savvy, and analyzing their payer mix and what each entity requires.
Read the full story by HealthLeaders Media's Dom Nicastro.
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