Resources by BHM Healthcare Solutions

Managed Care – Not New but our Healthcare Perspective Might Be

December 18, 2014

Managed care has been around for almost one hundred years, at least in theory. When placed up against fee-for-service payment models, however, it was a hard sell. Traditionally, the way that physicians were compensated for their services was a fairly straight-forward invoicing process: they would bill the patient (or later, the payer) for everything they did in terms of diagnosing or treating the patient. Everything.

Hospital Readmissions Are Costing Us $26 Billion Annually

December 17, 2014

Healthcare has become something of a hard science, if the focus on data and numbers is any indication. It would seem that the research, the endless reporting and spreadsheets of healthcare administration, has served to at least shed light on the problems healthcare is currently facing as an industry – but the fix isn’t likely to be in black and white.

Healthcare 2014 – A Retrospective

December 16, 2014

As 2014 draws to a close, many of us in the healthcare industry are looking back at the year we’ve had and reflect on what worked, what needs to change and what we can expect for 2015. As an industry, healthcare saw a continued move towards accountable care, shared decision making, value-based purchasing and patient satisfaction measures. Buzzwords abound, there was a lot for everyone – providers, patients and payers – to juggle this year. And it looks like the trend is apt to continue into 2015.

Preventable Mortality Down in Hospitals by 17%

December 15, 2014

Even though the Accountable Care Act has only been on the scene for many since Obama signed it into law back in 2010, the idea of accountable care vastly predates the law itself. The Clinton Administration had taken a similar model to Congress in the 90s, which was almost immediately denied, in part because the market wasn’t prepared for a payment reformation. Of course, not that it was any more ready come the 2000s, when the United States entered into a period of, in recent decades anyway, unprecedented economic recession. Still, the ACA went ahead and so too did the expectations placed on hospitals, providers and patients within the healthcare market.

New Rules for ACOs

December 12, 2014

Accountable Care Organizations (ACOs) may have an additional three years before penalties would be enforced for poor performance, according to a new proposal by the Federal government. These groups of doctors, hospitals, and providers that care for Medicare patients work jointly as ACOs toward the goal of retaining whatever additional financial resources are left over after completed care. Currently, there are about 330 ACOs in the United States, and together they have saved Medicare more than $700 million in healthcare spending.

Forming Alliances to Mitigate Risk – Payer Provider Perspective

December 11, 2014

We hear a lot about bi-partisanship in politics – but what about healthcare? Sometimes it seems like the payers and the providers, the administrative and the clinical, are across the aisle from one another in more ways than one, and it brings to mind the challenges faced by politicians who just can’t see from the other side’s perspective. While politics shoulders many competing agendas, when it comes to healthcare the bottom line is the same no matter where you are: good health for the best price. This is even true of the patient’s themselves, who are becoming more and more concerned with the cost of the services they receive – and using the internet to find out if there’s a better “bargain” on care somewhere else.

5 Challenges Hospitals Face in 2015

December 9, 2014

You might be thinking – “Just five challenges?!” and it’s true that the healthcare industry is facing many challenges at the moment. Five of them, however, are most specific to hospitals. We often think of hospitals as the “front lines” of healthcare, and while it may be true that the majority of practicing physicians, nurses and allied health professionals find employment there, new data shows that one vital piece of the hospital picture might be missing: patients.

5 Ways Healthcare Delivery Has Changed Forever | Doctor’s Channel

December 8, 2014

As part of BHM’s partnership with The Doctor’s Channel, Anthony Grimaldi, BHM’s Senior Vice President Provider/Hospital Division, explains the changes to the way that providers must deliver healthcare.

5 Things You Need to Know About ACA in 2015

December 5, 2014

Five years into the Affordable Care Act, the healthcare climate of the United States has continued to evolve and improve. While there are some long term changes required that have just begun to take shape, many changes brought about by the ACA are immediate gratification. Changes to Medicare and Medicaid have helped many Americans gain coverage that they previously wouldn’t have had access to. While the system is imperfect, there’s plenty of positivity to consider since it launched in 2010.

Revamping Your Revenue Cycle for 2015 |7 Things to Consider

December 4, 2014

There are few aspects of healthcare that are more controversial, confounding and frustrating than payment reform. It’s hard to imagine that there was ever a time when patients just paid the doctor for their services. Since that payment method created economic disparities in access among the rich and the poor, several reforms later we find ourselves somewhat on the opposite end of the spectrum: more patients than ever can have access to care, but the process for compensating physicians hasn’t been able to keep up. Doctors are rendering services without receiving payment – and their practices can’t sustain on that type of arrangement!

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