Archive for the ‘Finance’ Category

Building a Patient-Centered Model of Care

Over the past several years, the health care system has been attempting to define and create a “patient-centered model of care.” Most health policy experts, much less health care professionals, can’t seem to agree on what constitutes a patient-centered model of care. I think that a patient-centered model is less about discussing the comprehensive services offered to patients and is more about putting the patient in the middle of the relationship. A true patient-centered model surrounds the patient and provides a true coordinated personalized system of care.

In examining U.S. health care delivery, rarely are the words “coordinated,” “personalized” and “system” used in the same sentence ― much less actually delivered to patients.
Primary care medical homes (PCMH) were first developed several years ago in an attempt to develop a patient-centered experience. Even those physicians currently practicing in the PCMH model indicate that there are issues associated …

Continue reading Building a Patient-Centered Model of Care »

Tax Implications of the ACA – Just Bad Timing?

The tax provisions that the press prefers to call the “Bush tax cuts” will sunset and income tax rates (as well as phase-out provisions for itemized deductions and personal exemptions and numerous other provisions) will revert to pre-2001 levels. In addition, the individual income tax provisions contained in the ACA take effect. There are three primary taxes placed directly on individuals contained in the ACA.

Continue reading Tax Implications of the ACA – Just Bad Timing? »

Capital Continues to Pump into Healthcare Technology, What this Means for Georgia

As the healthcare industry continues coming to grip with the recently passed Obamacare legislation, we must now move on with other issues of importance that are contributing to the ongoing expansion of the industry, as well as economic development through jobs and new business growth.  There is perhaps no better place to observe this growth and the valuable contributions to the overall healthcare industry than what is taking place in healthcare technology, or “HCIT,” as it is commonly referred to in the industry.

HCIT has frequently been referred to as the fastest growing segment of the healthcare industry measured by revenues and investment activity, and one of the most rapidly expanding sectors in the entire US economy.  And as the industry has speculated about the changes that will come from Obamacare for some time now, HCIT companies are being pursued as some of the most influential and well-positioned players that will play a critical role in making those policies …

Continue reading Capital Continues to Pump into Healthcare Technology, What this Means for Georgia »

Role of Clinical Integration in Question of Doctors’ Relevance

Recently, another columnist on this blog posed a very serious and very pertinent question that the healthcare industry has been facing for some time now.  The question relates to how the current evolution and changes of the fundamental healthcare delivery model is gradually moving physicians away from the center focus of that system.  This was posed in an article that Mr. Olsen alluded to from The Economist titled, “The Future of Medicine:  Squeezing Out the Doctor“.   Among other topics, the original article and Mr. Olsen on this blog continued to discuss the impact that technology is gradually having on the way healthcare is delivered, such that today much less of a patient’s primary point of care is exclusively provided by their actual physician.

One of the primary drivers that the original article discusses can be summed up with this quote:  ”To treat the 21st century’s problems with a 20th century approach to health care would require an impossible number of …

Continue reading Role of Clinical Integration in Question of Doctors’ Relevance »

Taxes – Do We Know One When We See One?

As we approach the half-way point of 2012, an important court case that will dramatically affect the healthcare industry is about to be decided. Next month, the United States Supreme Court is scheduled to decide the constitutionality of the Affordable Care Act. The Supreme Court has heard oral arguments on and may decide the following issues:

1) Whether the penalty for noncompliance with the individual mandate is equivalent to a tax.
2) Whether the individual mandate is legal.
3) Whether the individual mandate is illegal, whether the rest of the Affordable Care Act is also illegal or whether it is severable from the individual mandate.
4) Whether Congress illegally required states to expand the Medicaid program.

Unfortunately, due to the various burdens employers and state governments face in complying with the Affordable Care Act, not all of these issues may be decided as soon as we hope. If the Supreme Court determines the penalty for noncompliance with the individual …

Continue reading Taxes – Do We Know One When We See One? »

The Path of Least Resistance….or Fiduciary Responsibility

Are those broken eggs in your basket? It’s a great time to check!

Continue reading The Path of Least Resistance….or Fiduciary Responsibility »


There’s been a great deal of debate regarding mergers in healthcare. For regional or smaller community hospitals, their viability in many cases may depend heavily on larger economies of scale. What about doctors, physician practices and outpatient centers?  From a lender’s perspective, there is definitely strength in numbers!  

As shrinking reimbursement becomes the 800 pound gorilla for all healthcare providers, we have to look towards improving efficiencies to survive. From throughput and case management to materials management and contract negotiations, providers have to find ways to improve across the board and cut waste within their existing processes. On top of improved efficiencies, they have to continually drive volume growth.   Procedure rooms with the lights off during operating hours at an ASC are critical dollars missed.  On one side of town there’s a patient waiting 3 days or more for a scan and on the other side of town there’s a CT sitting idle. 

Single …

Continue reading STRENGTH IN NUMBERS »

Red Tape -Why does an Undermanned Agency Create Unnecessary Work?

In general, the letter requests that the IRS make Part V, Section B optional for 2011 (as the IRS did for 2010) to allow additional time to work through the application of these rules to a diverse group of charitable hospitals, to eliminate redundancies that have no clear relationship to the statutory requirements of the law or that do not result in a clear benefit to the public, and to simplify reporting for increased understanding (and to eliminate unneeded paperwork).

Continue reading Red Tape -Why does an Undermanned Agency Create Unnecessary Work? »


It’s not what I say, but what you hear that has meaning for you. In all situations, clear communication is paramount to success and efficient operations. The ability to work together, understanding and leveraging different skill sets, leads to a better work flow.  Knowing your strengths and weaknesses, and knowing when the time and situation are right for turning over control to a trusted partner, will help strengthen your competitive advantage and greatly improve your chances of success in the most challenging sector of business.  We all need to get a lawn mower! 

If what you say and what people hear are two different things, you’re in trouble. Creating clear and concise channels for communication and protocol on top of a foundation of trust and confidence go a long way.  About the title of this post, I actually suggested, “We all need to get along more,” as in get along better, communicate better, find a balance of mutual respect.  But the person to whom I was speaking …

Continue reading WE ALL NEED TO GET A LAWN MOWER »

Healthcare and the 6-napkin Roast Beef Po’boy

Capital planning for the unexpected

I was enjoying my New Orleans’, 6-napkin roast beef po’boy, carefully avoiding the anticipated drip down my shirt and realizing how healthcare and this dripping sandwich have a lot in common. Healthcare is challenged from every angle and the constant, multi-front battle creates opportunity for waste, inefficiency and non-compliance.  Improving in one area almost certainly leaves another vulnerable.  If a provider gets caught up, legislation changes or reimbursements get slashed.  The drips in the napkin are an acceptable casualty because we know we can’t possibly keep it all in the bread.  But what about the drips down the chin? What about the drips on the shirt, embedded deeply in the fabric’s fibers and potentially causing permanent stain?   As the pendulum shifts from doing more with more, to doing more with less, and finally doing less with less, are we finding healthcare on an unsustainable trajectory?

While healthcare has always …

Continue reading Healthcare and the 6-napkin Roast Beef Po’boy »