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At least 523 records · Page 29Linked to original sources
PubMed1992

Changes in Medicare capital PPS rates and rules.

Author Grimaldi discusses recent changes in Medicare's capital prospective payment system (PPS) regulations, published in the Federal Register, September 1992, as well as major changes in operating cost guidelines that affect capital payments. Policy interpretations that the Health Care Financing Administration (HCFA) has issued in the past year are reviewed, and changes made to the Medicare cost report in order to accommodate capital PPS are summarized schedule by schedule.

Capital Expenditures↗
PubMed1996

Cost modeling as a technology assessment tool for radiology department capital equipment acquisitions.

Changes reshaping the healthcare delivery system impact capital equipment acquisition decisions within radiology departments. During an era of rapid technological advancement, acquisition decisions often favor new imaging technology with an emphasis on volume and revenue increases. With a slowdown or plateau in new imaging technology and significant changes in the healthcare delivery structure, greater emphasis is now being given to productivity and quality improvement investments. Such investments are aimed at reducing labor and material operating costs through capital investment in electronic alternatives, such as the digital viewing and storage of diagnostic images in lieu of film. This shift in emphasis presents a dilemma for radiology departments because it is often more difficult to show a quality and productivity improvement justification. One approach is to use a formal ¿technology assessment¿ (TA) process wherein a manager considers changes in processes, labor, equipment, space, and consumables, and then assesses that impact on cost, utilization, quality of care, and other factors. A cost model is a useful tool in this process. A review of a number of real world experiences demonstrates the benefits of more timely and informed capital equipment investment decisions. While the direct savings may not entirely offset such investments, TA analysis also evaluates in tangible benefits that may not be quantifiable in economic terms. Both tangible cost savings and intangible benefits need to be weighed against the net investment in a new technology.

Capital Expenditures↗
PubMed1996

Preparing for capitated hospital services.

Although HMOs have been reluctant to capitate hospital services, capitated payments allow hospitals greater control over their strategic and economic position. Healthcare financial managers have a role to play in demonstrating to HMOs that capitating hospital services can create a win/win situation.

Capitation Fee↗
PubMed1996

Capitation and integrated health care systems.

Integrated health care systems: a concept being discussed throughout Russia and the world. A concept with three different applications and a confusing interaction with the concept of "capitation payments." The health reform debate in Russia and the NIS can only advance if greater clarity is found for these concepts, and if medical leaders are prepared for the substantial changes in provider behavior that are required with integrated health care systems fueled by capitation payments. This article explores the twin concepts of capitation and integrated health care systems, and then the leadership challenges for Russian health sector managers as they prepare for these challenges of the twenty-first century.

Capitation Fee↗
PubMed1997

Capitation conundrum.

There are clearly many differences between fee-for-service and capitation. Making the transition to capitation poses some special problems and areas of risk that are not apparent from looking at either reimbursement method in isolation. The boundary and transition issues require special attention during the next several years as capitation is implemented in new markets.

Accounting↗
PubMed1997

Thinking strategically about capitation.

All managed care stakeholders--health plan members, employers, providers, community organizations, and government entitites--share a common interest in reducing healthcare costs while improving the quality of care health plan members receive. Although capitation is a usually thought of primarily as a payment mechanism, it can be a powerful tool providers and health plans can use to accomplish these strategic objectives and others, such as restoring and maintaining the health of plan members or improving a community's health status. For capitation to work effectively as a strategic tool, its use must be tied to a corporate agenda of partnering with stakeholders to achieve broader strategic goals. Health plans and providers must develop a partnership strategy in which each stakeholder has well-defined roles and responsibilities. The capitation structure must reinforce interdependence, shift focus from meeting organizational needs to meeting customer needs, and develop risk-driven care strategies.

Capitation Fee↗
PubMed1997

Coping with capitation.

Capitation is spreading as a payment mechanism as managed care plans and employers look for ways to hold down costs and make them more predictable. More provider organizations are using information technology to measure their costs, forecast risks and carefully analyze capitated contracts before signing them. They're also turning to information systems to fairly divvy up the capitated payments to physicians and other clinicians.

Actuarial Analysis↗
PubMedDate not supplied

A method for capitation rate calculation using financial data readily available to the laboratory manager.

The advent of managed care has expanded the universe of information needed by laboratory administration to properly manage a clinical laboratory. This article presents a method for calculating proposed capitation rates for laboratory services using financial information that is readily available to the laboratory manager. Having this information is essential before entering into negotiations with a managed care organization and also gives the manager information regarding the laboratory's competitive position in relation to market capitation rates. Once a cost-based capitation rate is determined, laboratory administration must assess whether or not to pursue the contract and how it can be consummated. This article briefly outlines questions to consider in determining whether and how to proceed in contracting with a managed care organization and the ongoing analysis that is required after the contract is won.

Capitation Fee↗
PubMed1998

Capitating home health care.

Managed care is beginning to make inroads into home health care, and more home healthcare providers are signing capitation contracts. Unfortunately, a lack of home healthcare cost and utilization data has made it difficult to set reasonable capitation rates. In addition, home healthcare providers currently have little control over care management and, therefore, cannot effectively manage utilization under capitation. They also are unused to thinking in terms of controlling utilization and guaranteeing services for a predetermined population at a preset price. In the long run, however, home healthcare providers and payers that develop cooperative working relationships will find ways to collect and share the information they need to make these arrangements mutually successful.

Capitation Fee↗
PubMed1998

Using real-estate-based financing to access capital.

One strategy employed by healthcare organizations to increase their market presence is the construction of new facilities. Accessing capital to fund such construction, however, has become more of a challenge. One relatively untapped source of building capital is real-estate-based financing. Nonrecourse mortgages, turnkey net leases, and synthetic leases can provide several advantages to healthcare organizations seeking capital, assuming issues related to building ownership, debt and balance sheet effects, and tax-exempt status have been thoroughly explored first.

Capital Financing↗
PubMedDate not supplied

An information system model for negotiating capitation contracts.

Capitation contracts require health care organizations to negotiate on a much more sophisticated and risky level. Understanding whether a capitation contract will allow a hospital to remain financially viable while providing quality care requires estimating the number of patients to be served, the amount and types of services to be offered, and the cost to provide them. This article presents an information system model designed to assist a large hospital, not only in determining true patient cost, but also in aggregating the cost information in different ways, such as conducting a case-mix analysis, to perform a more informed quote analysis for capitated contracts.

Academic Medical Centers↗
PubMed1980

Capital financing in an uncertain future.

A critical test of the hospital's ability to survive will be its ability to raise capital in private debt markets as traditional funding sources (philanthropy and government) continue to shrink. This article assesses the impact of inflation and recession on hospital capital financing and investment, describes what a commercial banker looks for in evaluating a hospital's ability to borrow, and suggests a role for trustees in meeting the hospital's capital needs.

Capital Financing↗
PubMed1984

Capital financing in prospective payment.

In the era of prospective payment, arranging financing for hospital capital projects is expected to become even more complicated than under cost-based reimbursement systems. This article outlines the information needed for a bond issue in the prospective payment environment, defines the roles and duties of several external persons and organizations involved with planning a major capital financing, and provides an overview of the entire process. This article assumes for illustrative purposes that a tax-exempt bond issue is going to be used to finance a facility expansion. This method was chosen since over 70% of all major capital financing for hospitals use the tax-exempt bond as the principal vehicle for attracting the necessary debt to finance a major construction project. The tax-exempt bond issue also requires the most detail in documentation and legal provisions.

Capital Financing↗
PubMed1987

Are healthcare REITs a cheap source of capital?

Many not-for-profit healthcare institutions are using REITs as a new source of capital. These institutions are finding REITs an attractive source because they provide 100 percent funding, reduce the responsibilities of hospital management, and allow access to a new base of capital. However, to be a source of capital, REITs require the sale of the institution's assets. This transfer of ownership can create significant differences in the management of the healthcare institution that might not be a welcome change.

Capital Financing↗
PubMed1988

Surviving and thriving with capitation contracts. Part 3.

Capitation agreements can offer a hospital both immediate and long-term benefits to its bottom line. However, before a hospital enters into such an agreement, it must understand the types of risk involved in this kind of arrangement, evaluate the capitation contract's key assumptions and underlying rate, and manage risk both administratively and financially. In this last article of a three-part series on strategic pricing in health care, the intricacies of capitation arrangements are explored.

Capitation Fee↗
PubMed1988

Finding funds under your nose with capital raising techniques.

As competition increases and patient utilization and reimbursement decline, financial managers are faced with exhausted debt capacity and increasing needs for capital. It appears to be an impossible situation. However, techniques that create underlying value can be used to raise needed capital without jeopardizing a hospital's debt capacity and credit rating. These techniques--off-balance sheet financing, sale/leaseback of undervalued assets, sale or lease of existing services, and debt restructuring--create additional sources of capital without threatening future debt capacity.

Capital Financing↗
PubMed1986

Capital payment under PPS: can hospitals still bloom?

Capital costs are presently treated as pass-through payments under PPS. However, this situation is only temporary and by Oct. 1, 1986, HCFA must endorse a proposal to incorporate capital costs into the framework of PPS. Several methods have been suggested--a capital add-on approach, a modified pass-through approach, and variations of these two approaches. Looking at a case study hospital--a large urban teaching center--results show that the modified pass-through approach is the most advantageous, providing the largest cash flow.

Capital Expenditures↗
PubMed1986

Assessing present and future capital expense levels under PPS.

The expected shift in the method of payment for capital costs will affect the way decisions are made by hospital executives. The capital expense ratio model is one way executives can better assess their present and future capital expense levels as payments begin to be made under a prospective payment system.

Capital Expenditures↗