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Continuing the consolidation in healthcare, hospitals that for decades have been the cornerstones of the not-for-profit sector--teaching facilities, Catholic hospitals and other church-affiliated institutions--are for the first time considering deals with for-profit chains.
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Managed care has gradually been replacing the traditional way in which doctors and patients interact. These changes are taking place at an increasing pace, which strongly suggests there will be a dramatic trend to managed care programs. It has become imperative to understand the business of medicine beyond the traditional "business manager" tasks of setting fees, analyzing tax consequences, and balancing the check book. Providers may be hard pressed to maintain the quality of care they feel comfortable giving as the regulations of managed care exert their pressures. A rational, systematic approach to evaluate managed care firms is presented in this article. Additional criteria will have to be added as new ideas for managed care evolve. Physicians and practices must make decisions concerning the level of their participation, depending on a variety of factors, some more sensible than others.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The first formal physician assistant (PA) program began at Duke University 25 years ago, write David M.S., and Kenneth Harbert, M.H.A., PA-C. Since then, PAs have become widely utilized in the medical field, yet little has been done to measure their financial contribution. The authors provide a methodology and framework for groups to measure the financial productivity of their PAs.
This notice describes the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program beginning October 1, 1994. The results of these evaluations are considered whenever HCFA enters into, renews, or terminates an intermediary agreement or carrier contract or takes other contract actions (for example, assigning or reassigning providers of services to an intermediary or designating regional or national intermediaries). This notice is published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act. We are publishing for public comment in the Federal Register those criteria and standards against which we evaluate intermediaries and carriers.
This mailed survey was a follow-up to a 1989 study to assess the status of pharmacy-directed, drug-related, patient care programs in response to the Pharmaceutical Inquiry of Ontario (Lowy Inquiry). A specific focus on Therapeutic Interventions and Drug Utilization Review/Evaluation Programs was adopted because the earlier study indicated a significant "financial return" for pharmacist time spent on these initiatives. A response rate of 62.2% (89 out of 143 hospitals) was achieved compared with an 80% response rate in 1989. Therapeutic interventions were performed by 97.7% of hospitals which identified an average of 184 therapeutic interventions per month and an 84.3% acceptance rate by prescriber. Based on data from 53 hospitals, an average of 29 minutes was taken on each intervention and financial data from 10 hospitals showed cost savings/avoidance of $49.34 per intervention. Drug Utilization program data was available from 45% of hospitals and specific financial data was provided by 29.2% of institutions. Cost savings/avoidance data demonstrated a return of $29.99 for every dollar invested in pharmacist time performing these activities. Collectively, both programs were recognized for their value in optimizing pharmacotherapy, improving patient outcomes as well as demonstrating a financial return to the institution. Despite the recessionary times, these programs are easily justified since they more than pay their own way.
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Jean Sylvestre, Ph.D., and Frank Urbancic, D.B.A., CPA, of the University of South Alabama, write that because of the financial challenges for health care, cash flow problems can arise. They offer techniques for interpreting and evaluating cash flow information as a means to more effective decision making.
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