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Payment reform will shift home health agency valuation parameters.

Changes authorized by the Balanced Budget Act of 1997 have removed many of the payment benefits that motivated past home health agency acquisition activity and temporarily have slowed the rapid pace of acquisitions of home health agencies. The act required that Medicare's cost-based payment system be replaced with a prospective payment system (PPS) and established an interim payment system to provide a framework for home health agencies to make the transition to the PPS. As a consequence, realistic valuations of home health agencies will be determined primarily by cash flows, with consideration given to operational factors, such as quality of patient care, service territory, and information systems capabilities. The limitations imposed by the change in payment mechanism will cause acquisition interest to shift away from home health agencies with higher utilization and revenue expansion to agencies able to control costs and achieve operating leverage.

Accounts Payable and Receivable↗

Spider diagram helps hospital cut the fat using clinical quality and patient satisfaction data.

A balancing act: When it became apparent that a 900-bed hospital in Detroit needed to cut costs to stay viable, leaders decided making across-the-board cuts would be as dangerous as making no cuts. Instead, they began measuring four different types of indicators on a new service-line basis using a spider diagram to ensure they were balancing the needs of administration, physicians, patients, and the community.

Benchmarking↗

Providers: hold yourself accountable before payers, others do it for you.

Financial performance data: Drilling down into comparative data can help health care providers quickly identify where costs are out of line. See samples of easy-to-read graphs you can adopt for your organization for everything from broad hospital measures to specific physician ordering practices.

Arizona↗

Independent assessment is key to financial well-being.

Both traditional group practices and IPAs have felt the impact of changes brought about by managed care. Group practices need to ensure that their financial reporting and cost-accounting methods capture information that is key to decision making. An independent assessment of financial procedures helps identify any outstanding issues and maintain financial well-being. This assessment should be conducted at least quarterly so that potential problems can be resolved, income opportunities explored, and cost-saving measures adopted in a timely manner.

Accounting↗