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PubMedDate not supplied

Budget variance analysis using RVUs.

This article details the use of the variance analysis as management tool to evaluate the financial health of the practice. A common financial tool for administrators has been a simple calculation measuring the difference between actual financials vs. budget financials. Standard cost accounting provides a methodology known as variance analysis to better understand the actual vs. budgeted financial streams. The standard variance analysis has been modified by applying relative value units (RVUs) as standards for the practice.

Accounting↗
PubMed1999

A look to the future. Home health PPS.

HCFA continues to move toward its goal of implementing a per-episode prospective payment system for home health care. What is in store for agencies, and how can they be prepared for all of the changes that will come when the shift from the current interim payment system to the new model is complete? If they are to thrive, agencies must understand the background behind IPS and PPS and what the future holds.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Proactive performance measures.

Adoption of a process of careful selection and implementation generating the appropriate proactive (leading) performance measures will provide an important tool with which to progress. When used in combination with traditional financial performance measures, proactive performance measures contribute to our cache of competitive weapons.

Benchmarking↗
PubMed1999

Diversification strategy and performance: implications for health services research.

Health care represents a promising area of research due to its uniqueness. In recent years, considerable progress has been made in diversification strategy and performance research but not the study of health services strategy research. This article reviews diversification strategy and performance in health services domains. Adopting Datta, Rajagopalan, and Rasheed's (1991) framework, the authors evaluate the theoretical and empirical contributions of this research. The limitations and theoretical implications of these efforts are also explored.

Financial Audit↗
PubMed1999

Value measurement in health care: a new perspective.

Vital to the success of any healthcare organization is the ability to obtain useful information and feedback about its performance. In particular, healthcare organizations need to begin to understand how non-value-adding work activities detract from their bottom lines. Additionally, financial managers and information systems need to provide data and reports throughout the continuum of care. Overall, healthcare organizations must align the management information and control systems with the planning and decision-making processes. The horizontal information system is a tool to manage three common problems facing today's healthcare managers: (1) the use of existing information to focus on control rather than improve business, (2) failure to focus on satisfying the customer, and (3) failure to combine their efforts with those of the employees by developing trust and a common focus.

Consumer Behavior↗
PubMedDate not supplied

Laboratory end-stage renal disease testing.

The Department of Health and Human Services, Office of Inspector General has incorporated end-stage renal disease (ESRD) into its 1999 Work Plan. Specifically, they will focus on identifying inappropriate Medicare payments for clinical laboratory services and their medical appropriateness. Under Medicare's composite rate reimbursement system, certain laboratory tests at established frequencies are covered under the composite rate. Any additional tests billed that are beyond the established frequencies must be supported by medical necessity. When billing laboratory tests for ESRD patients, it is important to know what tests are covered and at what frequencies under the composite rate. It also is important to understand the use of the 50/50 rule for determining whether automated multichannel tests are billable. This article reviews these details and provides insight into how laboratories should apply these rules when billing for ESRD testing.

Clinical Laboratory Techniques↗
PubMed1999

Securing insurance protection against fraud and abuse liability.

Healthcare organizations concerned about corporate compliance need to review securing appropriate insurance coverage as part of their corporate compliance program. Provider organizations often mistakenly expect that their directors and officers liability (D&O), malpractice, or standard errors and omissions (E&O) insurance policies will cover the cost of Medicare fraud and abuse fines. The insurance industry has developed a specific billing E&O insurance product to cover providers that run afoul of government fraud and abuse statutes.

Fees and Charges↗