Establishing an effective corporate compliance program, then managing and maintaining the program, is a complex and often difficult proposition for the traditional health care provider or health system.  When the health system is part of a “hybrid” organization, those tasks amplify in complexity to connect traditional care delivery to a completely parallel concept business workflow.  While business and health care compliance have underlying principal similarities to ‘always do the right thing’ regardless of the service being delivered, compliance needs for the health care delivery business component can be vastly different from the needs of the business entity.  In some cases, ...

Rural hospitals are closing at a record pace, and many of the reasons why could have been avoided.

By Robert Thorn, MBA, FACHE

Director, Pinnacle Healthcare Consulting

Last week, in Part Five of this six-part series on “we examined Topic #5, Telepharmacy.  This week, in Part Six, we examine Board Education, and how being accountable for care in a community requires the ability to make informed decisions.

Part Six: Board Education

I once had the opportunity to hear a legendary, now since-retired hospital CEO-turned-university professor give a presentation to a group of Critical Access Hospital boards with whom I was working.  Once each ...

Change is frequently difficult; however, without it, progress is stifled.  As part of the Medicare Physician Fee Schedule Final Rule, in 2019 The Centers for Medicare and Medicaid Services (“CMS”) announced significant revisions are coming for reporting physician time and effort as it pertains to office / outpatient Evaluation and Management (“E/M”) visit services.  These changes are tied to the 2018 ‘Patients over Paperwork’ initiative and they bring the biggest shift in documentation and reporting visit services since the early 1990s.  Below we will discuss these changes and how to manage the necessary adjustments.

The COVID-19 public health emergency (“PHE”) took ...

Rural hospitals are closing at a record pace, and many of the reasons why could have been avoided.

By Robert Thorn, MBA, FACHE

Director, Pinnacle Healthcare Consulting

Last week, in Part Four of this six-part series on “Six Things Every Rural Hospital CEO Must Do,” we examined Topic #4, Telehealth.  This week, in Part Five, we will look at Telepharmacy and how it can become a routine and relied-upon part of rural healthcare.

Part Five: Telepharmacy

As I travel to rural communities and learn more about how they operate, one constant challenge I see is related to in-house pharmacies for Critical Access Hospitals ...

Rural hospitals are closing at a record pace, and many of the reasons why could have been avoided.

By Robert Thorn, MBA, FACHE

Director, Pinnacle Healthcare Consulting

Last week, in Part Three of this six-part series on “Six Things Every Rural Hospital CEO Must Do,” we examined Topic #3, Strategic Planning.  This week, in Part Four, we will look at Telehealth, how it has become more commonplace due to the COVID-19 pandemic, and how it can remain a routine and relied-upon part of rural healthcare.

Part Four: Telehealth

With the introduction of COVID-19 into our world, providers have been scrambling to develop ...

PHC December 2020 – January 2021 Real Estate Practice Newsletter

By Allison Carty, JD, MBA

Director, Pinnacle Healthcare Consulting

Medicare Physician Fee Schedule Changes – What Now?

An Introduction…

As many in healthcare have been tracking, the Centers for Medicare & Medicaid Services (“CMS”) released the calendar year 2021 Medicare Physician Fee Schedule (“MPFS”) which contained key changes to evaluation and management (“E&M”) coding and documentation requirements.  These changes will have substantial compliance, coding and documentation, reimbursement, and compensation plan administration implications, including a notable impact on organizations that compensate physicians on a productivity model.  The question looms: how should organizations respond to the new rule?  How is your organization responding?

Preliminary Observations ...