A new model for care population management.

Steps toward building a population management model of care should include: Identifying the population that would be cared for through a population management initiative. Conducting an actuarial analysis for this population, reviewing historical utilization and cost data and projecting changes in utilization. Investing in data infrastructure that supports the exchange of data among providers and with payers. Determining potential exposure to downside risk and organizational capacity to assume this risk. Experimenting with payment models and care delivery approaches Hiring care coordinators to manage care for high-risk patients.

The value of mobile apps in health care.

Hospitals should keep three considerations in mind when developing a mobile app or tool: Focus on a tool that can help patients determine whether a physician visit is needed. Have finance professionals play a supporting rather than a leading role in the development of in-house mobile health apps. Keep it simple (for instance, by limiting the number of steps patients have to go through to use a mobile app or tool.

Moving from CFO to COO.

Strategies for positioning yourself for the role of COO or chief administrative officer include the following: Learn more than just the financial aspects of running a hospital or health system. Cultivate deep self awareness of your attributes as a leader. Find ways to accelerate innovation in your organization. Take a fresh look at issues that are continuing challenges for your organization.

Finding your organization's sweet spots for cost management.

Healthcare executives from three leading organizations offer these tips for driving sustainable improvements in value: Focus on fewer initiatives, execute them, make sure that the results are sustainable-then move on. Ensure that both clinical and operational experts take part in discussions on ways to improve value through care redesign and reengineering of processes throughout the organization. Zero in on the elimination of adverse events through evidence-based care for quick wins related to quality and cost.

A new road map for healthcare business success.

Action steps hospitals should take to prepare their organizations for a changing business development environment include: Developing a comprehensive forecast of the ways in which reform and market forces will affect patient volumes and service line demand. Aligning with physicians and other care entities in a tightly integrated way. Heightening transparency related to quality and cost. Investing in marketing and social media to strengthen the organization's market position.

Innovative approaches to cost containment.

Cost savings lessons learned by the hospitals featured include the following: Build diverse work teams to foster fresh ideas for improvement. Trust in the ability of staff to respond to an organization's challenges. Establish accountability for sustaining savings. Provide talking points for leaders to use in explaining initiatives. Support physicians during and after vendor negotiations. Respect the passions of all team members involved.

The value equation.

Effective approaches for increasing the value of care and services provided include the following: Developing a clinical quality value analysis model to help determine areas where expenses could be reduced while supporting high-quality, cost-effective care. Predicting what health care will look like 10 years from now and developing strategies that will position the organization to meet the challenges ahead. Integrating with physicians to improve the quality and efficiency of care.

Community benefit strategies for a changing economy.

Community benefit leaders offer these suggestions for meeting the healthcare needs of those most at risk: Review utilization data to assess the greatest areas of need in your community. Engage physicians and clinicians in determining how best to meet community health needs. Establish the business case for the program, both in terms of the value for the community and the reduction in healthcare delivery costs, where possible. Collaborate with other organizations.

Increasing ambient operating theatre temperature and wrapping in polyethylene improves admission temperature in premature infants.

AIM: To improve admission temperatures of preterm infants < or =31 weeks gestation by increasing the ambient temperature in the operating theatre and wrapping in polyethylene wrap at caesarean section. METHODS: A review of admission temperature of infants with gestational age < or =31 weeks from January 2000 to July 2002 was performed. Between October 2002 and 2003 the ambient operating theatre temperature was increased to 26-28 degrees C for deliveries < or =27 weeks gestation and to 25 degrees C for deliveries > or =28 weeks gestation. From September 2004 to December 2005 the ambient theatre temperature was increased along with wrapping infants in polyethylene. A clinical audit cycle review of admission temperatures and early morbidity and mortality was undertaken. RESULTS: 156 premature infants were included, 42 <28 weeks and 114 28-31 weeks gestation. The mean admission temperature in <28 weeks infants prior to intervention was 35.3 degrees C, after increasing ambient theatre temperature 35.9 degrees C, and after increasing ambient temperature and using polyethylene wrap 37.0 degrees C (P < 0.0001). For infants 28-31 weeks the mean admission temperatures in the three epochs were 36.3 degrees C, 36.5 degrees C and 36.6 degrees C, respectively (P = 0.002). There was no statistically significant difference in: total days of ventilation or oxygen, definite necrotising enterocolitis, intraventricular haemorrhage grade 3 or 4 or survival. CONCLUSIONS: Increasing the ambient temperature in the operating theatre and wrapping premature infants in polyethylene wrap improves admission temperature. Further studies are required to determine whether these interventions are associated with improved outcome in the premature neonate.

A team approach to cost containment.

Strategies for involving clinicians in efforts to reduce labor and supply chain expenses include: Working with nurse managers to develop an operations or productivity report that is truly useful. Establishing biweekly reporting of labor utilization per unit. Adding clinicians to your materials management and finance teams. Helping physicians understand the cost profiles of the products they are using and their impact on cost of care. Being patient while securing buy-in.

Schedule H: what hospitals should do to prepare.

Steps hospitals should take now to prepare for Schedule H include: Form a multidisciplinary group to address how to meet the reporting requirements. Review programs currently counted as community benefit, to ensure they meet IRS standards. Collect community benefit data in "real time." Sharpen charity care policies. Consider the use of IT to facilitate charity care decisions and community benefit data collection. Use tax year 2008 as a dry run.

Communicating the cost of care.

Suggestions for implementing a price transparency initiative include: *Comparing the automated results with manual estimates before going live; *Tracking variances between estimates and actual out-of-pocket costs; *Getting senior leaders on board; *Partnering with a vendor for technology needs; *Approaching the initiative from the consumer's perspective; *Soliciting feedback from consumers.

The art of customer service.

Strategies for improving the consumer service skills of finance staff include: Hire employees who have a customer service background. Work with your human resources department to provide customer service training. Monitor new hires extensively. Offer front-end employees scripted language for situations they may face on the job. Measure the quality of customer service provided. Provide incentives for performance.

Making a difference.

Mary Beth Briscoe believes healthcare finance professionals are in a unique position to make a positive impact on the world around them. As HFMA's new chairman, she's encouraging members to use their talents for the good of their organizations, their communities, and their profession.