Release of information: are hospitals taking a hit?

Outsourcing release-of-information requests helps hospitals alleviate administrative and compliance burdens and expense. Recently, state lawmakers have begun to draft legislation reducing the maximum fee that may be charged for copies of electronically stored records. The reduced fees may not cover expenses. If such legislation makes it difficult for outsourcing companies to make a profit from this service, hospitals ultimately could bear the expense and risk.

Institutional responses to Medicare's prospective payment system.

The introduction of Medicare's prospective payment system (PPS) meant an important change in the environment of US hospitals. The new payment system was expected to improve clinical and non-clinical efficiency in hospitals. A case study in a non-profit Pennsylvania hospital was performed to analyse the impact of PPS on hospital services. The hospital responded to PPS by a twofold strategy. First, attempts were made to achieve effective cost containment by improving the efficiency of intermediate and final outputs. Here special attention is paid to the activities of the DRG coordinator and the Utilization Review Committee and to the activities of nurses in their role as case manager. The second strategy was directed at revenue enhancement, initially mainly by shifting more costs to non-Medicare patients and later by trying to strengthen the position of the hospital in the local health care market. This second strategy was considered more important than the strategy of cost containment. With respect to organizational structure and policy-making, the following changes can be observed: a growing importance of strategic management; more integrated hospital-physician relationships; and the development of an adequate medical information system and a medical records department.

Enhancing hospital cash flow through improved medical records processing.

This article reviews a team-based effort to improve the performance of a key business process at Christ Hospital in Cincinnati. The quality improvement team reduced the time required to complete medical records following patient discharge. This effort had a major impact on the hospital's cash flow.

Controlling transcription costs.

Understanding what transcription costs and controlling the costs are two interrelated subjects, yet two very different subjects. Understanding what it costs is critical for your budgeting activity. Controlling the cost is essential for your management effectiveness.

A meeting of the mindsets: chart completion vs. clinical pertinence.

The authors describe their hospital's success in addressing a delinquent record crunch. As a result of its program, the hospital reduced accounts receivable by 45 percent.

When health information and fiscal management meet.

HIM professionals have skills that can allow them to contribute to the bottom line in many ways. The author describes areas where HIM expertise can make a difference in evaluating an organization's fiscal performance through analysis of services driven by health information.

Ten steps to successful chargemaster reviews.

Is your chargemaster current, compliant, and comprehensive? In the age of APCs, healthcare facilities would do well to answer these questions regularly. Here's how an HIM professional can help.

A new approach to chargemaster management.

After examining their charge description master management processes, HIM professionals, in conjunction with clinical and support departments, redesigned and automated several practice aspects. Turnaround times were reduced and end users are happier. Here's how they did it.

How to improve allocation of support service costs.

Better accounting for support service costs at outpatient facilities involves distinguishing between fixed and variable expenses, then creating separate budgets for them. To simplify this step, financial managers can create a surrogate, such as the number of patient visits, to represent service activity. Once this is completed, separated costs are allocated by using criteria that recognize short-term and long-term service use.

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.

Improving the bottom line with imaging technology.

Imaging technology creates efficiencies in medical record processing that can positively affect a hospital's bottom line by improving productivity, reducing labor costs, and generating income through accelerated accounts receivable operations and billable copying and correspondence functions.