How to reduce the risk of purchasing fraud.

Purchasing fraud leads to significant losses for healthcare entities and damages the reputation of the industry. Designing and implementing an effective internal control environment helps reduce the risk of fraud. An effective control environment includes a variety of policies, procedures, strategies, and tactics.

Picking up the scent: Wave of practice acquisitions by hospitals has antitrust regulators on notice.

With the growing wave of acquisitions of practices by hospitals, antitrust regulators are putting the deals under harsh scrutiny to see if they're just a cover for raising prices rather than coordinating care and improving quality. "If there's an issue, I want to know about it now," says St. Luke's President and CEO Dr. David Pate, whose hospital met such a roadblock. "Let's just see if there are issues. We don't believe that there are."

State systems Advance Planning Document (APD) process. Final rule.

The Advance Planning Document (APD) process governs the procedure by which States obtain approval for Federal financial participation in the cost of acquiring automated data processing equipment and services. This final rule reduces the submission requirements for lower-risk information technology (IT) projects and procurements and increases oversight over higher-risk IT projects and procurements by making technical changes, conforming changes and substantive revisions in the documentation required to be submitted by States, counties, and territories for approval of their Information Technology plans and acquisition documents.

Association Between Medicare's Mandatory Hospital Value-Based Purchasing Program and Cost Inefficiency.

BACKGROUND: The Patient Protection and Affordable Care Act instituted pay-for-performance programs, including Hospital Value-Based Purchasing (HVBP), designed to encourage hospital quality and efficiency. OBJECTIVE AND METHOD: While these programs have been evaluated with respect to their implications for care quality and financial viability, this is the first study to assess the relationship between hospitals' cost inefficiency and their participation in the programs. We estimate a translog specification of a stochastic cost frontier with controls for participation in the HVBP program and clinical and outcome quality for California hospitals for 2012-2015. RESULTS: The program-participation indicators' parameters imply that participants were more cost inefficient than their peers. Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased operating costs. CONCLUSION: The estimated coefficients for the outcome quality variables suggest that future determination of HVBP payment adjustments, which will depend solely on mortality rates as measures of clinical care quality, may not only be aligned with increasing healthcare quality but also reducing healthcare costs.

The Italian market: procurement update.

The procurement process in Italy is becoming more complex and expensive. In a complete overhaul of the system, there are new product classifications and new procedures to adopt.

Legal. Sharing the risk.

Negotiating IT contracts isn't for the faint of heart. Increasingly, hospitals are demanding that vendors share some of the financial and legal risk in case of product failure or an error.

Hospital adaptation to risk-bearing: managerial implications of changes in purchaser-provider contracting.

A number of countries have adopted contracting reforms in which hospitals are placed at financial risk. This risk has stimulated a number of adaptive strategies to achieve organizational success. This paper presents a model of six forms of contracting relationships and reviews the adaptation strategies observed in three health systems: the USA, England and the Netherlands. These strategies include service diversification, improved management information systems, the employment of marketing and contract managers, the use of clinical pathways, case management and concurrent/retrospective review of hospital stays, quality management and quality assurance programs, pre-admission authorization, discharge planning, and physician profiling and participation in management. These adaptive strategies have three implications for managers: increased 'partnering', with purchasers, collaboration with medical staff, and assumption of managed care roles. Two groups of institutions are at risk from the changes in hospital contracting: university teaching hospitals and inner-city hospitals serving socially deprived populations. The paper ends with implications for the education of hospital managers and research on hospital management and adaptation to contracting.

Testing of medical electrical and hospital laboratory equipment: DHSS recognition of the BSI Test House, Hemel Hempstead.

A new product must meet an ever-increasing number of requirements to be acceptable for the consumer, whether the product is to be marketed within the country of manufacture or exported. The requirements often vary between the consumers and between countries. The paper discusses the formalised requirements for medical electrical and hospital laboratory equipment. The British Standards Institution's Test House has recently been formally recognised by the Department of Health & Social Security for testing such equipment to HTM8 and ESCHLE.

Final notice regarding section 602 of the Veterans Health Care Act of 1992 entity guidelines--PHS. Final notice.

Section 602 of Public Law 102-585, the "Veterans Health Care Act of 1992," enacted section 340B of the Public Health Service Act, "Limitation on Prices of Drugs Purchased by Covered Entities." Section 340B provides that a manufacturer who sells covered outpatient drugs to eligible entities must agree to charge a price that will not exceed the amount determined under a statutory formula. The purpose of this notice is to inform interested parties of final program guidelines regarding eligible covered entities.

VA acquisition regulations: simplified acquisition procedures for health care resources--VA. Proposed rule.

This document proposes to amend the Department of Veterans Affairs Acquisition Regulations (VAAR) to establish simplified procedures for the competitive acquisition of healthcare resources, consisting of commercial services or the use of medical equipment or space, pursuant to 38 U.S.C. 8151-8153. Presently, the VAAR does not contain simplified procedures. In the absence of such procedures, the Department of Veterans Affairs (VA) follows the Federal Acquisition Regulation (FAR) and the current VAAR. Public Law 104-262, the Veterans' Health Care Eligibility Reform Act of 1996, authorized VA to prescribe simplified procedures for the procurement of health-care resources. This proposed rule prescribes those procedures.

What are the vendor's responsibilities in the purchase agreement?

Often, when buying computer software, computer hardware, or communications equipment, the vendor develops the contractual agreement concerning purchase, licensing, and maintenance. And often, this agreement falls short of the buyer's expectations. Therefore, it is important to understand what responsibilities should be required of the vendor, so as to negotiate a purchase contract that fits the buyer's needs and assures the purchase of equipment in good working condition.