Physician – Hospital Integration: Strong Governance Model Key To Long-Term Success

During the course of an integration negotiation, both hospital executives and physicians focus much of their attention on financial matters, and perhaps rightfully so.  However, a strong governance model may be the key to the long-term success of the relationship.   Many integrated physicians will often point to governance, and not compensation, as the reason why their arrangement ultimately succeeded or failed.  Not surprisingly, most physicians are concerned that they will lose practice autonomy following an integration, so certain aspects of practice op

An Attempt to Make Audits Less Burdensome for Hospitals

“House members look to ease Medicare audit burden on hospitals” is the title of a recent post by Pete Kasperowicz in his The Hill’s Floor Action Blog.  Last week, four House of Representatives members introduced bill H.R.

Two “Pay-For-Performance” Provisions of the Affordable Care Act Go Into Effect Oct. 1, 2012

Two major but less discussed programs under the Affordable Care Act took effect October 1, 2012, which are part of the government’s effort to deliver better quality health care.  Both programs aim to reward hospitals for providing more efficient and higher quality care and penalize those that don’t.

CMS Releases Three-Day Payment Window FAQs

On July 9, 2012, the Centers for Medicare and Medicaid Services (“CMS”) posted 43 frequently asked questions (“FAQs”) addressing various issues concerning the 3-day Payment Window Rule (the “Rule”).  As background, the Rule applies to outpatient services furnished (1) by a hospital or (2) by another Part B supplier (referred to herein as a “Physician Practice”) that is wholly-owned or operated by a hospital.  Under the Rule, the admitting hospital must bundle the technical component of all outpatient diagnostic services and related non-diagnostic services with t

10 Leadership Lessons Taken From IBM (Part 1)

For 20 years beginning in the 1960s, IBM was king of its universe: the mainframe computer.  Then came along such interesting start-ups as Microsoft, Intel and Dell and, as personal computers became more powerful, IBM’s mainframe business could no longer support the company.  Like healthcare providers today, IBM had the choice of transforming itself or going the way of the dinosaurs.