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What will be some of the pressing issues in the healthcare sector that will impact financial administrators in 2013? There’s a lot to choose from, that’s for sure, but a few healthcare experts narrowed the options down during a daylong session for members of the Maine chapter of the Healthcare Financial Management Association.
Above all, financial administrators will continue to see a push toward linking reimbursement to cost and quality outcomes said Chad Mulvany, a technical director with HFMA. In order to be successful in this environment, healthcare companies must leverage performance improvement projects, their people and their culture.
[See also: Physician pay to be tied to quality and cost of care]
Other hot topics Mulvany identified for the coming year include:
- Affordable Care Act-mandated Medicare and Medicaid cuts to hospitals and adjustments to disproportionate share hospital payments.
- Independent Payment Advisory Board (IPAB) continues to be a hot potato. The president, Mulvany said, may find it difficult to name people to the board because so many people dislike the idea of the board.
- Sequestration and the debt ceiling. What lawmakers do in the spring will determine if the sequestration cuts to healthcare programs happen. As for the debt ceiling, Mulvany said to expect that fiscal conservatives will require a debt reduction plan that will include hits to Medicare and Medicaid.
- Doc Fix. Lawmakers want a permanent solution to the sustainable growth rate problem, Mulvany said, but no one can figure out how to pay for it.
- Medicaid expansion in the states.
- Health exchanges. The federal government, Mulvany said, expected most states to want to set up their own exchanges but that’s not what has happened. Now the federal government is faced with a tight deadline and tight financial resources to set them up.
- The employer factor. The day is fast approaching when the employer-sponsored health plan will be a thing of the past, Mulvany said, but in the meantime, employers are focused on keeping healthcare costs down and that means they’ll be structuring incentive plans to encourage their employees to go to healthcare providers that have a record of high quality and reasonable costs.
Finance administrators can expect the Centers for Medicare & Medicaid Services to focus on integration and coordination of pay for performance programs in 2013 said CMS representative Andrew Finnegan.
For healthcare organizations, CMS’ focus means that they will be able, in some cases, to avoid payment cuts in 2015 and 2016, and be eligible for payment incentives.
Another hot topic of concern to financial administrators in 2013, but of more interest to hospital administrators, is an expected final rule from the Internal Revenue Service said E. Drew Cheney, CPA, principal at Baker Newman Noyes. The rule will detail the IRS’ Section 501(r) - additions to the requirements for hospitals to keep their 501(c)(3) status. Cheney said comments have been extensive on the rule, but he had no date for when the final rule will be issued.