RESUMEN
For many stand-alone hospitals, a merger, partnership, or affiliation may be the only option to access scale and remain viable in the nation's emerging new healthcare delivery system. These organizations can consider many options for affiliation, including traditional options such as affiliation with regional academic medical centers, a merger or takeover to become the corporate member of a large system, and acquisition by a for-profit system. Emerging options include mergers for scale and access to capital, private-equity transactions, and arrangements involving insurance vertical integration.
Asunto(s)
Instituciones Asociadas de Salud , Motivación , Toma de Decisiones en la Organización , Competencia Económica , Instituciones Asociadas de Salud/economía , Instituciones Asociadas de Salud/estadística & datos numéricos , Inversiones en Salud/clasificación , Estados UnidosRESUMEN
Implementing an effective clinical integration program requires deliberate investment of time and resources in five key areas: Physician leadership, Physician-led care management, Quality monitoring, Patient information and data sharing, Payer engagement.
Asunto(s)
Organizaciones Responsables por la Atención , Integración de Sistemas , Gestión de la Información/organización & administración , Reembolso de Seguro de Salud , Liderazgo , Registro Médico Coordinado , Innovación Organizacional , Rol del Médico , Control de Calidad , Estados UnidosRESUMEN
When assessing the financial implications of a physician alignment and clinical integration initiative, a hospital should measure the initiative's potential ROI, perhaps best using a combination of net present value and payback period. The hospital should compare its own historical and projected performance with rating agency median benchmarks for key financial indicators of profitability, debt service, capital and cash flow, and liquidity. The hospital should also consider potential indirect benefits, such as retained outpatient/ancillary revenue, increased inpatient revenue, improved cost control, and improved quality and reporting transparency.
Asunto(s)
Financiación del Capital , Prestación Integrada de Atención de Salud , Economía Hospitalaria/organización & administración , Prestación Integrada de Atención de Salud/economía , Relaciones Médico-Hospital , Estados UnidosRESUMEN
Hospitals contemplating developing an accountable care organization (ACO) will be rewarded for improving quality and reducing waste, but a chief strategic concern is the fear of losing volume. Hospital financial leaders considering an ACO should conduct a detailed financial analysis that examines the net impact of both shared ACO savings and hospital volume changes. A key part of this analysis should be an assessment of the organization's prospects for using the ACO to increase market share.
Asunto(s)
Continuidad de la Atención al Paciente/normas , Prestación Integrada de Atención de Salud , Economía Hospitalaria , Calidad de la Atención de Salud , Prestación Integrada de Atención de Salud/economía , Prestación Integrada de Atención de Salud/organización & administración , Hospitales/estadística & datos numéricos , Estados UnidosRESUMEN
Recent economic challenges have left many independent hospitals and their boards concerned about long-term viability of their organizations as stand-alone facilities. The CFO's role should be to facilitate a candid, objective assessment of the organization's ability to continue to go it alone. Key indicators that should be considered in such an assessment include patient volume, degree of physician alignment, profitability, current debt burden, cash, available capital versus capital requirements, and credit rating changes.
Asunto(s)
Financiación del Capital , Administración Financiera de Hospitales/organización & administración , Recesión Económica , Administradores de Hospital , Rol Profesional , Estados UnidosRESUMEN
Physician employment, professional services agreements (PSAs), and income guarantees are three effective compensation-based strategies hospitals can use to achieve physician-hospital alignment. In choosing one or a combination of these strategies, hospitals should assess the strategic, regulatory, and financial considerations associated with them. Each strategy raises different implementation concerns-for example, employment presents the issue of compensation, PSAs involve greater regulatory constraints, and income guarantees test the long-term loyalty of physicians.
Asunto(s)
Contratos , Relaciones Médico-Hospital , Médicos/economía , Contratos/economía , Estados UnidosRESUMEN
A hospital can acquire a physician-owned facility's assets or buy equity in the facility. The purchase price must fall within the bounds of fair market value. A professional services agreement also must reflect FMV. The purchasing hospital should determine whether the freestanding center should become a hospital outpatient department.