Who could have ever guessed that the United States of America would fall so far behind in education, childhood death statistics, scientific research, manufacturing jobs, and even overall, general healthcare? Yes, of course, we are still a wonderful, strong country with incredible resources, but somewhere along the line, the train seems to have jumped off the track just a little, or is that like being a little pregnant? No one would ever have conceived that a spark plug would be worth more than GM stock, but that’s exactly what happened last year. Or how about the fact that large investment banks responding to the mandate to increase home sales by spreading the risk internationally could have helped put this entire world on the verge of a national depression?
For years now I’ve written about the need to provide some type of safety valve for the uninsured, underinsured, and those struggling to make it from layoff at age 58 to Medicare at age 65. Not unlike the Kennedy-Katzenbaum bill, (you know, that HIPAA bill that was just meant to provide health insurance portability), we have healthcare reform legislation. The really challenging thing about this new bill is that it was primarily written by policy wonks fifty percent of whom will not be working in Washington D.C. in a few years, and worse than that, it will be interpreted by policy wonk lifers who will be there long after we are all dead.
So, the “Healthcare Oil Spill” has been addressed. What will it mean? What does it mean? How will it impact all of us? That remains to be seen. The good news is that 30 million more people will finally have a safety net. The bad news is that there are still two wars going on that are draining our treasury. There is still financial chaos among the countries lovingly referred to by the EU as the PIIGS (Portugal, Ireland, Italy, Greece, and Spain), and, along with this group, spending in the United States has been out of control for at least nine years.
What will happen is anyone’s guess. How things will be interpreted is anyone’s guess. How the law will be enforced is every one’s guess, but in a recent round table discussion at the Mid-State HFMA meeting, we heard four CFOs discuss the challenges that they currently face and will continue to face as life becomes even more complex. After that session, I’m thinking that lots of mud pushed in the head of the well might just be the cure! Goodness knows there was enough mud thrown around during this last election cycle. Maybe we could redirect it back to the source? I do know for sure that one thing is clear: CHANGE is INEVITABLE, the train is back on the track, and it’s coming straight toward our physicians, hospitals, and nursing homes.
How do we cope with that change? Make sure that every ounce of fat is cut from the system. Take a look at the list below and contact SunStone Consulting for the next steps:
- Charge Process (CDM)
- Documentation Accuracy Program
- Inpatient Coding and Compliance
- Outpatient Claim Analysis
- Pharmacy Revenue Cycle
- RAC Assessment
- Reimbursement & Financial Analysis
- Revenue Cycle
- Transfer MS-DRG Review
- Workers’ Compensation Recovery
- Employee Health Insurance Advocacy