Posts Tagged ‘finance’

And one more thing . . .

August 12th, 2010

These blog posts are supposed to be directed toward creating healing hospitals. That objective seems to be compromised from time to time as I post genuine opportunities for hospital CFO’s and CEO’s to trim monies from their budgets, to find money that their hospitals should have received, or to initiate new ventures that will create additional, positive economic yields for their facilities.  I’m sorry, but I just can’t help myself.

One of my “gifts” as a CEO was to always find ways to pay for the challenges that we faced so that new ideas, new modalities and  new healing techniques could be introduced to our healthcare environmentI even wrote a book about it. Interestingly, the biggest push back that I experience when presenting to my former peers is that bottom line, no nonsense question: “How the heck are we supposed to pay for this stuff?”

The Benefits of Healing Hospitals

View more presentations from Nick Jacobs.

Over the years I’ve prepared charts, graphs, and narratives demonstrating the dramatic growth patterns, the huge economic surpluses, the wonderful bottom lines that were generated by embracing a “healing” philosophy, but those of you who have been lured by “snake oil salesmen” in your past lives are very leary that my passionate dialogue is simply that, dialogue. You have  no  reason to believe me when I say that improving your employee morale will improve your patient satisfaction scores. Of course it’s common sense, but if you’re too nice to your employees, they’ll think you’re a push over and they’ll take advantage of you, right?  Well, after 22 years of niceness, the one thing I can tell you is that niceness can be confused with weakness, and that needs clarification early on in your journey.

You see, my recent devotion to the economics of healthcare was prompted by the knowledge that you will be treating much larger quantities of patients for less reimbursement. Consequently, new streams of funding will be imperative. For example, the annual amount of discretionary healthcare dollars spent on integrative and holistic medicine is well into the double-digit billions of dollars.  Logic would tell you that at least a percentage of these dollars could be spent at your facilities.  The downside is that your patients have not been used to paying cash for anything except co-pays, but the reality is that “they will pay,” if the service is meaningful, helpful, and healing; money simply becomes a way to get them there.

Wellness Wheel - Image credit: Marquette UniversityIf you, however, don’t believe that massage is good for you, don’t believe that some people respond well to acupuncture or Reiki, don’t care that aroma therapy, floral essences, or pet, music and humor therapy have a place in “legitimate medicine,” that’s a problem, a personal problem.  Go on vacation to some place like Canyon Ranch, and let go for a few days.  Allow yourself to be open to new modalities.  The body and mind can work extremely well together . . . if you’ll just give them a chance.  More importantly, you can generate additional funds for your facilities that will result in additional growth in market share, in patient loyalty, and in patient and employee  satisfaction.

So, this week’s tip . . . financial transaction services: Over 1/4 of your facilities daily financial transactions are completed electronically.  We are currently providing the interface for your financial transactions that will reduce your costs of doing electronic business exponentially.  It is seamless, requires no interruption of your current banking relationships, and invisible to the patients and your staff, but why, for example, would you pay 4.5% if you could complete the same transaction for 2.5%?  It’s savings that can contribute to your bottom line to allow you to supplement your staff with those individuals who can add additional depth, healing activities, and peace of mind to your patients’ experiences.

It’s all good.

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Staying Humanly Grounded and Healthcare Reform

December 26th, 2009

Each year I put up the tree and begin to believe that it is magic. The room feels and looks warmer. Often, I’ve considered leaving it up all year as a symbol of joy, love, and happiness, but when I returned home last evening it hit me that it was not the tree as much as it was the carefully wrapped packages beneath it. Once they were gone, the room seemed void of its magic.

It hit me that those packages represented anticipation, love, and sharing in ways that truly touch your soul. Those acts of love represent the essence of that entire experience, price or cost don’t really matter.  It’s the giving.

Healing Hospitals: little girl in hospital bed with caring doctorI try to end every night by reading CarePages from a local children’s hospital website; stories of young children that have many times reached the end of effective treatment and are waiting to meet their destiny decades before their time might have been.  The outpouring of the deep, soulful hurt that their parents, siblings, and grandparents are experiencing from this journey is always profoundly moving to me.  In many of these instances, the only gifts that we have left to give them are our  love and support.  That, however, is not the case for the majority of our fellow men in this country.

It won’t be long until the final product of the healthcare reform effort will appear.  We all know by now that it will be a patchwork quilt of sometimes horrendous compromise.  We can also count on the fact that the negative rhetoric will reach decibel levels typically heard only when standing in close proximity to a jet engine.  The pundits will parade up and down the isles of righteousness, and they will be spouting off their theories regarding what should have happened.  At the end of the day, however, when we approach our bathroom and bedroom mirrors for that last inevitable look, we must all dig into our humanity and ask one very real question: “Will it be better for the uninsured than it had previously?”

As a former hospital CEO, it became evident to me in the first six months of my administrative training that only those without insurance were destroyed by the system.  Only those who were not under Medicaid or an other insurance were hit with the awful burden of paying for everything at the full, retail price.  The fallout was clear.  Due to the risk of having to pay full costs to the hospital, they either were too frightened to go for treatment until it was too late, or they lost what little they had; their homes, their savings, and their possessions.

In a country with such unbelievable abundance, where not just the number but also the quality of the cars, clothes, and even pets that we own are held up as barometers of success, we have often allowed our fellow man to suffer and die for economic reasons.

That fact is no more obvious than at any children’s hospital in Pennsylvania, where you’ll see parents from conservative states where childhood transplantation surgeries were always denied, so as to avoid increased taxes.  You’ll see these parents waiting in line to establish residency here so that they can at least have a chance to save their child’s life.

Healing Hospitals: Mother kisses son in hospital bed

Regardless of your politics, regardless of the dysfunctional (mal-)functioning of our government, in which some of our representatives and senators have taken us to the brink of collapse due to their inability to co-operate; regardless of these issues, we are looking at the beginning of health care reform.  I just pray that we don’t revert to the inhuman practices of our recent past.

It’s time for a human win.

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It’s Been (Quite) a Year…

December 19th, 2009

Last year at this time, as word of the global economic meltdown was beginning to take hold, we saw the beginning of a decline in all aspects of purchasing, including the  optional surgeries and tests in our hospitals.  At the same time, as a member of several volunteer boards, we began to see declines in ticket sales that went as high as 20%.  Later, we met with restaurateurs who indicated that their business was down between 10 and 20%, an amount that proved to be terminal for numerous marginal companies.

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As the year proceeded, we saw  hospitals make extensive cutbacks in employee  education, travel, and marketing.  This trend became the norm in the industry.  The healthcare-related industries that seemed to hurt the most were those involved in construction and new equipment acquisition.  One type of firm that did well was financial consulting groups, like SunStone Consulting, LLC , organizations that specialized in finding money that hospitals had already earned, but had either not been staffed deeply enough to pursue or that did not know the processes necessary to generate these funds.

For those of us in administrative consulting, the year has been interesting.  Decision makers stepped back a little and waited to see where Obamacare was heading, to collect more cash in a society where “cash was definitely king,” and to cut back on new initiatives until things had settled down economically.  These leaders watched the markets, looked at investment activities, counted revenue versus expense results, and generally became more conservative in their leadership approaches.

What’s on the horizon:  There is an old saying that “He who looks into a crystal ball to predict the future will get crystal in his eye,” that is not far from truth.  Are we completely out of the woods?  Not by a long shot.  Will there be additional taxes, additional expenditures that are not budgeted nationally?  Yes, most assuredly, there will be, but are we certainly seeing more positive signs in virtually every economic indicator that would predict at least a somewhat more optimistic overall outlook.

Wall Street Journal: Pointing to renewed signs that the global slump is bottoming out, the International Monetary Fund on Wednesday upgraded its outlook for 2010 while slightly trimming this year’s forecast.

The overleveraged global financial system continues to cast a shadow over the economic outlook, however, and the fund urged policymakers not to become complacent about recent market improvements.

“Financial conditions have improved, as unprecedented policy intervention has reduced the risk of systemic collapse and expectations of economic recovery have risen,” the IMF said in its updating its outlook for the world economy and financial system. “Nonetheless, vulnerabilities remain and complacency…

100_on-iceSo, if we embrace those little rays of hope as a means of restarting the economic engines, if we visualize a better future for all of us, if we focus on the positive, at the very least we most likely will find a better parking space at the Mall!

Happy Holidays and here’s knowing that 2010 will be a better year for everyone.  (It wouldn’t take much!)

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The List

July 25th, 2009

Okay, so if you are in healthcare administration and you have any interest in what’s going on in my world, just take a quick read of this descriptive list of services from various organizations with whom I have become aligned.

healthcare_puzzle450

In terms of creating value for any of you, the first organization that I obviously believe should be on your list is SunStone Consulting.  In order to help explain our work, think of the following list:  Transfer DRGs, Worker’s Comp, Compliance and RAC readiness assessments.  These represent just a few of the professional services in which SunStone specializes for hospitals.

What about the rest of the list?

  1. Virtual elimination of  “accounts receivable.”
  2. The building of software bridges to anywhere.
  3. Expertise in telemedicine delivery.
  4. Business flow software systems, like Legos, that can be added for any business unit.
  5. Research software that delivers, white papers, proteomic and genomic research results, and pharmaceutical tie-ins through its unique search engine.
  6. Marketing research for any occasions.
  7. Business development and lobbying services.
  8. Food services.
  9. Environmental savings and income solutions.
  10. Educational training in all aspects of management expertise.
  11. Biofeedback systems for stress management.
  12. Hazardous waste disposal.
  13. Response systems for data breaches, i.e, notification mailings and call centers.
  14. REIT-type investment and building solutions for expansion projects.
  15. Searches for all executive and executive medical and PhD leadership positions.
  16. HR software to ensure objective  employee evaluations for quality improvement.
  17. 24 hour translation services for hospitals and physician office practices.
  18. Comprehensive  proteomic lab services for sophisticated oncology/cancer testing.
  19. Electronic Medical Records
  20. Physician office billing systems.
  21. Strategic planning expertise for hospital medical staffs.
  22. Physician practice diagnosis and “repair.”
  23. Grant writing and fund raising for all aspects of healthcare: residencies, research, job training, nursing schools, and so much more.

If you need to find funds, are looking to have money returned to you that you have rightfully earned, want to improve your business quality and efficiency, are in need of comprehensive analysis to help you start, improve, or garner maximum profitability from a business unit, or just want to improve your bottom line, follow the money . . .

Check out SunStone Consulting’s Global Solutions, and give me a call.  It’s what we do.  (This was not a paid announcement.  Rather, I just wanted to let you know what I’m up to besides board, administrative, and personal consulting and assistance.)

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Something’s Gotta Give, Something’s Gotta Give, Something’s Gotta Give!

November 1st, 2008

My Facebook friend, Anne Zieger, editor of Fierce Health Finance, wrote a compelling piece the other day regarding the potential demise of hundreds of hospitals. Her prediction is based upon some very valid financial realities, and we are witnessing them locally as well as nationally. Not unlike the little banks in our area that seemed to have been insulated from Wall Street’s collapse, some of these national problems seem to be washing over some of the smaller hospitals with relatively minimal damage. Yes, many of us have seen as much as a 10% decrease in elective, outpatient procedures.

In fact, while visiting a really upscale mall for a photo session with my two year old granddaughter, Lucy, an employee engaged me in a conversation about the rotten economy. About five minutes into the conversation, she indicated that there are currently 150 stores in the chain for which she works, and that only five percent of them made budget last month. Portrait pictures must fall into the category of a luxury as their business is severely impacted by this economy. More directly, however, she indicated that she needed stitches removed the other day, and that, “she did it herself” rather than spend the $20 co-pay.

So, are we seeing decreases in important tests? Are we seeing patients avoiding emergency room visits? Are we seeing patients cutting their prescriptions in half? Yes, to all of these questions. Anne, however, seemed to be talking about the “big boys,” where their millions or billions in investments have recently tanked. If you are so big that your income from running the hospital is not a major source of protection, and your income from your investments is propping you up, then the problems begin to manifest themselves exponentially.

“Some hospitals are responding by digging into their investment income more deeply than usual, using it to finance capital projects, or even meet operational needs. Others are issuing bonds with the scary codicil that they’ll buy them back if finicky investors want to dump them,” states Zieger in her column.

She further goes on to explain that “both of these situations put a huge squeeze on hospitals’ long-term viability. One robs from their long-term assets to solve medium-term problems, while the other puts the hospitals at risk of being bled dry by investors who get spooked.”

Well, wouldn’t ya know? Yes, we are seeing a few challenges due to decreased electives, but not because we were living off of our investments. The other good news is that, because we froze our fixed pensions several years ago, we are seeing very little impact upon them from the huge drop in those investments as well. Unlike many of our larger peers, neither of these issues is similar. Between the drops in the market, the loss of pension funds, the decrease in electives, and the down-grading of their viability by the bond markets, their challenges look galactic in size compared to ours.

Sometimes smaller is just safer.

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