The Best Things in IT Are "Free": Making the Most of an Information Technology Donation (Late Fall 2007)

For community physicians, buying an electronic health record (EHR) system can be overwhelming in terms of both cost and management of the implementation process, the end result of which is that most have not yet taken the plunge. However, as a result of new legislation enacted in October 2006, hospitals have the opportunity to help alleviate these worries. This issue of Insight addresses key tenets of an effective EHR business planning process and strategy. A management overview, rather than a legal opinion of the regulations, can be found in the “Quick Reference Guide: Stark Law Exception and Anti-Kickback Statute Safe Harbor.”  Quick Reference Guide

Focus Your Efforts By Developing a Strategic Theme (Fall 2007)

Organizations are improving their ability to link the financial feasibility and financial impact of strategic options to their overall strategy. However, this increased focus on financial analysis often regresses into the evaluation of independent initiatives and the financial return that each initiative can provide. This issue of Insight presents the development of a strategic theme during strategy formulation to ensure that the initiatives identified at the final stage match up with the strategic vision determined earlier in the planning process.

Community-Based Medical Schools: Challenges and Opportunies in a Class of Their Own (Summer 2007)

In 1960, there were 85 medical schools in the United States. In response to the demand for medical education and physician shortage, the next two decades saw a rapid expansion of these institutions, fueled mostly by the creation of public, community-based medical schools. In a relatively short period of time, these 18 community based medical schools have collectively established a national reputation of providing premier medical education and training, particularly to instate residents. Further, their practice plans have gained a reputation for offering high quality healthcare services to a broad patient base in their communities without regard to socioeconomics. This issue of Insight addresses the opportunities, challenges and realities faced by these schools to grow programmatically across all three components of their mission – academics, patient care, and research.

Organizational and Governance Structure for Employed Physician Networks (February 2008)

As hospitals continue to expand their employed physician networks, hospitals are increasingly turning their attention to designing organizational and governance structures that support the growing networks and foster physician leadership. Recently, ECG held a panel discussion with health system executives (with strong backgrounds in building employed physician networks) to review the challenges in designing effective organizational and governance structures, and strategies deployed to overcome these challenges. This executive briefing summarizes the variety of organizational and governance structure tactics discussed at this forum..

Preparing Your Medical Group for the 2008 Medicare Physician Fee Schedule Changes (December 2007)

The U.S. Senate Committee on Finance has stepped in and stopped a scheduled 10.1 percent price reduction in the 2008 Medicare Physician Fee Schedule (PFS). However, Medicare reimbursement has failed in each of the past 5 years to keep up with the cost of doing business as measured by the Medicare Economic Index (MEI). This 0.5 percent increase represents a temporary patch and delays the work that federal lawmakers must undertake to achieve a long-term solution to this annually recurring problem. This Executive Briefing offers our thoughts on the impact, implications and possible actions for medical groups to take in light of these changes.

Managing Basic Science Departments in a Changing Environment (December 2007)

Various external and internal factors are creating financial and organizational stress on basic science departments and are compelling school of medicine (SOM) leadership to focus more of management’s attention on these entities. This Executive Briefing describes key environmental pressures on basic sciences and offers specific analyses and initiatives for SOMs to consider in supporting the continued success and contributions of these departments and programs.

Beyond Key Financial Indicators:  A More Comprehensive Look at Improving Your Professional Fee Revenue Cycle (November 2007)

There are clear benefits to using a comparison of your organization’s financial performance to industry standards to identify improvement opportunities. However, to elevate the performance of the professional fee revenue cycle, a more comprehensive assessment of your organizational and operational structure is required. This article discusses the key components to review beyond typical financial indicators to better understand the improvement opportunities for optimized cash flows through streamlined operations and organizational enhancements.

Five Critical Elements to Successfully Developing Your Community Cancer Center (November 2007)

Not long ago, a diagnosis of cancer sent patients packing their bags for comprehensive cancer centers such as M. D. Anderson Cancer Center. Today, however, patients are often able to receive cutting-edge cancer therapies in more convenient settings closer to home. Community cancer centers make clinical and financial sense, with as much as 15 percent of a hospital’s profits coming from oncology services. As a result, many community hospitals are considering developing a cancer center which requires high-quality services in a coordinated, patient-centered environment. This Executive Briefing provides a synopsis of five critical success factors for developing a community cancer center.

Physician Activity Study: Identifying Opportunities to Improve Efficiency Using an Electronic Health Record (November 2007)

While information about the benefits and drawbacks of electronic health records (EHRs) has been published, very few studies illuminate the level of inefficiency in paper-based physician practices. In a recent engagement, ECG Management Consultants, Inc., measured the efficiency of physicians in both paper- and EHR-based environments to clearly understand opportunities and trade-offs of each system. ECG then developed strategies to dramatically reflect the efficiencies gained within an EHR-based environment.

Optimizing Community Electronic Health Record Implementation Opportunities (November 2007)

Given the Stark law relaxation and Anti-Kickback Statute (AKS) exception, health systems are increasingly evaluating opportunities to provide electronic health records (EHRs) to community physicians in conjunction with implementing the system in owned or affiliated practices. However, without careful planning, resource utilization may not be optimal and could result in higher than anticipated costs. In this briefing, we highlight a project that addressed determining the required staffing for implementing an EHR to community practices (as well as owned). The project further provided approaches to optimizing implementation and a tool that allows organizations to quickly model this information for use in making strategic and business decisions.

Navigating the Fiercely Competitive Outpatient Surgery Market in Light of the New Payment System (November 2007)

The Centers for Medicare & Medicaid Services’ (CMS’s) long anticipated final rule to change Medicare’s ambulatory surgery center (ASC) payment system will profoundly alter how and how much Medicare pays ASCs. Once implemented, the new system is expected to shift new cases to the ASC setting and broaden the procedure mix of many single-specialty ASCs. This executive briefing summarizes the key aspects of the new payment system and highlights strategies to help hospitals navigate the outpatient surgery market.

Solutions to Emergency Department Call Coverage Issues:  The Office of Inspector General Provides Hospitals With its First Guidance to Payment Solutions (October 2007)

Advisory Opinion 07-10, issued in September by the Office of Inspector General (OIG), provides hospitals with new insight and guidance into this critical issue.  As the consulting firm providing fair market value (FMV) justification of the arrangement detailed in the OIG advisory opinion, we have developed this executive briefing to outline the implications for administrators in structuring these arrangements and justifying them from an FMV perspective.