The healthcare industry seems to be in a constant state of flux.

Not only is the doctor patient relationship changing with greater expectation on service and communication, but the way in which Medicare and other government programs assess and reimburse for services has also changed. The federal government has mandated that 30% of all Medicare payments made to hospital would be done using the pay for value model. This represents a sharp change for an industry that has focused primarily on fee for service. According to a recent survey conducted by the Health Information and Management Systems Society (HIMSS) entitled, HIMSS 2016 Cost Accounting Survey reveals the struggle that many providers are facing making the transition. The study consisted of 102 participants in the study representing executives and financial professional from a variety of U.S. based healthcare providers. The work uncovers key findings about both attitudes towards the transition and practical ability to meet deadlines.  To help clients, prospects and others understand key issues uncovered in the study, Hanson & Co has provided a brief summary below.

Survey Trends & Results:

  • Alternative Payment Models – An important survey finding is that many providers have already started the transition to alternative payment models. According to the survey, 45% of participants indicated their organization has started moving away from the fee for service model.

  • State of Readiness – A large portion of this number also indicated they are not comfortable with their organization’s ability or readiness to make the transition to an alternative payment method model. Only 3% indicated their organization was highly prepared to make the transition to a value based payment system in the coming months.

  • Rural v Urban – There was a sharp difference in the willingness of healthcare organizations to adopt an alternative payment method based on whether they serve rural or urban environments. According to the study, 48% of participants serving urban areas where interested in implementing alternative payment methods. This is in contrast to the 31 % of participants serving rural marketing that expressed interest in adopting alternative payment methods.

  • Transitional Tools – Respondents agreed that there needs to be additional tools provided to help them through the transition including; tools to evaluate quality of care, better communication between providers and a clear and specific definition of quality care between types of diseases.

  • Standards – Almost all of the survey participants indicated their organizations are looking to the industry to develop a clear process and consistent approach to managing the exchange of information between providers involved to ensure quality care, pricing, price transparency and cost accounting.

It’s encouraging that many providers have started or are moving towards alternative payment models. However, it’s clear from this study that additional assistance is needed industry-wide to help these companies prepare for and adjust to a new billing process and system. Beyond this, individual doctors should also expect to see a change in the patent care process. Additional communication between providers will become more necessary.

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While the survey report does show encouraging progress, it’s important to remember that when this system is implemented healthcare providers across the country will feel the impact with changed process and systems controls. If you have questions about the study or for assistance with managing your company’s tax, accounting and audit needs, Hanson & Co. is here to help. For additional information please contact us at (303) 388-1010, or click here to contact us. We look forward to speaking with you soon.