HFMA Session to Explore Financial Mgmt./Reimbursement Challenges

Health care chief financial officers know how to set up contracts and manage finances of the organization under current reimbursement arrangements, but emerging reimbursement arrangements bring challenges.


Health care chief financial officers know how to set up contracts and manage finances of the organization under current reimbursement arrangements, but emerging reimbursement arrangements such as bundled payments and accountable care organizations that emphasize the coordination and quality of care bring new challenges, says Dan Marino, president and CEO at Health Directions LLC, an Oak Brook Terrace, Ill.-based consultancy.

For instance, CFOs now need to look at 30-day readmission rates and gain expertise in financially tracking, and analyzing quality indicators and appropriately contracting with payers. A payer may offer a 5 percent bonus on reimbursements for reducing readmission rates. But how does a CFO know if 5 percent is appropriate?

At a session during the Healthcare Financial Management Association’s National Institute,  June 24-27 in Las Vegas, Marino will walk through the new financial management and reimbursement challenges, metric reports to track and manage, and other issues such as clinical integration initiatives.

For example, diabetic patients go to the emergency department because of poor disease management “so, as a CFO, you want to be able to track what those costs are and how to develop diabetes management programs, and then contract preferred rates with payers,” Marino says.

In essence, the 3.5-hour session at 8:00 a.m. on June 24, “Best Practices for Designing Accountable Care Financial Systems,” is an extensive ACO 101 course for CFOs, he says. “The change in health care is inevitable, and CFOs and organizations that begin to proactively manage the change process will be in a much better position to financially sustain and improve going forward.”

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