Healthcare financial management : journal of the Healthcare Financial Management Association
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Healthc Financ Manage · Nov 1997
Practice management companies improve practices' financial position.
To maintain control over healthcare delivery and financial decisions, as well as increase access to capital markets, some group practices are forming their own physician practice management companies. These companies should be organized to balance the expectations of physicians with the values of capital markets. This organization should include retained earnings, financial reporting in accordance with generally accepted accounting principles (GAAP), predictable earnings and cash flow, physician ownership and leadership, and incentives for high-quality management. Three large, primary care and multispecialty clinics that merged to form a new physician practice management company increased their access to capital markets and improved their overall financial position, which will help them achieve long-term survival.
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Many physician group practices struggle over whether to buy or lease equipment. While purchasing has been the traditional method of acquiring equipment, leasing often can be more cost-effective. Conducting a lease-versus-purchase analysis can help group practices arrive at the most cost-effective decision. Careful consideration of the alternatives can lead to the best use of the group's resources to meet its financial goals.
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Healthc Financ Manage · Jul 1997
Using profiling for cost and quality management in the emergency department.
Overutilization and underutilization of resources are inappropriate and may result in unacceptable quality of care and increased morbidity. Current data are needed to monitor the use of clinical resources and help identify physicians with appropriate cost/quality outcomes and those who may have utilization or quality problems. ⋯ Such a program can be especially valuable in the emergency department of hospitals, where wide variation in practice patterns may occur because of the episodic nature of patient encounters. A reduction in practice variations saves time and increase patient throughput in many cases.
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The federal law pertaining to the creation of the Medical program, USC 42, recognizes the Medicaid beneficiaries sometimes receive healthcare services at facilities outside of their home states. This law, therefore, requires that Medicaid plan provide for the inclusion of out-of-state providers in their programs. ⋯ Healthcare providers can take steps to ensure they receive payment for the services they provide to out-of-state Medicaid patients. These steps include billing for such services properly, investigating additional sources of reimbursement, appealing reimbursement decisions, and participating in bordering states' Medicaid programs as contract providers.