Outsourcing and the 44 million dollar question?

Tuesday, January 31st, 2012

Have you heard this yet?

Bronx-Lebanon Hospital owes Alexis Rodriguez, and several hundred other patients, an apology.  It was just “a simple mistake,” of course.  But tell that to Alexis Rodriguez. 

Basically, the billing firm handling invoicing for Bronx-Lebanon Hospital made a data entry error that placed the invoice number in the “Amount Owed” field.  So several hundred patients received bills to the tune of eight digits!

Here’s a link to the full article: “You’re Better – and You Owe $44 Million.”

Now, don’t get me wrong.  I’m not faulting Bronx-Lebanon for outsourcing their billing.  We think outsourcing is one of the smartest things a hospital can do.

But here’s the thing:   The company they chose to trust with invoicing their patients fell short when it to came time to quality review.

And that, my friends, created a mess.

Outsourcing can be a risky business when you don’t hire the best.  Here are some tips to keep in mind if you’re considering outsourcing:

  1. Details, details, details:  In this case, this little faux pas happened because the company Bronx-Lebanon chose to use didn’t pay attention to the details.  It’s vital for a company to pay attention to little details that can make the difference between a job well done and an embarrassing mess. So when you’re considering outsourcing a job to a company, pay attention to little details like what kind of presence they have on social media or how they handle communications such as responses to your e-mails.  These little clues can give you insight into how they may handle your job.
  2. Pricing:  Outsourcing can’t be a matter of finding the lowest bid and running with it.  Who knows how much money Bronx-Lebanon has lost in cleaning up this snafu, but you can bet they’ve lost quite a bit in future earnings just based on a sullied reputation.  And errors like this aren’t the only possibility when you go with the lowest bidder.  Any time corners get cut or quality is sacrificed for price, you run the risk of looking bad, or possibly even running into legal trouble.
  3. Reputation:  You’ve got to be able to trust the company you’re working with to have the same quality standards as you and your facility.  A solid firm you’re going to hire needs to have a strong reputation you can trust.  A history of success you can research and rely on.  I wasn’t able to find much about the company Bronx-Lebanon used for their invoicing.  Maybe that says something.

I know from my own experience, outsourcing has its pros and cons.  So if you’re going to enjoy the benefits and steer clear of the potential hazards, you need to be able to settle on a company with the history and reputation to stand behind their work and keep your name out of the headlines.

Tell me, what guidelines do you follow when hiring a vendor? Any best practices you look for when outsourcing?  What do you do to pay attention to details?  Let me know in the comments.

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What Gives? Hospitals hiring Broke Doctors?

Wednesday, January 25th, 2012

I’m finding a trend going on in health care right now, and I’m trying hard to make sense of it.

Based on this article from Fierce Health Care, hospitals are employing 32% more physicians since just over a decade ago.  They’re basing the numbers on the 2012 version of AHA Hospital Statistics.  Take a look at this:

“Although 55.1 percent of physicians are not employed or under contract with hospitals, the report reveals that 20.3 percent are covered by a group contract, 17.3 percent are directly employed, and 7.2 percent have individual contracts, the article notes.

What’s more, the amount of hospitals employing hospitalists rose from 29.6 percent in 2003 to 59.8 percent in 2010, according to the report. Meanwhile, hospitals’ intensivist employment increased from 20.7 percent to 29.7 percent between 2007 and 2010, H&HN Daily notes.”

Now, generally, I’d say this is really good news.  But the confusion comes in when I see this kind of information reported on CNN.com: Doctors Going Broke.

This article pointed out some more interesting stats, but also some in-depth stories from the front line where private practices are suffering the worst.  Here’s a few snippets from the article:

“”A lot of independent practices are starting to see serious financial issues,” said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.”

And I thought this line really hit the nail on the head:

“Also on his mind, the impending 27.4% Medicare pay cut for doctors. “If that goes through, it will put us under,” he said.”

So there seems to be a disconnect here: doctors are going out of business left and right for a combination of reasons, yet hospitals are hiring on more doctors than they did 12 years ago when profits were far higher.

To succeed with that kind of strategy, the hospital had better be focusing strongly on collecting receivables and containing cost.  Unfortunately, not all of them are.

What do you think about this disconnect?  Are these figures likely to turn around any time soon?  Or is it going to continue?  Let us know in the comments and let’s discuss!

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Michele Bachmann’s Crusade against Obamacare

Thursday, January 5th, 2012

Michelle Bachmann’s Crusade against ObamaCareIn the last two days, Michele Bachmann, Minnesota Congresswoman bowed out of the Presidential race to focus specifically on a campaign to partner with Congressman Steve King and signed his  “Repeal ObamaCare” pledge.

After signing the health-care pledge  and her appearance on Tuesday with King, Bachmann launched into what was essentially her final closing argument of the six-month caucus campaign that will make or break her candidacy.  Bachmann ended her campaign to become the 2012 Republican presidential nominee on Wednesday.

See Jason Noble’s post here:  Michele Bachmann stands with Steve King; delivers final closing argument

As well, see this post by John Connor:  Obamacare’s Terrible, Horrible, No Good, Very Bad Year

The questions that come to my mind are:

  • Is Michelle Bachmann going to lead healthcare into more limbo?
  • Is it worth scrapping Obamacare to be replaced with a lack of direction on healthcare and how to improve it?
  • What is it going to take to get real direction on this issue?

What are your thoughts?

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