As reimbursement moves to value-based models, the need for tracking and monitoring your revenue cycle is critical. Independent advisors can help you collect all of your revenues for the services you work hard to provide. Revenue cycle professionals have many areas of required reporting and compliance to help you optimize the integrity of your revenue cycle.
Medicare/Medicaid Cost Reports and Reimbursement
Your Medicare cost report is more important to the financial success of your organization than you might think. It’s the way Medicare, and for some, Medicaid, determines reimbursement for many services you provide as a critical access hospital. Too often, CAHs simply update last year’s Medicare cost report. Preparing a cost report should involve more than reiterating last year’s filings with this year’s data. Cost reports can also provide insight about opportunities for improvement, like areas of improved compliance and possibilities for increased Medicare or Medicaid reimbursement. Annual assistance with the preparation or review of your Medicare cost report can help you increase your reimbursement, identify possible risks and make you feel more confident about your Medicare/Medicaid reimbursement.
Eide Bailly’s reimbursement specialists understand how important your Medicare cost report is to your financial success. We’ll take time to understand your hospital operations to help ensure proper Medicare/Medicaid reimbursement under cost-based rules. We personalize our service, obtaining quality data and completing your cost report on time—not just in time.
Operational Strategy and Process Improvement
Healthcare organizations are operating in challenging environments—from moving to value-based reimbursement to adapting to new technologies all while cost-cutting reaches diminishing returns. These factors make developing and maintaining a strong operational strategy mission critical.
Business advisors can help you optimize care resources to improve your financial and operational performance to become a market leader and deliver population health to your community. Business advisors can also help establish a sustainable system based on your data to assist your team with identifying opportunities and bringing them to fruition. The easy-to-navigate improvement methodologies are designed for clinics, hospitals, senior living and outpatient facilities.
Capital, Budgeting and Finance Strategy
Any time a healthcare organization is considering a significant change such as new service lines, remodeling or rebuilding, it is crucial to make the right strategic financing decisions. How will you structure the debt? What impact will it have on return on investments? What is the best source of funding? How will it affect your long-term financial viability? By answering these questions to identify sources of capital and credit, strategic financing professionals can help you feel confident in your decisions.
Strategic financing professionals provide the following financial strategy and related services:
- Board education
- Strategic planning facilitation
- Forecasted financial statements
- Pro forma analysis
- Debt capacity studies
- Lease versus purchase analysis
- Departmental budget development and training
- Physician demand modeling
- Market demand studies
Our healthcare team has in-depth experience working with healthcare organizations nationwide to assist them in making the right strategic financing decisions, as well identifying funding sources.
As part of participation in the 340B program, healthcare entities are subject to audits by the Health Resources and Services Administration (HRSA). Should an audit result in corrective action, you may need to repay vendors, change your policies and procedures or be removed from participation in the program.
Eide Bailly understands 340B requirements and the elements of compliance identified by HRSA. Our team reviews all 12 elements of compliance with you to ensure that you maintain eligibility in the program. We provide you with a compliance report to help you prepare for a HRSA audit, as well as recommendations for improvement. In addition, we can be on-site to help you quickly respond to a corrective action plan from a HRSA audit.
Community Health Needs Assessment
In order to maintain tax-exempt status, hospitals exempt under 501(c)(3) are required to conduct a Community Health Needs Assessment (CHNA) every three years. Failure to comply with the CHNA rules can result in $50,000 in excise taxes and potential loss of 501(c)(3) status. The requirements of the process are clearly defined by the IRS and require publicly reporting the findings on tax returns and its website.
While performing a CHNA can be a time-consuming process, it can also provide a hospital with meaningful information about the health issues important to its community members. Working with a professional can help ensure the hospital meets the IRS requirements while benefiting from meaningful interactions with the community.