HFMA’s Annual Conference kicked off June 22 in Denver with a major industry announcement, and over the next three days, the event featured timely news, guidance and best practices for healthcare finance professionals. Here is a sampling of the content offerings from the 80+ sessions at the conference.
HFMA announces new tool to quantify the performance of the healthcare industry
HFMA is formally taking the lead in providing the healthcare industry with true measurements of the system’s capacity to meet present and future demand, C. Ann Jordan, JD, president and CEO, announced June 22 during the kickoff session of the Annual Conference.
Jordan described the launch of the U.S. Healthcare Vitals Tracker, which “creates a common starting point for a context of a national dialogue on rising costs and underwhelming outcomes compared to fellow developed countries.”
The Tracker is a composite index consisting of indicators in two main areas: national health affordability and functional longevity. Each area consists of underlying measures and sub-measures that reflect recognized and validated metrics such as infant mortality, consumer price index, food quality and unemployment rates.
Specific weighted sums are assigned to each category based on expert feedback, and the sums are rolled up into the two main areas for comparative correlation and to create a cumulative annual score.
By itself, the Tracker does not offer solutions to systemic problems. Rather, it is one component of a new HFMA strategic business initiative called Vitalic Health, which is dedicated to the pursuit of financial sustainability and better healthcare outcomes through solve-based convening.
The Tracker and upcoming Vitalic Health initiatives have never been more needed, Jordan said, given deepening financial strain across the industry and an increasing expectation “to understand the real levers of affordability and outcomes. Not just unit cost, but cost of care. Not just clinical metrics, but community well-being.”
Leadership panel: Why health systems aren’t going anywhere
Traditional hospital organizations will remain central to the U.S. healthcare system, but they must evolve to meet new demands, industry executives said as part of a panel discussion during the June 22 general session.
New approaches are needed to overcome daunting challenges posed by high costs, labor shortages, demographic shifts and inadequate government payment rates. Systems must lead in improving care integration and coordination, and they must take responsibility for the total cost of care, panelists said during the discussion, which was moderated by C. Ann Jordan, JD, president and CEO of HFMA.
“I don’t view the disruption that’s coming as replacing health systems, but they certainly will not look exactly the same,” said Marcus Whitney, founder and managing partner of the healthcare venture capital firm Jumpstart Nova and Secretary-Treasurer for HFMA’s Board of Directors.
“If we’re going to figure out this cost issue, this access issue, this labor availability issue, this employer cost issue, [health systems] can’t look exactly the same,” Whitney said. “But I have complete trust in the leaders on this stage and in the audience to navigate us to where we need to go five and 10 and 15 years from now.”
Dan Liljenquist, senior vice president and chief strategy officer with Intermountain Health, said acute care needs are too substantial to imagine hospitals and health systems fading away or undergoing radical changes.
“I do think you’re going to see dramatic changes in how we handle end of life,” Liljenquist said. “We have to [have] those conversations.”
A look at issues surrounding Medicaid state-directed payments
While the potential impact of the reconciliation bill on Medicaid state-directed payments (SDPs) has generated attention in healthcare circles (see the lead news brief on page 14), other concerns about the payments are less familiar.
In a presentation June 23, two subject matter experts with LS Point and an executive with the for-profit health system Universal Health Services noted that even without the reconciliation bill, key regulatory changes loom for SDPs. For example, CMS will require SDPs to be included in base capitation rates starting in 2028-29, eliminating separate payment terms.
That has a downside for providers.
“The protection that a lot of you providers are used to where you say, ‘Great, I paid my tax or my [intergovernmental transfer] to get a $100 payment. The plan isn’t eating off of that.’ That’s no more,” said Jaret Kanarek, partner with LS Point. “And now that becomes at-risk.”
Even before any changes take place, the boost from 2024 regulations that set the average commercial rate (ACR) as the limit for SDPs may not be felt uniformly. One reason is the lack of consensus on which data sources can be used in determining the ACR in each state.
Integrating bundles with direct contracting
A direct-contracting program at Vanderbilt University Medical Center paid off in lower costs for employers, strong clinical outcomes and substantially higher patient-satisfaction measures, according to a presentation June 24.
The contracts feature bundled prices for nine specialties, among them maternity care, treatment for cardiac arrhythmias, bariatric surgery and treatment for substance-use disorder, said Ruchika Talwar, MD, a medical director with Vanderbilt Health Employer Solutions. Some of the bundles include follow-up care over the span of a full year and all of them waive patient cost-sharing.
The bundles cover 11,000 patients and have lowered employer costs by 16%, Talwar said. The maternity bundle saved $1 million in NICU costs and reduced C-section rates by 25%.
She added that the net promoter score for the bundles is 83, while across healthcare, the average is 46.
“That really hammers home the patient experience that is central to this program,” Talwar said.
