Health Care Reform Being Negotiated

According to FOX News’ Chad Pergram and Megan Whittemore along with the Associated Press, 52 “Blue Dog” Democrats remain the only barriers to passing a health care reform bill.  This group is known for its fiscally conservative ideology and wants to make sure the bill that is passed solves relevant issues.  Most recently, the Blue Dogs have demanded that the health care reform bill include an affordable government option for small businesses as well as competitive pricing to avoid private insurers going bankrupt. 

Last night, the group met with House Speaker Nancy Pelosi and White House Chief of Staff Rahm Emanuel for almost 7 hours.  Although a compromise has yet to be reached, the two sides remain confident.  Representative Mike Ross (D-Arkansas) is content that with each meeting, progress is made. 

The problem seems to be time and the deadline set by President Obama that has representatives like Jane Harman (D-California) anxious.  She explains that the negotiations have been “very, very hard” and that even though both sides agree of broader areas of concern, such as lowering drug prices, they disagree on “specifics”. 

As polls continue to show declining confidence in Obama’s health care plan, the Blue Dogs have gained leverage and are now able to better negotiate with the rest of Congress.  If the group of 52 disagree with the final proposal and vote against it, it will not pass. 

On Monday, Henry Waxman (D-California), House Energy and Commerce Committee Chairman offered a revised proposal for the group.  However, Blue Dogs have asked for cost specifics that were not immediately available.  It looks as if the bill will not be put to a vote by the deadline that Obama had first given. 

Click here to read the entire article: ‘Blue Dog’ Vote Pivotal in Passage of Health Care Reform Bill

MD Trying to Prevent Nursing Shortage

Washington Post staff reporter, Rick Rojas, recently wrote an article documenting the incredible efforts going on in Maryland to increase the number of nurses as well as nursing educators.  The Maryland Hospital Association plan to give $15.5 million over the next five years to 17 MD nursing schools to increase the number of students they can accept in their programs, which should also increase the number of nurses in the state.  The grant money will be coming from a number of sources, but mainly from healthcare providers, insurers, and individual donors all worrisome over the inevitable nursing shortage. 

The number of patients filling doctors’ offices is growing at an alarming rate in MD.  Catherine Crowley, VP of the Maryland Hospital Association, explains that with life expectancies going up due to more healthy and active citizens, Maryland will need 10,000 more nurses than it currently has in order to meet the needs of patients. 

According to Nancy Fiedler, a spokeswoman for the Maryland Hospital Association, the average age for a nurse in MD is 47, and about 43% of all nurses plan on retiring sometime in the next three years.  Crowley says the problem is further developed when approximately 1,000 qualified nursing school applicants are turned down each year due to inadequate faculty numbers and classroom space. 

Crowley estimates that about 360 more faculty members are needed in MD nursing school programs.  The schools also have to buy upgraded medical technology and new laboratories.  Since the distribution of monies has been announced, Montgomery College, one of the recipients, already has plans in place to invest their piece of the pie into three new laboratories. 

To read the entire Washington Post article, click here: Preventive Medicine for A Shortage Of Nurses

Alternative Funding Options for Small Business Owners

Diana Ransom, a small business reporter for the Wall Street Journal, has some tips for financing your small business.  Business owners are discovering that their typical sources are restricting loans’ credit terms as well as the number of loans they give out.  An April survey done by the Federal Reserve shows 75% of domestic banks are tightening credit for small businesses, up from 70% in January.  Credit card companies are also increasing their rates and limiting their terms for small business cards, if they still offer small business cards to begin with.  While traditional lines of credit dry up, below are five alternative sources of funding for small businesses:

Government-backed loans: The Small Business Administration (SBA) started to guarantee up to 90% of some loans.  According to Brian Hamilton, CEO of Sageworks in North Carolina, preferred SBA lenders might be more apt to give your business an SBA-backed loan.  Ever since President Obama signed the American Recovery and Reinvestment Act (ARRA) in February, the weekly loan dollar volume has increased more than 40%. 

Community banks and credit unions: As the lending situation improves, community banks are looking to issue more loans.  Also, as larger lenders tighten their terms, credit unions will have the option of taking on more small business loans.

Peer-to-Peer networks: Websites such as Prosper, Virgin Money and Lending Club allow borrowers to find individual private contributors online to fund their businesses.

Microlenders: Recently, the higher rates generally given by microlenders have come down.  One microlender, Accion, reduced its rates from between 11% and 18% to between 8% and 15%.  In addition, the SBA offers microloans at rates between 8% and 13%. 

Accounts Receivable Factoring: Although CIT, one of the nation’s largest factoring firms, is going under, there are plenty of other smaller and comparable factoring firms that will advance you up to 90% of the receivable.  PRN Funding, LLC is one of those factoring firms.

Click here to read the entire Wall Street Journal article: Five Alternative Sources of Funding

How Medical Transcriptionists can become more Efficient

Even though medical transcription is an integral part of the health care system, the process can become tedious and boring for the people transcribing.  The Association for Healthcare Documentation Integrity (AHDI) and the Medical Transcription Industry Association (MTIA) are currently updating their “Metrics for Measuring Quality in Medical Transcription”, which is slated for a fall debut.  If you cannot wait a couple more months, Cheryl McEvoy of Advance’s Journal for Health Information Professionals, has you covered with tips for improving health documentation.  Below is a summary of her advice:

Rushing: Do not focus on your speed while transcribing.  Accuracy is the most important part of documentation and typing faster does not improve the quality of the document.  According to Barb Marques, President of AHDI, you can improve your pace without sacrificing quality by building templates around each doctor that has a customary way of dictating specific sections.  However, don’t assume that every dictation will be standardized and be sure to listen to each one carefully.

Zoning Out: Marques says that transcriptionists should be actively engaged while at work.  You need to be extremely focused on what you are typing and if it actually makes sense within the context of the document.

Distractions: This is mainly a problem for MTs who work from home.  Instead of working from the living room with the TV on and your kids running around, find a quiet area in the house to get your work done.  Also, have quality head phones and a comfortable chair to make the experience enjoyable.

Blanks: Sometimes there are spots where we cannot decipher what the doctor said.  Don’t worry about it, and continue with the rest of the document.  By the end, you should have a better grasp of the context of the document so you can go back and try to fill in these blanks. 

Errors: Donna Brosmer, a quality officer at Spheris in Franklin, TN strongly encourages MTs to proofread their work.  It doesn’t take too long to go over the work you have done.  By doing so, you can eliminate grammatical errors and typos and avoid mistakes with drug names and doses.  She also advises to get in the habit of seeing errors by searching for errors in signs or restaurant menus. 

Falling Short: It is unlikely to achieve perfection in every document you produce.  However, striving towards a perfect score is commendable.  Ask your quality assurance supervisor for regular and timely feedback.  You should look to accept constructive criticism from your QA supervisor to improve your work.

Jackson Health System Needs Better Cash Flow

According to an article in the Miami Herald, the Jackson Health System in Miami-Dade is running out of money.  As its tax revenues continue to fall, a record number of uninsured patients are flooding emergency rooms and receiving free care.  In addition, the hospital system is expected to have $56 million in losses this year and $168 million in losses next year.  Many hospitals across the country are facing the same challenges as Jackson.

The root of Jackson’s problem is its $121 million shortfall in tax support needed to pay for charity care.  This number is estimated to increase substantially over the next couple of years as the number of uninsured patients is expected to increase 27% this year and the amount of revenue from sales taxes is expected to fall. 

Eneida Roldan, Jackson’s chief executive, has come up with a 100 Day Plan to cut costs and improve efficiencies.  She has two main goals for the plan: improve billing and collecting practices and improve cash reserves by getting quicker payments from insurers and governments.  Improving cash flow is a difficult task because of slow-paying insurance companies, but is absolutely necessary due to a recent finding that Jackson will be unable to make payroll by the end of 2011. 

Jackson is fighting to get stimulus dollars, but these proposals have not been approved by Washington.  Presently, the system is making internal structural improvements.  However, it is holding off on some long-term capital improvements so that operating losses can be funded.

Healthcare vendors currently working with Miami-Dade should pay close attention to future developments on this story.

To read the entire article, click here: Miami-Dade’s financially-strapped public hospital system to ask for more tax money 

New Jersey takes action to avoid Nursing Shortage

Forty-six former nursing masters and doctoral students have been chosen to participate in the New Jersey Nursing Initiative.  The $22 million program, which is privately funded by the Robert Wood Johnson Foundation in Princeton, has pledged to help solve the looming nursing shortage in the state. 

The 46 participants will be receiving a $50,000 stipend, along with full-rides to attend in-state schools.  However, they must teach nursing students at a New Jersey college for a minimum of three years after graduation. 

According to Susan Bakeswell-Sachs, director of the program and nursing dean at the College of New Jersey, women opting to enter different professional fields and a decline in scholarships for nursing students throughout the 1990s are two main causes of the current shortage.  In addition, Nurses who work in clinical settings make on average $50,000 more per year than a nurse educator. 

Even though studies from the early 2000s predicted nursing shortages within the next 15-20 years, enrollment in the field has dramatically increased.  However, the number of faculty and administrators cannot accommodate this influx.  In fact, roughly 50,000 nurse student applications are denied each year because of faculty shortages.

Billboards in Philadelphia are urging nurses to move into the classroom so that more aspiring nurses can be educated and the nursing shortage can be averted.  The recession plays a role in the shortage as well, but surprisingly a positive one.  Nurses who would otherwise be retired are still working due to financial constraints. In addition, nurses who had been temping part-time when the economy was in better shape have also started going back to full-time employment. According to Linda Aiken, a researcher at the University of Pennsylvania, believes that once the recession ends, the nursing shortage will most likely become a crisis as these older nurses begin to retire; add in Obama’s proposed health care plan to provide 47 million more Americans with health insurance, and the nursing shortage of today seems almost irrelevant.

Click here to read the article: Scholarship program aims to stem N.J. nursing shortage

Nursing Shortage threatens Health Care Reform Success

The medical staffing factoring experts at PRN Funding recently came across an article in The Daily Tell that focused on the nation’s nurse shortage. A summary of the article is included below:

The number of nurses in America is declining at an alarming rate.  As the aging baby boomer population demands health care, more nurses are depended upon everyday.  Nurses are vital to health care success.  In fact, with more nurses working in a healthcare setting, fewer medical mistakes are made and fewer hospital-acquired infections are obtained.  Studies also show that hospitals with more nurses have shorter patient stays and lower patient mortality rates.  There are currently 2.5 million nurses in America; projections for 2025 have this number at 500,000. 

Luckily, the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) have begun working together on an initiative to inject more qualified nurses into the American health care system.  Their partnership will create a panel of health care experts and aims to create and improve nursing education programs for the future. 

Risa Lavizzo-Mourey, president and CEO of RWJF explains that, “For health reform to succeed, and for patients to receive better care at a cost we can afford, we must change the way health care is delivered.  And nursing is at the heart of patient care.”

Nurses currently make up the largest section of the health care workforce.  Hopefully this initiative keeps it that way. 

To read the entire article click here: Nursing initiative will address future of healthcare, nursing shortage

AHDI Asks for Welcome Videos

In preparation for their 31st Annual Convention and Expo, the Association for Healthcare Documentation Integrity is asking its members to generate video welcome messages.  AHDI is encouraging members who plan on attending ACE09 as well as companies that will not be able to appear at the show to contribute.

The video should be 1-2 minutes long and include a welcome message to ACE attendees.  Webcam video is the only format that will be accepted.  Once you are finished recording, upload the video to AHDI’s FTP folder (more details below).  Also, download a free FTP solution program, such as FileZilla for Firefox users, so that you can upload your video. 

Address:    Username: AHDIVideo      

Password: acemovies      Port: 21  

Jobs in Health Care Rising

President Obama’s Council of Economic Advisors released a report Monday surveying the parts of the labor force that are expected to grow most rapidly in the future.  The report is a reminder to everyone in the health care industry that it is one of the few industries still growing.

Specifically, professions in health care including home health care, outpatient care, and medical laboratory positions will add the most jobs. 

This is good news to our clients as well as to entrepreneurs looking to start their own healthcare-related business!

Click here to read the complete New York Times article: Job Growth in Health is Expected to be Strong

Remote Deposit Popular Among Small Businesses

A recent article from the Wall Street Journal profiled a growing trend among small businesses: depositing checks over the Internet. Instead of being pressed to make physical deposits with banks during the week from 9:00am-5:00pm, remote deposit offers the convenience of depositing checks at any time and place.  All you need is an Internet connection, a personal computer, and a scanner. 

In 2008, a survey conducted by Aite Group LLC of 300 businesses with less than $10 million in annual revenue found that about 16% were depositing checks online.  By the end of 2009, the firm predicts this percentage will jump to 25%. 

While firms try to cut costs in the down economy, some question why businesses are willing to pay the bank a monthly fee to use remote deposit.  Some banks charge upwards of $85 a month for the service as well as the fixed cost for the check scanner.  The convenience factor of remote deposit seems to outweigh the extra costs though.  Diane Rubinstein, controller of The Epilepsy Foundation, was quoted in the article, and she explained depositing checks online has helped her accept 200-300 more checks per month, and it saves time and paper.

Another advantage of depositing checks online is it increases a company’s cash flow.  Some banks will place the money into your account the next day if the remote deposit is made by a certain time the night before. 

As with any online banking service, there are several security risks involved with remote deposit.  Hackers could gain access to your account and checks could be scanned more than once.  Michael Kaiser, the executive director of the National Cyber Security Alliance, advises companies stay up-to-date with security software and frequently change their passwords. 

Click here to read the entire article: Not-So-Personal Banking