We understand that the constantly evolving regulatory environment creates significant challenges for hospitals and health systems. Health reform is pressuring hospitals to do more with less and guiding many to improve the efficiency of their financial operations. Hospitals nationwide are taking a "fresh look" at many of their services, including their ambulatory care networks.
The professionals in our Healthcare Industry Practice have a long history of working with a multitude of ambulatory care practices, including free-standing clinics and extension clinics of hospitals, evaluating their operating performance and considering new ways to be paid for their services. In addition, members of our Healthcare Industry Practice have worked with various state Primary Care Associations (PCA) to evaluate the impact of health reform on the financial operations of primary care clinics. Our team shares our expertise with industry executives by providing extensive training on best practices in the financial operations of ambulatory care providers.
J.H. Cohn specialists help clients devise innovative and tailored solutions to improve operating performance, ensure compliance with all regulatory requirements, and develop effective strategies for success in the ever-changing landscape. Our healthcare industry practice helps clients:
- Estimate and ameliorate the fiscal impact of Medicaid reforms, including transition to new reimbursement methodologies;
- Assess existing operational performance and identify opportunities for efficiencies and enhanced reimbursement, including potential for conversion to a Federally Qualified Health Center model;
- Strategize the organization's role in health reform including Accountable Care Organizations (ACO), patient-centered medical home (PCMH), managed care, and the Medicare-Medicaid Coordination Office, and Center for Medicare and Medicaid Innovation;
- Develop and implement corporate compliance programs, assess high risk areas, and respond to Office of the Inspector General and state audits and inquiries;
- Collaborate with other providers with respect to residency training programs, including impact on GME/IME reimbursement; and
- Develop creative solutions to CMS' "value-based purchasing" efforts including emergency department diversion projects and potentially preventable readmissions initiatives.