Assessing the effect of increased managed care on hospitals.

This study uses a new relative risk methodology developed by the author to assess and compare certain performance indicators to determine a hospital's relative degree of financial vulnerability, based on its location, to the effects of increased managed care market penetration. The study also compares nine financial measures to determine whether hospital in states with a high degree of managed-care market penetration experience lower levels of profitability, liquidity, debt service, and overall viability than hospitals in low managed care states. A Managed Care Relative Financial Risk Assessment methodology composed of nine measures of hospital financial and utilization performance is used to develop a high managed care state Composite Index and to determine the Relative Financial Risk and the Overall Risk Ratio for hospitals in a particular state.

The availability of health care information for consumer use.

This study assesses the current availability of health care cost and quality information at both the state and national levels. More than 130 sources were contacted, including all state commissioners of health and state hospital associations. Eighty-one percent of the responding states report provider-specific information to the public, 73% require providers to submit data to the state, and the department of health or a state health care commission is the data collection entity of 69% of the states.

Controlling the patient accounting department.

Control, the final function of the four-step management approach discussed in this series of columns, is aimed at establishing standards of performance, measuring current performance under those standards, and taking action needed to ensure that organizational objectives are met. It follows planning, organizing, and directing. Often a manager plans wisely, organizes key department processes efficiently, and directs employee activities effectively--but neglects to set standards and controls for successfully completing the department's plans.

The search for solutions to the indigent care crisis.

Providing care to the medically indigent is draining the financial resources of many hospitals. While a unified plan has yet to emerge from Congress, several proposals are being considered. These range from expanding Medicaid to requiring that employers provide a minimum level of healthcare benefits to employees.

Executive roundup. Surviving the cash flow crunch.

With today's dual pressures demanding quality health care at more affordable prices, it's little wonder many hospital executives are worried about their institutions' financial health--and even their jobs. Still, many of these officials are trying to keep a positive face on things. In part, they express the hope that creative product supply systems and better overall communication with vendors will generate efficiencies and help offset dwindling reserves.

Medicaid: reviewing the program.

This is the final article in a series reviewing the Medicaid program. This article will review the various payment methods used by individual state Medicaid programs and will discuss the current status of litigation initiated on a state-by-state basis in response to inadequate Medicaid payment levels to hospitals and other healthcare providers. A Medicaid information resource listing is provided as a source of reference for patient account managers to obtain additional, specific information concerning administration of the Medicaid program by the various state Medicaid plans.