Since 2000, there has been $538 billion worth of care provided for which no payment has been received. An unpaid claims analysis should be performed on a regular basis to measure any revenue loss that may be occurring due to sub-optimal claims management processes. An effective analysis can help organizations determine process issues, payer problems, and site-of-service issues to help staff redesign processes, improve technology integration and increase revenue moving forward.
The current healthcare environment is marked by intense pressure, rapid change and deep regulatory uncertainty. U.S. hospitals are struggling to adapt to this tumultuous and increasingly complicated environment, failing at an alarming rate. Through qualitative and quantitative research with hospital executives across the country, a new study examines how changes in healthcare today are impacting these institutions and what they are doing to survive.
Securitization may allow your company to efficiently leverage the value of your accounts receivable into a low-cost, committed financing platform. In practice, your company will receive cash due from its accounts receivable immediately, and such proceeds can be used for any corporate purpose, including reducing more expensive debt or reinvesting into the business.
The London Interbank Offered Rate (LIBOR) is a benchmark interest rate for seven maturities (overnight to 12 months) quoted in five currencies. LIBOR is widely used as a benchmark rate in lending, borrowing and derivative transactions, relating to an estimated $350 trillion of financial instruments. The Financial Conduct Authority (FCA) believes the markets supporting LIBOR are no longer “sufficiently active” to ensure the rate is representative of market conditions. Now what?
Refunding Valuation Analysis: An Issuer’s Decision Tool
PNC Capital Markets LLC has built a new model to value call options of tax-exempt fixed rate bonds to assess refunding efficiency. Called “ReVal," it differs from standard industry practice that typically use a form of the Black-Schole Option Pricing Model.
ReVal’s pragmatic approach to defining “Peak” Present Value Savings looks at historical relationships between MMD and U.S. Treasury securities to estimate a point in time that will achieve Peak Present Value Savings. Is the ratio of Refunding Efficiency sufficient to execute the trigger for your organization?
Identifying and Collecting Patient-Responsible Balances
With the evolution of high-deductible health plans and health savings accounts, consumers are now responsible for a larger portion of their healthcare expenditures. Currently 29% of covered workers are enrolled in a high-deductible health plan/healthcare reimbursement account (HDHP/HRA) or healthcare savings account (HSA-Qualified HDHP). This shift can lead to a rise in bad debt.
Many leading healthcare providers identify and collect patient-responsible balances prior to service and/or at the time of service, significantly increasing the likelihood of timely payment for services performed. Find out how your organization can benefit from these best practices.
Enterprise Risk Management: Consider Both Sides of the Balance Sheet
Incorporating both sides of the balance sheet can be essential to properly managing a healthcare organization’s enterprise risk in a holistic manner. Furthermore, doing so can help to maintain a level credit rating, stabilize Days Cash on Hand, and comply with debt covenants.
By performing an Enterprise Risk Management analysis, a healthcare system can calibrate its investment portfolio to help ensure that it is optimized relative to its liabilities. Over the near term, this can help to provide continuity of operations; over the long term, we believe that this can help to fuel organizational growth.
Making Sense of Uncertainty: The First PNC Healthcare Executive Symposium
PNC Healthcare’s first annual PNC Healthcare Executive Symposium created a unique environment for executive level discussion and dialogue on key industry challenges.
Twenty-six CEOs and CFOs attended. Key organizations represented included Highmark, the Cleveland Clinic and Penn Medicine. The two-day event opened with a networking reception and a dinner presentation on cybersecurity, followed by a day of discussions about the key issues facing boards and management, including:
A new way to evaluate liability portfolio risk
When it comes to managing liability portfolios in the healthcare industry, standard practice consists of evaluating finance alternatives based upon a comparison of cost of capital followed by an assessment of the risk of each product alternative. Developed by PNC’s Capital Markets group, a new process starts with assessing risk in your healthcare system’s existing liability portfolio.
7 trends that will drive the year in healthcare
Many healthcare systems have experienced weakness in financial performance that requires them to examine their current strategies, the adequacy of their information systems and the revenue and cost assumptions under which they were operating. This article shows how successful organizations are addressing these issues.
Benchmarking cash posting automation
PNC’s 2016 survey of Healthcare Client Advisory Board members tracks trends in cash posting and associated cost reduction potential. Survey results can help you benchmark your own processes and point the way toward improvement.
Mitigating pension risks in a volatile environment
Pension plan sponsors are faced with a volatile political landscape that presents significant opportunities and risks. The uncertainty facing the Affordable Care Act is just one of the issues that sponsors will face in 2017 and beyond. Do you have a legacy defined benefit plan, or are you looking at a potential merger where your liability needs to be considered?
Veterans Health Administration (VHA) Teams With PNC to Reduce Administrative Costs
In an industry where only 56% of aggregate claims are paid electronically, the Veterans Health Administration’s eBusiness Solutions team receives more than 85% of its claim payments via Electronic Funds Transfer (EFT). Like the veterans it serves, VHA has achieved its goals through a disciplined approach to its mission.
Beginning in 2003, with PNC’s help, the eBusiness Solutions team began a focused outreach campaign to maximize enrollment of insurance payers for electronic claim payments and remittances (835s).
PNC Epic Case Histories Demonstrate Measurable Improvements
More than 60 Epic clients, representing 20 health systems, presented case studies on Epic integration, shared information and networked with peers in the healthcare industry. During the forum, Penn Medicine presented a detailed case study showing how they automated cash reconciliation by implementing the Epic Cash Management module using custom lockbox files from PNC.
The Miracle of a Proactive Strategy
Denials prevention/management and patient payment estimation/collection are two areas where hospitals have historically taken a reactive approach and continue to fall short from the standpoint of performance. Although providers can correct and resubmit claims, submit appeals to payers, and bill patients 30 to 60 days after their healthcare service has been rendered, these approaches are time consuming and costly. Hopefully, your organization’s approach to these critical functions doesn’t require a “miracle” to get it under control.
The Road Ahead in U.S. Healthcare - Will Patients Take the Wheel?
With the passage of the Affordable Care Act and other recent trends in the U.S. healthcare system, we are experiencing a paradigm shift toward patient-centered care. PNC Healthcare commissioned Shapiro+Raj to explore this shift and what it means for the future of healthcare. This white paper summarizes the results of their study.
The Frugal Healthcare Provider - Saves and Earns with PNC's P-Card Program
Shannon Medical Center in San Angelo, Texas, has served the Concho Valley for more than 80 years. Today it is licensed for 400 beds and is the designated lead level 3 trauma center for the region. The locally-owned health system has a nationally-recognized intensive care unit and critical care for fragile newborns is also among its many services. In order to continue to grow and deliver the state-of-the-art services its diverse community requires, the hospital has maintained the frugal nature of its founders, J.M. and Margaret Shannon. Shannon’s Board of Directors keeps a laser focus on the bottom line.
Healthcare Advisory Board Update
With the passage of the Affordable Care Act and other recent trends in the U.S. healthcare system, we are experiencing a paradigm shift toward patient-centered care.
Healthcare Virtual Card Payments — Just the Facts
Healthcare regulations continue to focus on ways to reduce cost and increase efficiency for both Providers and Health Plans, including a renewed emphasis on electronic payments. Electronic Funds Transfer (EFT) payments sent via the ACH Network are now considered a HIPAA transaction; therefore, Health Plans are required to provide EFT payments if requested by a Provider.
Are You Ready for Chip Cards?
In October 2015, a new technical standard for credit cards will be introduced. The standard is also known as Europay, MasterCard® and Visa® or EMV, after the developers of the technology. It is designed to ensure that microchip-embedded payment cards (chip cards) are compatible with the terminals of merchants who accept them.
PCI DSS: The Security Your Customers Are Looking For
Cybercriminals are just like any other criminal — they prey on the weak and vulnerable. And they are discovering that many small merchants have not implemented even the most basic security measures.
Get to Know Greg Jelinek
In October, 2014, PNC Healthcare welcomed Greg Jelinek as our new executive vice president.
PNC Healthcare Matters Newsletter is for informational purposes only. No part of this document may be reproduced in any manner without the prior written permission of PNCCM. Under no circumstances should it be used or considered as an offer to sell, or a solicitation of an offer to buy, any of the securities or other instruments mentioned in it. The information contained herein is based on information PNCCM believes to be reliable and accurate, however, no representation is being made that this document is accurate or complete and it should not be relied upon as such. Neither PNCCM nor its affiliates make any guaranty or warranty as to the accuracy or completeness of the data set forth herein. Opinions expressed herein are subject to change without notice. The securities or other instruments mentioned in this document may not be eligible for sale in some states or countries, or suitable for all types of investors; and their value and returns may fluctuate and/or be adversely affected by changes in exchange rates, interest rates, or other factors.
Read a summary of privacy rights for California residents which outlines the types of information we collect, and how and why we use that information.