Four things some health system leaders have done to boost the bottom line.

 1. Focusing on our people, our patients, and our communities and acknowledge that at the end of every decision is a person. Remaining viable as a healthcare provider in our communities requires us to identify opportunities to increase efficiencies and sustainable processes.

2. Strengthening its workforce through medical provider retention and recruitment. In addition, enhancing telemedicine strategies to ensure their patient population is able to receive access to medical care wherever they are. 

3. Enhancing and increasing the medical group's contribution to the system's bottom line by increasing access to primary care physician practices through scheduling optimization to ensure patients have a clear and easy pathway to obtain primary care and continuing chronic disease management by leveraging our patient portal and online presence.

4.  Accessing the underpayment recovery platform, which analyzes every remittance received in a 12-to-24-month period to determine contractual compliance of each reimbursement. All done on a contingency basis where there are no upfront fees, costs, ongoing tasks required from clients. See sample below.

Larry G. Potter

Lgpotter33@gmail.com

8 hospitals went bankrupt this year!!

 

A summary of the 8 bankrupt hospitals:

*San Benito Health Care District, CA.

*The Hospital at Westlake Medical Center, a physician-owned hospital in Westlake Hills, Texas.

*Martin General Hospital, a 49-bed facility in Williamston, N.C., suspended operations Aug. 3 and plans to file for bankruptcy.

*Mercy Iowa City filed for Chapter 11 bankruptcy Aug.7

*Texas hospital, Trinity Regional Hospital Sachse 

*Madera (CA) Community Hospital filed for Chapter 11 bankruptcy March 10. 

*Montebello, CA.-based Beverly Hospital filed for Chapter 11 bankruptcy April 19. 

*St. Margaret's Health, filed two petitions of Chapter 11 bankruptcy for its St. Margaret's Spring Valley (Ill.) and St. Margaret's Peru (Ill.) facilities. 

ADHC may be able to help your facility, all work is solely on a contingency basis. There are no upfront fees, costs, ongoing tasks required from our clients. We take on 100% of the risk and effort to recovery revenues for our clients. We are only compensated when we successfully recover underpayments.

Text us at 1-847-872-4047

A computer-assisted navigation platform that helps surgeons perform complicated operations

 

The Seattle-based medical technology company Proprio has started training surgeons to use its FDA-cleared device to navigate spinal surgeries through artificial intelligence, augmented reality, and light field.

The technology in Paradigm, a navigation platform, helps surgeons digitally map and visualize the surgery site. It also has the potential to decrease complications and make operations more efficient.

San Antonio-based Methodist Healthcare System invested $75 million to reopen a shuttered San Antonio hospital before the end of the month.

Forest Park Medical Center has been closed since 2015 and the COVID-19 pandemic delayed Methodist's construction and reopening plans. 

After redevelopment, the new Methodist Hospital Landmark location will have 54 beds, 12 operating rooms and 27 private patient rooms. 

The facility will allow them to have more capacity as a system since it happens to be in a growing part of the city of San Antonio.

One can only hope they get enrolled in the underpayment recovery service which would be a risk-free addition to their RCM (Revenue Cycle Management) efforts. This forensic audit is performed on remittances AFTER all other RCM efforts have been completed including other internal or external underpayment recovery efforts. They only engage remittance files that our clients expect no further revenues from. Therefore, our services compliment all other RCM efforts and provides new revenues…100% of the time.

We work solely on a contingency basis. There are no upfront fees, costs, ongoing tasks required from our clients. We take on 100% of the risk and effort to recovery revenues for our clients. We are only compensated when we successfully recover underpayments.

Larry G. Potter

Senior Advisor

Text 1-847-872-4047 for any questions.

Hospitals had a challenging financial year in 2022 as expenses skyrocketed without a similar lift in revenue and reimbursement.

 Key ratios

Source: Moody's Investors Service, "Medians - Operating performance weakens as tough expense environment persists." The report was released Sept. 7, 2023 and includes data from freestanding hospitals, single-state and multistate healthcare systems for the 2022 fiscal year.

1. Operating margin: -0.3 percent

2. Excess margin: 2.4 percent

3. Operating cash flow margin: 4.9 percent

4. Return on assets: 1.7 percent

5. Three-year operating revenue CAGR: 6.5 percent

6. Three-year operating expense CAGR: 7.7 percent

7. Cash on hand: 205.6 days

8. Annual operating revenue growth rate:

9. Annual operating expense growth rate:

10. Total debt-to-capitalization: 31.9 percent

11. Total debt-to-operating revenue: 31 percent

12. Current ratio: 1.7x

13. Cushion ratio: 24.9x

14. Annual debt service coverage: 4.0x

15. Maximum annual debt service coverage: 3.6x

16. Total debt-to-cash flow: 3.6x

17. Capital spending ratio: 1.1x

Over 400 hospitals and medical facilities are now using an underpayment recovery service that is a risk-free addition to their Revenue Cycle Management (RCM) efforts. 

This forensic audit is performed on remittances AFTER all other RCM efforts have been completed including other internal or external underpayment recovery efforts. 

The company only engages remittance files that their clients expect no further revenues from. Therefore, their services compliment all other RCM efforts and provides new revenues…100% of the time.

The Underpayment System historically uncovers 5-30% of commercial payments which have been paid incorrectly on every analysis. Their collection statistics for commercial payer underpayments are 85-90% of identified claims. The majority of contracts allow providers to appeal claims that have been underpaid or paid incorrectly for up to 12 months from the last response by the insurer.

After 12 months, they will expire, at which point hosputals will never be able to bill or collect. This system recovers additional underpayments owed on zero balance accounts. Dollars underpaid after EMR/EHR and billing systems have fully processed claims as “PAID IN FULL”.

Larry G. Potter

Senior Advisor

Lgpotter33@gmail.com

Over 50 hospitals closing departments or ending services...30 minutes might have saved them!!

A number of healthcare organizations (56) have recently closed medical departments or ended services at facilities to shore up finances. 

One, Rumford (Maine) Hospital closed its maternity program March 31 after 97 years in service!!

UChicago Medicine AdventHealth GlenOaks hospital in Glendale Heights, Ill., plans to discontinue its obstetrics services.

Charlotte, N.C.-based StarMed Healthcare announced it was closing two satellite locations July 19.

Many of these could have been avoided by making use of an underpayment recovery program that these hospitals used with all work being performed solely on a contingency basis. How long does it take to complete your analysis audit process?

Minimum facility time is 30 minutes or less to upload 835-electronic billing records through our proprietary encryption platform, which uses the highest HIPAA standards. Once we have received all contracts and data files it typically will take around 14 days to complete the analysis and start the appeals process.

Sample Case Studies:

• 123-bed Texas hospital: $6 million in underpayments through BCBS alone.

• 142-bed Louisiana hospital:  $10 million+ in underpayments for top 4 payors.

• Large Pennsylvania Private Hospital: $1.2 million in underpayments from their 4th largest payer. Represents 18% of their collections for the payer.

• A hospital network: $30 million in underpayments from just three facilities.

• A large Ohio physician group: $7 million in underpayments in BCBS professional alone.

• A Tennessee clinic: $1 to $1.5 million in underpayments per payer contract

• Small Texas Community Hospital: $4,048,555.44 in underpayments from BCBS alone.

• A Missouri hospital: Over $20 million in underpayments

Larry G. Potter

Lgpotter33@gmail.com

Per Newsweek, these are the top 8 smart hospitals in the USA.

 1. Mayo Clinic-Rochester (Minn.)

2. Cleveland Clinic

3. Massachusetts General Hospital (Boston)

4. The Johns Hopkins Hospital (Baltimore)

5. Mount Sinai Hospital (New York City)

6. MD Anderson Cancer Center (Houston)

7. Memorial Sloan Kettering Cancer Center (New York City)

8. Brigham and Women's Hospital (Boston)

They are using smart technologies including the use of electronic functionalities, telemedicine, digital imaging, artificial intelligence, and robotics.

Our underpayment recovery service is a risk-free addition to your Revenue Cycle Management (RCM) efforts. Our forensic audit is performed on remittances AFTER all other RCM efforts have been completed including other internal or external underpayment recovery efforts. We only engage remittance files that our clients expect no further revenues. Therefore, our services compliment all other RCM efforts and provides new revenues…100% of the time.

We work solely on a contingency basis. There are no upfront fees, costs, ongoing tasks required from our clients. We take on 100% of the risk and effort to recovery revenues for our clients. We are only compensated when we successfully recover underpayments.

Our results are unrivaled. To date we have analyzed billions of dollars in reimbursements and remittances against 1,000s of unique and often complex payer contracts and have found noncompliance and underpayments for 100% of our clients. The typical result is 10%-20% of gross payer receipts in recovery.

Larry G. Potter

Lgpotter33@gmail.com

 Your Growth ​& Health Are​ Our Business

Tax Incentives | Expense Reduction | Retirement Plans | Corp. Financing | Smart Medical