An Important Announcement!

The Monticello Group is on the move!  Over the next few days, you may experience difficulty reaching us as we transition into our new office.  Please be patient and have a great weekend!

Top 10 trends for 2011 include IT, new care models

from http://healthcareitnews.com

NEW YORK – Information technology underpins many of the care models healthcare providers will use to cut costs and improve healthcare, according to business advisory firm The Camden Group, which just released its Top 10 Trends in Healthcare in 2011.
“2011 is the year when a growing number of providers move forward with new care delivery models and run into the very real challenges posed by overhauling traditional ways of treating patients," says Steven T. Valentine, president of the Camden Group. "The fundamental question is whether providers can manage costs and improve quality while maintaining provider choice and open access. As always, the devil is in the details."
The Camden Group predicts the following 10 trends will have major and continuing impact on the healthcare sector during 2011:

1. Insurance membership will take a hit from slow recovery. Few unemployed will take advantage of COBRA, while employees, faced with paying more of their health plan premium, will select high-deductible, low-premium PPO plans, hurting HMOs.
2. No easing on payment pressure. Although health plan payments will keep pace with inflation and operating cost increases, they will not make up for declining or stagnant Medicaid and Medicare payments.
3. Patients will postpone care, hurting providers. With high unemployment and underemployment, and increased out-of-pocket costs, people will continue to put off treatment, keeping volumes at hospitals, ambulatory centers, and physician offices soft.
4. Cost is king. Soft volume, downward pressure on revenues and deteriorating payer mix with increased bad debt will drive providers to seek more cost savings. However, unions, staffing ratios and regulations will make cuts difficult. At the same time, health plans will begin to explore and increase the use of tiered networks and stratify payment to encourage use of lower-cost providers.
5. Capital remains elusive. As in 2010, most non-profit hospitals will find it difficult to access capital. Lenders are requiring an increase in days cash-on-hand, coverage ratio, stronger EBITDA and smaller borrowings. Credit rating agencies want to see: 1) physician alignment strategy, 2) clinical integration and cost reduction action, 3) IT plans and 4) plans to capture more market share.
6. Physicians will make or break new care models. To improve outcomes and lower costs, hospitals and medical groups will focus on accountable care, bundled payments, patient-centered medical homes and/or clinical integration. Reducing variation in care – primarily by physicians – will be central to any successful strategy. An effective bundled payment strategy, for example, requires specialists to address clinical resource consumption and supply cost and use while standardizing care protocols in conjunction with hospitalists and intensivists.
7. Construction focus is on fast returns. Construction projects will be scaled down, with a focus on regulatory compliance, enhancing throughput, improving care/outcomes and, if possible, capturing additional market share. Providers also will prioritize construction that generates superior returns, such as surgical services and imaging centers. Do not be surprised to see the growth of freestanding emergency departments to reduce the need for hospitals, increase access, and provide capacity for the newly insured.
8. IT becomes more pervasive – or else. Information technology underpins providers' ability to shift to new care models, so IT moves to center stage with efforts to implement electronic medical records, computerized physician order entry and health information exchanges. Provided, of course, medical facilities already have in place e-prescribing, PACS and online results reporting and scheduling.
9. Let's make a deal. Mergers and acquisitions will be brisk as more hospitals and physician groups acknowledge they lack the resources to invest in information technology, facilities and equipment for new delivery models or the leverage to negotiate effectively with health plans. Given their central role in new models, the value of primary care medical groups will increase. It is possible that health plans will enter the market to acquire these medical groups.
10. Market share, market share, market share. Hospitals and medical groups have underutilized assets and must get them busy. Providers also realize that more volume will generate incremental revenue and decrease per unit cost. Hospitals will hunt for new programs to fill empty or underperforming assets.

Virtual Interview Prep

Urban hospitals, primary-care docs most likely to seek EHR money: HHS

courtesy of www.modernhealthcare.com

by Rich Daly

Posted: January 14, 2011 - 12:00 pm ET

Large and urban hospitals and hospital systems are more likely than other facilities to plan on meeting meaningful-use standards early to receive incentive payments for their use of electronic health-record systems, according to survey data presented by Dr. David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, at a news briefing in Washington on Thursday.

The survey on EHR use, partially funded by the government, was conducted by the American Hospital Association. Another EHR survey discussed at the briefing—this one conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics—identified primary-care physicians as the clinicians most likely to plan early adoption of an EHR system.

"This latest survey reveals that primary-care physicians have broken out of the pack," Blumenthal said.

Ultimately, most physicians "in the prime of their practice" and hospitals are likely to participate in the EHR program, Blumenthal said.

Stephen Lieber, president and CEO of the Healthcare Information and Management Systems Society, said he expects "close to 100%" of hospitals will end up participating in the program.

"Especially with the penalty phases that kick in down the line, I don't see how any hospital can afford not to participate," Lieber said.

About 8,300 hospitals and physicians—no further breakdowns are available—have registered with the program through the CMS since registration opened Jan. 3, according to a CMS spokesman.

Read more: Urban hospitals, primary-care docs most likely to seek EHR money: HHS - Healthcare business news from Modern Healthcare http://www.modernhealthcare.com/article/20110114/NEWS/301149953#ixzz1BKINuJHj
?trk=tynt

2011 So Far

Things have really heated up this week--there's something in the air right now (other than snow in 49 states!) and we have seen a major uptick in job volume and hiring urgency in these first two weeks of the new year.  

You are in a uniquely great position to make this a fantastic year.  You not only have the advantage of being in a high-growth industry; you have the experience to stand out among the competition.  So, if you have given even a fleeting thought to seeing what else is out there, start looking now.  If you're already looking, look harder, don't settle, and get excited about the job search again because the right job is out there and your experience matters.

Happy Hunting,

HIT Recruiters

January 2011 BLS Report

First Friday Preview

Thanks, but no thanks...

from theladders.com

Keep it professional and there's nothing to be squeamish about when you turn down one job offer for another. Use this advice to explain your regrets.

By Andrew Klappholz

It sounds too good to be true. One highly touted job seeker was hit with a perfect financial services storm: job offers from Goldman Sachs, JP Morgan Chase and Blackrock — all at the same time.

This was the situation facing one client of career coach Connie Thanasoulis-Cerrachio, a partner at SixFigureStart and former head of staffing for Merrill Lynch Asset Management.
Is it an embarrassment of riches to be presented with such wonderful opportunities in the wake of a global financial crisis? Sure, but this job seeker also had a difficult task on her hands. She had to turn down two of these three giants and do so in a way that protected her relationships and reputation at each.

In an era where very few can afford to burn any bridges, she handled the matter gracefully and honestly.

“In one case, she referred someone else for the position,” said Thanasoulis-Cerrachio. “In both cases, she explained why it was critical for her to accept the offer she did. Respect was felt all the way around.”

Respect is the ultimate goal when declining a job offer, said Ginny Clarke, author of “Career Mapping: Charting Your Course in the New World of Work.”

“No one is taking this stuff personally,” Clarke said. “Don’t lie. If you like another job [more], be honest.”

She suggests contacting the hiring manager quickly and by phone — never in an e-mail — and offer specific reasons why another opportunity is a better fit for you, whether it’s the hours, location or industry trends. In the event that you’re taking another offer because it’s a higher salary, it should be at least $10,000 more per year if you’re going to use money as your official explanation. If it’s within that margin, Clarke suggests emphasizing a secondary reason during the call, such as stability or a clearer promotional path.

Declining a job offer by phone this way is more professional and respectful, and provides an opportunity for an open exchange where you could give helpful feedback to the hiring manager. Then, you could follow up with him by sending your contact information at your new job.

“There’s nothing wrong with saying, ‘Here’s where I ended up,’ ” she said.
Many job seekers feel squeamish about declining an offer after selling themselves during the interview process, but that’s not a legitimate concern in a professional setting, Clarke said. “It doesn’t mean that you’re disloyal. It’s not about loyalty but it is about integrity.”

The ‘Reputation Issue’

As a recruiter, Clarke once had a candidate who was offered a job and then had a family emergency that meant he wouldn’t be able to move there. The man was in a tough spot, but he chose to put family first and quickly explained his sensitive situation to the manager who offered him the job.

“She respected that about his character — that he made that decision,” Clarke said.
The man stayed in touch with the company and when his family matter stabilized months later, he reapplied to the company and got the job.

Not all job seekers are so graceful. Another one of Clarke’s candidates applied for a job without ever planning on accepting it. He was just “playing” her client in order to leverage a promotion with his current employer.

“It damaged his reputation,” she said. “There’s a reputation issue you’re trying to maintain.”

On Smarter Health

Outlook for 2011

from modernhealthcare.com | by Joseph Conn

While 2010 marked a tipping point for electronic health records in the healthcare industry, 2011 will likely produce a rapid uptake by healthcare providers in higher-quality EHR systems, chiefly because of a very heavy federal thumb on the scale and relatively low adoption rates at the start of the year.

Look for 2011 to be a year of frenetic activity in healthcare information technology. Both hospitals and office-based physicians will be scrambling to implement and meaningfully use EHRs to qualify for Stage 1 federal clinical information technology incentive payments under the American Recovery and Reinvestment Act. At stake are an estimated $27 billion in payments over the life of the multiyear IT incentive program. 

 

 

The share of hospitals with either a basic or a comprehensive EHR was 11.9% in 2009, but only 2% reported having EHR systems that would allow them to meet the federal government's meaningful-use criteria, according to research published in August in the policy journal Health Affairs.

The researchers, headed by Ashish Jha, a physician and an associate professor of health policy and management at Harvard School of Public Health, also found a widening IT divide opening between the digital haves and have-nots in this country.

Meanwhile, a little more than half of office-based physicians in direct patient care already will start the year using some kind of EHR, based on preliminary, official measurements of the National Center for Health Statistics, an arm of the Centers for Disease Control and Prevention.

The NCHS annual survey conducted between April and July 2010 asked more than 10,000 office-based physicians (excluding anesthesiologists, pathologists and radiologists): “Does this practice use electronic medical records or electronic health records (not including billing records)?” According to preliminary data in a report released in December, 50.7% of the physicians said they do use some type of system.

But the survey also queried physicians on whether their systems had any or all of 21 functions, 16 of which were deemed essential to having a “fully functional” EHR and seven of which were needed for a even a “basic” system.

Preliminary numbers show that just 10.1% of physicians were using fully functional systems, while 24.9% were using basic systems. Interestingly, the rates of adoption—that is, the differences in percentage of adoption one year over the next—dropped for undefined EHRs and basic EHRs between 2008 and 2010, while the rate of change for fully functional EHRs rose slightly.

The clock started on the Medicare and Medicaid portions of the IT incentive program Oct. 1, 2010. To get paid federal incentives, hospitals have until Sept. 30 to string together 90 consecutive days of meaningful use of an EHR system under the Medicare program, but merely adopt, implement, or upgrade a system under Medicaid. Hospitals can register and receive IT incentive payments under the Medicare and Medicaid programs.

The clock started Jan. 1 for physicians, who also have to meet 90 days of meaningful use under Medicare rules, or adopt, implement or upgrade a system under Medicaid requirements, but either within calendar year 2011. Physicians, unlike hospitals, can't double dip and receive payments under both programs.

Simultaneously, the federal government will operate a host of other programs to boost the use of health information technology, including IT workforce development programs at the junior college, undergraduate and graduate levels; funding and policy support for state-level health information exchanges; a Beacon communities program to push cutting-edge practical applications of health IT; and a system of regional health IT extension centers to assist providers in selecting and adopting EHR systems.

Read more: 2011 Outlook: Information technology--Set for a growth surge - Healthcare business news from Modern Healthcare http://www.modernhealthcare.com/article/20110103/MAGAZINE/301039954#ixzz1A5P5Cvgr
?trk=tynt

3 Minute ROI

Check out GE Healthcare's fresh approach to educating providers on the value of EMR...