Health Capital Topics 2012

This book is a compilation of excerpts from articles originally published in the newsletter, Health Capital Topics, which have been organized by topic in relation to the Four Pillars concept.

Health Capital Topics is a monthly e-newsletter, which has been published by Health Capital Consultants since 2007, featuring timely topics related to the regulatory, reimbursement, competition, and technology aspects of the U.S. healthcare delivery environment. It is sent monthly to over 12,000 healthcare executives, physicians, attorneys, accountants, and other professionals in the healthcare industry. Copies of past Health Capital Topics newsletters, as well as special alert issues, can be found at www.healthcapital.com.

Some of the articles represent a retrospective look at a topic as noted by the date of original publication that appears following the article title. The intent of this book is to serve as an (admittedly abridged) brief annual primer and reference source for these issues. In the months and years ahead, we will strive to continue staying on top of key issues in the healthcare industry and presenting them in the monthly e-publication issues of Health Capital Topics and special alert issues.

Table of Contents

SECTION I. REGULATORY TOPICS

Accountable Care Organizations Series

Healthcare Reform's Tax Provisions Strain IRS Resources

Medicare Advantage Plans Squeezed in 2012 Under Healthcare Reform's

Tax Provisions Strain IRS Resources

Dealing with the Medicare Doughnut Hole

Medical Loss Ratio Final Rule Divides Consumers and Insurers

What the New Form 990 Means for Exempt Organizations

HHS Releases Final Rule on State Health Insurance Exchanges

Individual Insurance Under Healthcare Reform: A Boon for Policyholders

SCOTUS Upholds Health Law - What Happens Next?

Federal Fraud Task Force Has Largest Takedown to Date

Statutory Elimination of Physician-Owned Hospital Exceptions

CMS Auditing Series

First Annual RAC Report: Missouri is the “Big Winner”

CMS Continues Self-Referral Disclosure (SRDP) Settlements

Auditing Programs: Back to the Drawing Board?

Public Health Series

Medicaid Expansion: A Fiscal Decision to Ensure Access to Care

AHRQ Quality Indicators Toolkit Offers Hospitals Implementation Guidance

Preventive Care: What is an Ounce Really Worth? 

New IOM Report Calls for Better Learning and Adoption 

SECTION II. REIMBURSEMENT TOPICS

Vermont Adopts Single-Payor System

CMS Bundled Payments Initiative: Four Models for Coordinated Care

CMS Bars Medicaid Payments for Preventable Conditions

Value-Based Modifier: Another Step Toward Value-Driven Healthcare

Better Patient Outcomes Through Pay-for-Performance

SECTION III. COMPETITION TOPICS

Insurer-Run Care Expanding into Retail Clinics

Capital Spending in the Current Healthcare Environment

Provider Supply Series

Update on Pediatrics

Shared Decision Making: A Step Toward Patient-Centered Care

SECTION IV. TECHNOLOGY TOPICS

CMS Finalizes Rule on Telemedicine

The Expense of the ICD-10 Conversion

HIPAA Version 5010: What and When

Whistling Past the Graveyard Series

Stage 2 Meaningful Use: What’s Coming Down the Pike

SECTION V. ABOUT HEALTH CAPITAL CONSULTANTS

Firm Background

HCC Leadership Team

Robert James Cimasi, MHA, ASA, FRICS, MCBA, AVA, CM&AA

Todd A. Zigrang, MBA, MHA, FACHE, ASA

Anne P. Sharamitaro, Esq.