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GLG News by General and Acute Care Hospital Economic Experts

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Roche adds to anti-MRSA arsenal in Europe

April 8, 2009

Roche introduces new LightCycler MRSA advanced test in EU | www.roche.com

European healthcare organizations have always been more aggressive in identifying MRSA infections. Europe popularized the "search and destroy" protocol of MRSA containment. This new method by Roche is a valuable addition in this arsenal. I expect the LightCycler MRSA Test by Roche to be popular and very lucrative for Roche.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Winners and losers in Healthcare IT

October 14, 2008

Stark Offers Bill to Hasten e-record Adoption | modernhealthcare.com

This will soon be the best time in history to be selling Healthcare IT software and services. More money will be spent in the next three years than ever before. It may not be the best time for the staff at many hospitals. The staff are woefully unprepared for a quantum leap in Healthcare Technology.

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Boomers numbers and demands point to increased demand for medical real estate

July 1, 2008

Aging Baby Boomers Will Drive Demand for Healthcare Properties Over Next Decade, Grubb & Ellis Report Reveals | www.bio-medicine.org

Baby boomers are rapidly aging. According to Census Bureau by 2010 there will be 77 million people aged 55 and older; a number which will grow to a whopping 98 million by 2020. This aging population, living longer with chronic illnesses and more demanding of cafeteria-type service will drive the demand for medical services and more medical real estate into the forseeable future.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

What can Hospitals do about their Spending and Borrowing in 2008?

April 21, 2008

University Hospitals in Cleveland makes aggressive refinancing move | blog.cleveland.com

Increasing interest rates and debt service, a Decrease in available cash, a Migration to more fixed rate borrowing and appeals to state governments for assistance, a delay in physical plant additions/upgrades

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

There will be significant growth in Healthcare Real Estate in the next ten years. But in what areas?

April 4, 2008

Aging Baby Boomers Will Drive Demand for Healthcare Properties Over Next Decade, Grubb & Ellis Report Reveals | www.bio-medicine.org

For one reason, this industry has outperformed the commercial average for the most recent eight years. Secondly, demographics are driving medical services. More of the population is aging. People are living longer. And Medical technology is improving at a rate that provides new and better healthcare services. Thirdly, there is never a down year for Healthcare space. Whether there is a recession or not, the demand for Healthcare services continues.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Walk in Clinic business may not be as easy as it appears.

February 6, 2008

Operator of Walk-In Clinics Shuts 23 Located in Wal-Mart Stores | www.nytimes.com

Yes, WalMart has a large pool of patients. And there are competitive advantages with regard to the convenience of a pharmacy and over the counter remedies. However, having patients is only one piece of the puzzle. The business of medicine is more complex than merely having patients or customers.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Repayments to Medicare May Be Too Much to Ask

December 3, 2007

Medicare | Some Hospices Forced To Repay Medicare for Exceeding Reimbursement Limits as Patients Live Longer Than Expected | www.kaisernetwork.org

The government has paid hundreds of millions less as a result of these measures. Now, the government has targeted the Hospice industry. Of course, there is no physician that can predict how long a patient will live. Physicians sign orders for Hospice patients that are terminal. The physician cannot know how many days of Hospice care will be provided. Much of the Hospice care is provided in a patient’s home and not in an acute care hospital or skilled nursing facility. Of course, there is no physician that can predict how long a patient will live. Physicians sign orders for Hospice patients that are terminal. The physician cannot know how many days of Hospice care will be provided. Much of the Hospice care is provided in a patient’s home and not in an acute care hospital or skilled nursing facility.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Scorecards Represent a Simple and Inexpensive Tool in Hospital Turnarounds

December 3, 2007

Crouse Hospital's Turnaround Shows There's Hope For Distressed Hospitals | www.hfma.org

Board restructuring, Implementation of appropriate information systems, Productivity and staffing, Debt restructuring, Revenue cycle improvements, Supply expense reductions, New contracts and capital equipment approval processes are the Turnaround areas that scorecards can be helpful with.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

What can be done to improve ER collections?

November 15, 2007

Improving Emergency Department Copay Collection | wiki.hmccentral.com

The first step is to find out what copays are in the Emergency Room. A simple Excel spreadsheet needs to be developed showing what Medicare, Medicaid, Commercial insurance and managed care companies require as a copay. The second step is to communicate to the Admissions department, insurance department; patient financial services representatives, collectors and non-clinical staff involved. Once everyone knows what the copay is then collection can be attempted. The third step is to find out how many of the ER visits are represented by each of the aforementioned categories. It is assumed that there are more self pay visits in ER than in any other area of a hospital. It is helpful to know however, how many are in what payor group. Then we can estimate how much is lost from various copays. There are also restrictions on Medicare bad debts.

Richard Baland, Sole Proprietor

Richard BalandSole ProprietorRichard Baland, CPA What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Swing Bed Strategy

November 7, 2007

The Swing-Bed | www.rwjf.org

Some hospitals review swing bed utilization as follows: 1)Initial review within 24 hours to see if inpatient criteria are met. Criteria incorporate Severity of illness and Intensity of Service. Severity of Illness can be shortness of breath, multiple effusions or other symptoms. In other words, the patient has to be sufficiently sick to merit an acute care setting; 2)After 3 days in acute care, if stable or in need of therapy or other services, they can be moved to Swing beds. They can have IV antibiotics in Swing bed but the goal is to migrate them to taking the fluids by mouth by day 5; and, 3)The UR nurse reviews the patient’s medical chart, interviews the patient and compares the review results to the established guidelines. The UR nurse contacts the payer to justify the stay including but not limited to the medical necessity and the covered services.

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