The story of Richard Timmins of a rural community outside of Seattle may be typical of some of your patients who have signed up for Medicare Advantage Plans lured into those plans by lower fees and extra benefits. 

We need innovation to face the challenges of these seemingly insurmountable issues. Who has some field tested solutions? Please let us know and we will share with others.

At the close of the 2024 enrollment period Medicare Advantage programs according to CMS gained 2.9% more members, bringing the total enrollment to 32.9 million. This number includes seniors who signed up for Medicare Advantage with Part D coverage.

In the mid - 20th Century, the Federal Government through Hill-Burton Grants funded many hospitals in rural areas. These grants stopped in 1997. These hospitals were very much needed. There was little hospital construction during the depression and after World War II there was still limited access to healthcare, especially in rural areas.

The wealthiest citizen in Japan is Tadashi Yanai. He is the founder of the $73 billion apparel empire of Uniqlo. He is 74 years old and has $36 billion in personal wealth. His success is due to his nontraditional thinking in the land of ingrained tradition

Why and Who?

The most common reasons hospitals and medical clinics all over the country are dropping Medicare Advantage Plans are EXCESSIVE PREAUTHORIZATION REQUIREMENTS AND DENIALS COUPLED WITH

SLOW PAYMENTS FROM INSURERS, according to Becker's Review, Chris VanGorder,PresidentandCEOofScrippsHealthsaid,“It’sbecomeagame of delay, deny and not pay.”

Are You Aware That by December 30, Millions of Patients May be Denied Access to Needed Medical Services Including Your Hospital?

Hospitals and doctors do not have to stand by when seniors are being bombarded by advertising for Medicare Advantage plans. They can be proactive and give them accurate information to help them make the best decision their health and quality of life.

It’s Medicare Open Enrollment from October 15 to December 7. Seniors are intensely marketed at this time by companies offering Medicare Advantage plans. Currently half of Medicare eligible individuals are enrolled in these plans.

TCI participated in the Delta Region Community Health Systems (DRCHS) Development Conference in Memphis last week. It was extremely well organized and useful. Barbara Carey gave a presentation on Winning the Hearts and Minds of Your Community, winning loyalty, investment and engagement in your hospital.

Healthcare Leadership Competency

Effective healthcare leaders have qualities that fall into three categories:
Communication Skills, Confidence and Competence.

 Today we focus on "Competence." What competencies do successful healthcare leaders demonstrate?

‘Give Purpose to the Lives of Those Who Work for You!’

Jack Welch was one of the most successful and celebrated business leaders of all time. Under his leadership as CEO and Chairman of GE for 20 years, the Company’s value rose 4000%. He attracted and developed talent throughout the organization. His leaders were highly recruited by other Fortune 500 companies for CEO roles.

DRIVING CHANGE - Wins the Leadership Superbowl

Ochsner Health System recently announced the layoff of 770 employees. This is a major change because Ochsner always said that it would never have layoffs. They were across the board and affected executives as well as staff.

COMPLACENCY is “baked into” healthcare. Processes are established, compliance rules and bureaucrats in every system guard the status quo. It takes a remarkable leader who can communicate to all levels in the system simultaneously and to the communities. This is very important when the system must be disrupted to thrive in the current dynamic environment.

At the recent Beckers Annual Review Conference, many panelists discussed the need to embrace change and disruption as the key to future financial stability and growth. Because of the current dynamic environment of healthcare, maintaining the status quo does not seem viable.

Tomislav Mihaljevic, MD is Croatian by nationality and a cardiac surgeon and the CEO of the ever expanding Cleveland Clinic system. Currently, the system is comprised of 22 hospitals, 20 in the US and one in London and one in Abu Dhabi. The Abu Dhabi hospital is focused on Cancer Care. They see global opportunities in healthcare.

Mike McCall, Vice President of TCI and I attended the Beckers’ Annual Review Conference on April 3 - April 6 at the Hyatt Regency in Chicago. It was extremely informative and we encourage you to consider attending in 2024.

CEO communication is challenging and critical during organizational change. Since healthcare is so dynamic, the challenge is ongoing. TCI understands. We have worked behind the scenes on this issue for twenty years.

The world of healthcare is very busy. The day to day tasks can be overwhelming for those who have direct care of patients. The decisions and constant change weigh heavy on those in leadership positions. How do you stay inspired and motivated in work on which lives depend?

Looking at trends in hospital margins there are mixed results. In a Kaufman Hall report published on March 29, 2022, the data for 900 hospitals showed that median operating margins declined 11.8% last February and 26.7% year over year.

The Auditors are Coming...

Looking over the financials of 2022 can be discouraging for hospital leaders. The bottom line doesn’t look as forecasted last January. Cutting costs, managing your revenue cycle have only produced incremental results. We have a better idea.

One of the easiest ways to drive traffic to your website and build credibility with consumers is to start an “over the top,” engaging blog.

Your hospital has experts in medical specialties, nutrition, exercise, pharmacology, wound care and sleep disorders. Mining the knowledge of those experts and featuring them to address high interest health issues brings attention to your hospital and drives down the cost of patient acquisition. A well-executed blog program will double traffic to your website.

What is HRSA?

The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services is the primary federal agency for improving health care to people who are geographically isolated, economically and medically vulnerable. This is the agency that manages the 340b program, but they do a lot more.

What is Rebranding?

Rebranding is positioning your hospital for the vision that the hospital leaders have of the hospital now and in the future. It is establishing a new identity that reflects the hospital’s current services and strategy and differentiates the hospital from competitors.

Attract More Patients

TCI knows that in 2022 patients behave like other consumers. They want quick, impactful information that helps them to make a personal decision on a product or service.

I grew up in a neighborhood grocery store. My parents earned enough income for us to be comfortable. We went to Catholic schools, had vacations, a large house and boating was our hobby. My parents paid for my college education as well as my brothers. They were generous to their church and charities.

Information drives decisions. What does your community or communities know about your hospital or hospital system?

Data is pointing to the huge growth in the healthcare sector as the largest generation - the baby boomers - are aging and requiring more healthcare services. The "Boomer" generation has been referred to as the “pig in the python” because their numbers dwarf those of other generations.

When healthcare consumers search for a healthcare provider, they use many digital resources that are influential...

In TCI’s experience, hospitals lose patients because of unidentified reputational issues. A hospital’s reputation depends on the experience of the patients in the Emergency Room, Surgery, Med- Surg, ICU, Laboratory, Imaging, Rehabilitation, Wound Care, Admissions, Billing, Obstetrics and other specialty services.