Core Recovery Bureau Quarterly Newsletter
Oc ober 2009 Jeanne Marttiin,, Ediittor
Jeanne Mar n Ed or
Editor’s Note: By now I’m sure many of you have heard of the “Red Flag Rules”. Nationally, about 35
million security breaches occur in the United States, giving way to many millions of consumers having
their identities stolen. As always, the Credit Bureau of Traverse City and Core Recovery Bureau hold
privacy as one of our top priorities. We urge you to review the guidelines to determine how this legislation
could affect you. Deadline for compliance to this legislation is November 1. To learn more, go to
Again, we welcome your comments and suggestions. Please email them to: firstname.lastname@example.org
How Will Pay-for-Performance Programs Play Into Healthcare
The House Majority Leader Steny Hoyer provide optimal patient care, such as the
recently stated the U.S. spends twice as adoption of healthcare technology to track
much per capita on healthcare than almost patient data. Clinical measures focus on
any other industrialized nation. Because of preventative services (immunization),
this, healthcare reform is one of the top common clinical conditions (diabetes, heart
legislative priorities of the new Obama attack, or pregnancy) or complications
administration. Cutting costs is often the (surgical infections).
focus of reform debates, but many in the Tracking performance measures is a key
healthcare industry feel the focus should be component to P4P. Until recently, there has
on how to deliver efficient, affordable, been a heavy reliance on administrative data
quality care. (claims data, pharmacy data, referral data,
Pay-for-performance (P4P) programs lab order data) to track performance
implement payment models for providers of measures. Dr Bagley of the American
care based on their performance measures Academy of Family Physicians explains
of quality and efficiency. These programs determining performance based on this data
can incentivize participating physicians by “is pushing it [claims data] beyond its design
giving bonuses, but other plans can withhold limits, since claims data was not set up to be
payments or set a differential fee schedule. used for anything other than billing.”
This is a dramatic shift from the previous Many industry groups have weighed in
fee-for-service model that did not factor on the P4P debate. The American Hospital
quality into reimbursement. Association “supports the concept of
Many different payor groups have begun aligning payment incentives with the
implementing P4P programs. Government provision of high-quality care, but
agencies, large employer groups and private recommends moving forward thoughtfully
health plans have all implemented P4P in a and deliberately as the development of
variety of forms. According to a white incentive-based programs are proving
paper released by Frost & Sullivan entitled complex.”
Beyond Bonuses: Physician perspectives on In May 2009, Bridges to Excellence
performance measures and P4P, (BTE) released findings of a study to
performance measures can be based on determine the extent to which the size of
structural implementations or clinical rewards impact physician participation
measures. Structural implementations rates for P4P programs.
measure readiness of the infrastructure to
Continued on next page
Continued from page 1 Ongoing questions still remain on whether
incentives can justify costs. For these
The research, published in the May issue of programs to be effective, physician
The American Journal of Managed Care, found participation is crucial. Individual health
P4P programs work if the incentives are plans or employer groups may have difficulty
appropriately set based on the intensity of maximizing physician participation in all
effort. coverage areas. In certain coverage areas, the
“The bottom line is simple: P4P works. number of patients in a P4P program could be
However, to work the incentives have to be relatively low and not worth the implement-
meaningful and relevant to the physicians,” ation costs. How these programs fit exactly
said Francois De Brantes, CEO of BTE. into healthcare reform still remains unclear,
The research titled Physicians Respond to but legislation is expected this year.
Pay-for-Performance Incentives: Larger (or not)
Incentives Yield Greater Participation, found
physician participation in P4P programs rose
as reward dollars increased, but could not
identify what the ideal compensation would be Everyone makes mistakes
to entice all providers to participate. Embarrassed by the typo that somehow
Although it was found that as more health made its way into the final draft of your all-
plans offer P4P programs, physician important report? Maybe you’ll feel better
participation increased. The research suggests after checking out these goof-ups from
as physicians become comfortable with P4P church bulletins:
programs, they become more willing to
participate. Don’t let worry kill you.
The Frost & Sullivan white paper states The church can help.
participation may still be lacking because If you have children and don’t
physicians are concerned about being held know it, we have a nursery
accountable for outcomes with factors they do downstairs.
not have direct control over. Patient We’ll be meeting in the north and
compliance can affect outcomes. Many south end of the building.
physicians would rather be compensated for Children will be baptized at both
the structure they provide patients instead of ends.
direct outcomes. Patient adherence to There will be an ice cream social at
medications, or even if they can afford to take 4 p.m. All ladies giving milk,
them, cannot be controlled by the physician. please come early.
This could directly impact/penalize hospitals Friday will mark the first meeting
servicing lower class or socio-economically of the Little Mothers Club. All
disadvantaged people. Physician societies women who wish to become Little
recommend P4P programs should reward Mothers, please meet the minister
improvement as well as absolute performance privately.
measures. On Easter Sunday, Mrs. Smith will
Pay-for-performance programs have be asked to come forward and lay
become a serious part of the healthcare an egg on the altar.
reform debate. The women of the congregation
have cast off clothing of every
kind. They’ll be displayed in the
We need eight new choir robes due
to the addition of several new
members and the deterioration of
some older ones.
Our new tithing slogan: “I upped
my pledge. Up yours.”
Foreclosure Activity Remains The 25 Year Test
On a hot August day, a crew was working
Near Record Level in August with pickaxes and shovels on railroad tracks
in the middle of the desert.
All of a sudden Bill McClanahan, the
U.S. foreclosure activity decreases less than president of the company, drove up in his
one percent from the record high set in July limo. He looked over the crew and pointed
2009. to the oldest man there and said, “Charlie, is
Foreclosure filings—default notices, Charlie, proud to be noticed by the
scheduled auctions and bank president, shouted back, “Sure is, Bill.”
repossessions—were reported on 358,471 The president motioned for Charlie to
U.S. properties during August 2009, come over. Charlie wiped the sweat off his
according to the August 2009 U.S. brow, put on his T-shirt and climbed into
Foreclosure Market Report released by the air-conditioned limo.
Realty Trac. The number of foreclosures After reminiscing for about 10 minutes,
represents a decrease of less than one Charlie walked back to the crew. His
percent from the previous month, but still coworkers were curious to find out how he
an increase of nearly 18 percent from knew the president of the company.
August 2008. The report also shows one in Charlie proudly boasted that he and Bill
every 357 U.S. housing units received a started working for the very same company,
foreclosure filing in August. at the very same job, at the very same pay,
on the very same day more than 25 years
With one in every 62 housing units earlier.
receiving a foreclosure filing in August, Then one of the wise guys said: “Wait a
Nevada continued to document the nation’s second. If you and Mr. McClanahan started
highest state foreclosure rate, despite an 8 working for the same company, at the same
percent decrease in foreclosure activity from job, for the same pay, on the same day more
the previous month. A total of 17,902 than 25 years ago—how come he’s the
Nevada properties received a foreclosure president now and you’re still out here
filing during the month, an increase of 53 sweating with us?”
percent from August 2008. This took the wind out of Charlie’s sails
and as he hung his head he said, “Well, if
Florida documented the nation’s second you want to know the truth, 25 years ago I
highest state foreclosure rate, with one in started working for minimum wage, but Bill
every 140 housing units receiving a started working for the company.”
foreclosure filing, and California Twenty-five years ago, Charlie was looking
documented the nation’s third highest state for a job, while Bill was looking to start a
foreclosure rate, with one in every 144 career.
housing units receiving a foreclosure filing. Twenty-five years ago, Charlie was looking
for something to do while Bill was looking to
Other state with foreclosure rates ranking do something.
among the nation’s 10 highest were Arizona, Twenty-five years ago, Charlie was looking
Michigan, Idaho, Utah, Colorado, Georgia for something different to do, while Bill was
and Illinois. looking to make a difference.
Start Early and Recover More $$
The longer you wait to turn accounts to a third party
collection agency, the less collectable they are.
The median liquidation percentage of accounts turned to
collections over 180 days old is only 11-19%.
You need to spend your time working on past due
accounts less that 90 days old and refer those older ones to
collections. Start early and you will increase your bottom
Call us today for a free analysis of your current collection
Sources: “How Will Pay-for-Performance
Programs Play Into Healthcare Reform”, Pulse, July
“Foreclosure Activity Remains Near Record Level In
August”, ACA International, September 2009
Disclosure: This information is not presented to be
used as legal or professional advice on specific facts or
matters. Readers with specific questions should refer
them to their own attorney for guidance.