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Navigating through a complex healthcare environment

09/15/2017

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In an industry that continues to multiply in its complexity – thanks in large part to new government regulations, ever-shifting economic sands and new trends in business structures – more and more physicians and healthcare organizations are finding themselves in growing need of savvy business guidance.

For example, the prospect of changes to the tax code can have a substantial impact on any health care venture, whether corporate or individual. And while the future of tax cuts is yet to be determined in Washington, D.C., it’s a situation that Janice Sansing, LBMC’s director of tax and accounting services, always keeps on her radar.

“Decreased rates would certainly be a welcome change to our client base, and that could affect some decisions that need to be made between now and the end of the year,” Sansing explained. “For example, if taxes go down, some physicians might defer some of their income until the following year.”

Another hot-button issue facing physicians is structuring allocation models for a practice. In recommending how partners could best share profits, your business advisor should take into account factors such as physician specialties, volume of procedures and costs of certain high volume overhead expenses.

Sansing and her team also play a vital day-to-day support role, assisting health care ventures ranging from physician groups to hospitals. The firm’s audit, tax and advisory group covers everything from accounting and tax-compliance to payroll and tax preparation.

“We do management-consulting projects for practices, whether they’re adding a physician to the staff, devising buy-in or buy-out strategies, preparing for a merger or analyzing whether it’s better to rent or own a medical space,” Sansing said.

The firm’s information security services group is one example of how LBMC has increased the breadth of its overall knowledge base over the years. According to Bill Dean, senior manager of the division, health care organizations are becoming a larger and larger target for hackers in search of both data and money. As a result, LBMC’s information security team is tasked with helping health care providers protect their cyber information.

“Electronic medical records are one the most valuable digital assets sought by attackers, due to the vast amount of information, and the longer shelf life than credit cards, which you can easily cancel if they’re lost or stolen,” Dean explained. “You can’t just turn off Social Security number, and you don’t necessarily know when people are using that type of information.”

Another of his department’s responsibilities is protecting clients’ computer systems from malware and ransomware. To that end, LBMC conducts regular penetration tests against his clients’ computer networks, emulating attacks on firewalls and phishing via e-mail to assess data vulnerability. They also perform risk assessments and 24X7 security monitoring for on attacks and intruders for their clients.

“Computers are essential to providing healthcare, so any disruption to those systems can have a direct impact to healthcare,” Dean said. “Cyber security is not always a practice’s number one objective, but more companies are starting to take it seriously due to its overall importance.”

The firm also serves its medical clients in the areas of coding and compliance, particularly issues arising from Medicare’s new Quality Payment Program. Whereas payments have historically been based on fees for individual services rendered by individual providers, the system is evolving into one where payments are packaged for a multidisciplinary team spread across providers and facilities, based on the specific patient being treated and the level of quality and value-based care rendered.

“Change is happening, but it’s not fully here yet, so LBMC’s Healthcare Consulting Practice advises its clients on how to continue to operate a compliant and profitable practice where one foot is in a fee-for-service canoe and the other is in a bundled, value-based payment canoe,” explained senior manager Katie Graham. “It’s no easy task, and we are proud that our experienced team doesn’t just keep our clients afloat, but positions them for maximum success.” An example of one specific compliance-related issue involves running analytics on client billing data to spot any outlying patterns that might be perceived as a red flag by Medicare.

“Any potential outlier activity can be proactively investigated, and we can assist clients by ensuring that all necessary supporting documentation is kept on file or by recommending the necessary operational and educational adjustments to ensure compliance going forward,” said senior manager Rachel Harris.

“In our healthcare data analytics practice, we are also seeing an increased demand for custom dashboard development, which allows our clients the benefit of real time data alerts on outlier, or even just “off projected,” swings in financials, service mix, etc.”  Harris adds that, “Not waiting for monthly reporting packages (that can be cumbersome to begin with) allows executive and management teams to most effectively monitor and manage their business lines with a click of a button.”

For an increasing number of healthcare providers like hospitals, medical practices and individual physicians, regulatory compliance related to fair market value (FMV) and commercial reasonableness (CR) is increasingly important.  Compensation (CV) and Business Valuation (BV) services provided by qualified valuation experts are an essential part of an effective compliance program, managing the substantial financial risk organizations face today.

As the healthcare industry continues to evolve as does physician practices/ healthcare entities demand for business advisors with expertise in an array of service areas. LBMC currently firm devotes more than 35 percent of its time to the health care industry, staffing approximately 60 professionals who specialize in health care-related issues. The LBMC team currently serves some 50 physician groups in the East Tennessee region alone.

As seen in the Knoxville News Sentinel.

Posted in: Healthcare