August 2023 Newsletter
Presidents Message
In the Academy Award-winning film Forrest Gump, actor Tom Hanks sat on a bench pontificating how Life is Like a Box of Chocolates. “You never know what you’re gonna get,” Hanks said with a southern drawl.
The AAHAM ANI is not a box of chocolates as it is certain what an AAHAM member will receive at the Annual National Institute: quality education and amazing networking opportunities.
The reason I am pictured sitting on the Forrest Gump bench on the Paramount Studios lot is that the 2023 AAHAM ANI will be held at the Loews Hollywood Hotel in Los Angeles (Hollywood), California, October 10-12, 2023.
The AAHAM ANI is the only healthcare industry event dedicated to patient financial service professionals. The AAHAM ANI enables AAHAM members the opportunity to learn from diverse perspectives, exchange ideas, and foster connections and collaborations with fellow members as well as speakers.
Please take note to take advantage of the AAHAM Early Bird registration rates before August 11, 2023!
From the educational perspective, AAHAM members will be able to accomplish a lot by attending the AAHAM ANI. Members will be learning from other Revenue Cycle professionals about their expertise and resources, learning about hot new topics in the PFS arena, enjoy major networking with fellow healthcare peers, learning problem-solving ideas, and earning up to 20 AAHAM CEUs.
ANI attendees will gain practical skills and learn proven methods for improving one’s performance and bringing back ideas for their teams. Learning from real success stories means you will save time and money trying to figure out what works. The AAHAM ANI challenges your current way of thinking and provides advice and takeaways.
AAHAM ANI also offers amazing networking opportunities one should not miss, especially with the Hollywood backdrop. You will be able to interact with leaders in the field, learn from each other’s challenges and successes, and create lasting connections.
Of course, there will be time for attendees to take in a few of the sights. The Stars on the Hollywood Walk of Fame, the Capitol Records Building, the hand and footprints of legendary stars in front of the TCL Chinese Theatre, a hike up to the Hollywood sign or Griffith Observatory, and Universal, Warners Bros., and Paramount Studio tours are all within walking or short Uber distance.
I hope to see many of you this October in Hollywood.
~Chuck
Save the Date!
Join AAHAM Tennessee Music City Chapter for the webinar “Empowering Patients: Navigating Healthcare Financing Challenges with Confidence” with CarePayment and the Tennessee Chapter of HFMA. Stay tuned for more details to come via email as well as the chapter website!
Date: September 19, 2023
Time: 11 a.m. – 12 p.m. CST (Noon to 1 p.m. EST)
Board Member Spotlight: Christine Bianchino
Meet Christine, Associate VP of Compliance & Health Information at New Bridge Medical Center. She loves all things healthcare and enjoys working with different groups of people to solve problems and create better solutions. Christine is extremely forthcoming and candid with people. She will always ask the question nobody wants to ask and will always answer the question no one wants to answer.
Asked about her free time, Christine will tell you that her Peloton is her obsession, cooking is her passion, and her family is her grace.
Her favorite quote is “If you want the rainbow, you gotta put up with the rain.” ~Dolly Parton
The Four Issues that Will Impact Healthcare Services Providers and Insurers Most in the Last Half of 2023 and First Half of 2024
By Paul Keckley July 24, 2023
As the first half of 2023 financial results are reported and many prepare for a busy last half, strategic planning for healthcare services providers and insurers point to 4 issues requiring attention in every boardroom and C suite:
Private equity maturity wall: The last half of 2023 (and into 2024) is a buyer’s market for global PE investments in healthcare services: 40% of PE investments in hospitals, medical groups and insurtech will hit their maturity wall in the next 12 months. Valuations of companies in these portfolios are below their targeted range; limited partner’ investing in PE funds is down 28% from pre-pandemic peak while fundraising by large, publicly traded, global funds dominate fundraising lifting PE dry powder to a record $3.7 trillion going into the last half of 2023. In the U.S. healthcare services market, conditions favor well-capitalized big players—global private equity funds and large-cap aggregators (i.e., Optum, CVS, Goldman Sachs, Blackstone et al) who have $1 trillion to invest in deals that enhance their platforms. Deals done via special purpose acquisition corporations (SPACS) and smaller PE funds in physicians, hospitals, ambulatory services and others are especially vulnerable. (see Bain and Pitchbook citations below). Addressing the growing role of large-cap PE and strategic investors as partners, collaborators, competitors or disruptors is table stakes for most organizations recognizing they have the wind at their backs.
Consolidation muscle by DOJ and FTC: Healthcare is in the crosshair of the FTC and DOJ, especially hospitals and health insurers. Hospital markets have become increasingly concentrated: only 12% of the 306 Hospital Referral Regions is considered unconcentrated vs. 23% in 2008. In the 384 insurance markets, 23% are unconcentrated, down from 35% in 2020. Wages for healthcare workers are lower, prices for consumers are higher and choices fewer in concentrated markets prompting stricter guidelines announced last week by the oversight agencies. Big hospitals and big insurers are vulnerable to intensified scrutiny. (See Regulatory Action section below).
Defamatory attacks on nonprofit health systems: In the past 3 years, private, not-for-profit multi-hospital systems have been targeted for excess profits, inadequate charity care and executive compensation. Labor unions (i.e., SEIU) and privately funded foundations (i.e., West, Arnold Venture, Lown Institute) have joined national health insurers in claims that NFP systems are price gaugers undeserving of the federal, state and local tax exemptions they enjoy. It comes at a time when faith in the U.S. health system is at a modern-day low (Gallup), healthcare access and affordability concerns among consumers are growing and hospital price transparency still lagging (36% are fully compliant with the 2021 Executive Order). Notably, over the last 20 years, NFP hospitals have become less dominant as a share of all hospitals (61% in 2002 vs. 58% last year) while investor-owned hospitals have shown dramatic growth (from 15% in 2002 to 24% last year). Thus, the majority of local NFP hospitals have joined systems creating prominent brands and market dominance in most regions. But polling indicates many of these brands is more closely associated with “big business” than “not-for-profit health” so they’re soft targets for critics. It is likely unflattering attention to large, NFP systems will increase in the next 12 months prompting state and federal regulatory actions and erosion of public support. (See New England Journal citation in Quotables below)
Campaign 2024 healthcare rhetoric: Republican candidates will claim healthcare is not affordable and blame Democrats. Democrats will counter that the Affordable Care Act’s expanded coverage and the Biden administration’s attack on drug prices (vis a vis the Inflation Reduction Act) illustrate their active attention to healthcare in contrast to the GOP’s less specific posturing. Campaigns in both parties will call for increased regulation of hospitals, prescription drug manufacturers, health insurers and PBMs. All will cast the health industry as a cesspool for greed and corruption, decry its performance on equitable access, affordability, price transparency and improvements in the public’s health and herald its frontline workers (nurses, physicians et al) as innocent victims of a system run amuck.
To date, 16 candidates (12 R, 3 D, 1 I) have announced they’re candidates for the White House while campaigns for state and local office are also ramping up in 46 states where local, state and national elections are synced. Healthcare will figure prominently in all. In campaign season, healthcare is especially vulnerable to misinformation and hyper-attention to its bad actors. Until November 5, 2024, that’s reality.
My take:
These issues frame the near-term context for strategic planning in every sector of U.S. healthcare. They do not define the long-term destination of the system nor roles key sectors and organizations will play. That’s unknown.
- What’s known for sure is that AI will modify up to 70% of the tasks in health delivery and financing and disrupt its workforce.
- Black Swans like the pandemic will prompt attention to gaps in service delivery and inequities in
- People will be sick, injured, die and be
- And the economics of healthcare will force uncomfortable discussions about its value and
In the U.S. system, attention to regulatory issues is a necessary investment by organizations in every state and at the federal level. Details about these efforts is readily accessible on websites for each organization’s trade group. They’re the rule changes, laws and administrative actions to which all are attentive. They’re today’s issues.
Less attention is given the long-term. That focus is often more academic than practical—much the same as Robert Oppenheimer’s early musings about the future of nuclear fusion. But the Manhattan Project produced two bombs (Little Boy and Fat Man) that detonated above the Japanese cities of Hiroshima and Nagasaki in 1945, triggering the end of World War II.
The four issues above should be treated as near and present dangers to the U.S. health system requiring attention in every organization. But responses to these do not define the future of the U.S. system. That’s the Manhattan Project that’s urgently needed in our system.
Resources in addition to citations that follow:
Federal Trade Commission, US Department of Justice www.ftc.gov, www.doj.gov.
Gallup https://news.gallup.com/poll/508352/americans-confidence
Voting is now open for the 2024-2025 AAHAM Officer election
Voting is now open and ends on August 18, 2023 6:00 pm EDT. Vote here. If you have any questions, are unable to log in, or if you need a ballot number, please contact Moayad Zahralddin at moayad@aaham.org or 703-281-4043 ext. 4.
Certification
Thinking about getting your AAHAM certification? Do you know any colleagues or staff that are ready to become certified?
AAHAM includes a FREE digital study guide with each exam registration, providing the information you need to pass the exam at an extraordinary value! Take advantage of this great offer, along with the key benefits that AAHAM certification offers:
- Improving your earning potential
- Getting a competitive advantage with current and prospective employers
- Granting you the recognition you deserve
- The registration deadline for the August 2023 CRCE, CRCP and CRIP AAHAM exams is August 4th. Don’t miss the next opportunity to become AAHAM certified in 2023! CRCS and CCT exams are available for scheduling throughout the year, applications need to be received at least 30 days prior to the exam
Register today. More information regarding all of AAHAM’s Certification Programs are also available on our website.
Call for Committee Chairs
Our chapter is still looking for those interested in chairing committees. Chairs and co-chair spots for our committees are now open. Please reach out to Chuck at (843) 325-2447 or cacquito@sacfirm.com if interested. He will be more than happy to discuss the possibilities with you. If looking to make a mark and improve your resume, AAHAM leadership positions are a fast track to achieving those goals.
AAHAM Job Board
If you are interested in listing a job ad on AAHAM’s Job Board, you can submit a request here.
Volunteer Opportunities
Learn more about our chapter’s leadership positions and volunteer opportunities by reaching out to Chuck at cacquisto@sacfirm.com. After all, Tennessee is the Volunteer State.
Our Mission
To be the premier professional organization in healthcare administrative services. Through a national organization and local chapters, we provide quality member services and leadership in the areas of education, communication, representation, professional standards and certification.
