HFMA Enters Debate Over Future of Healthcare

If Tuesday’s national meeting of the Healthcare Financial Management Association proved anything, it was that healthcare providers are perceived as the source, root cause, and even villain behind the nation’s healthcare crisis–regardless of whether it is true or not.

The keynote speaker yesterday morning, Donald Berwick, pulled no punches about who was responsible in his mind for the healthcare mess. Berwick, the former head of the Centers for Medicare and Medicaid Services and newly announced candidate for governor of Massachusetts, rebuked the attendees of HFMA’s Annual National Institute (ANI) for fraud and waste.

Berwick and a colleague collected all the estimates from published literature that estimated inefficiency or fraud in healthcare: The most conservative estimates were 21 percent, the highest estimates were 47 percent. Berwick’s and his colleague put their estimates at over 30 percent.

“Finance leaders, one out of three dollars being spent on healthcare in your organization helps no one at all,” he scolded. “That’s waste.”

A system so inefficient means there is “an opportunity for thorough redesign of care,” Berwick said. “Knowing that three out of every ten dollars minimum is being flushed down the toilet, that’s not responsible leadership.”

Preceding Berwick was HFMA CEO Joseph Fifer, who has been on the job for a year. Healthcare providers are under attack, and the public and lawmakers perceive healthcare professionals as resistant to change, unfriendly to patients, following arbitrary rules and prone to being secretive if not sometimes greedy, he said. “We should not be surprised by the attention we are receiving,” Fifer said.

“The reason the debate over healthcare is so raucus is because of the money, is it not,” Fifer said. The time has come for HFMA to respond to these complaints and charges. “Should not the people that deal with money have a voice,” he said. “People want to know why healthcare costs what it does and what we’re doing about it. And we need to move beyond the rhetoric.”

Over the coming months, HFMA will be issuing “point-of-view statements,” he said, on a series of controversial topics–acquisitions and affiliation strategies, reconfiguring cost structure, physician strategies, societal benefit evaluation, and measuring and communicating value.

The organization will also tackle the controversy over pricing. “We’ll bring some perspective to this misunderstood issue,” Fifer said.” When I say misunderstood, it’s misunderstood on both issues,” he said.

HFMA is  in the process of forming a task force to address transparency, he said. The task force will include representatives from employers, payors, patients, physicians, and hospitals.

When complete it will provide guidelines to make pricing more transparent.

The pricing task force will be modeled after the Medical Debt Task Force, which was formed to shine a light on collection practices. The task force include healthcare providers, collection agencies, credit bureaus, and patient advocates, and when finished will produce “a common set of collection practices that should be standard across the industry.”

“These are just the first steps,” he said. “There are more to come.”

You can see Fifer’s remarks on YouTube here: