Healthcare

Many of our professionals across audit, tax and advisory have dedicated their careers to healthcare organizations because the industry presents some of the most complex challenges facing our nation. However, the potential for positive impact is immeasurable.

AT THE INSTITUTIONAL LEVEL

Health systems and hospitals of all sizes, both public and private, risk loss of revenue unless they put in place systematic processes to assess operational fitness, troubleshoot deficiencies, and transition seamlessly to new reimbursement methodologies. CohnReznick brings in the expertise needed to analyze the financial, regulatory, and technical activities of the organization across functions. Among many of the outcomes, we may identify areas of improvement, risks, and liabilities, structure training programs, and develop solutions to Medicare and Medicaid purchasing initiatives.

AT THE COMMUNITY LEVEL

CohnReznick is active in helping community health centers evaluate their performance and reimbursement and regulatory procedures in order to operate efficiently. Each organization needs to develop its own optimal response to healthcare reform and approach to federal grants management. Our work with organizations such as the National Association of Community Health Centers, National Council for Behavioral Health, state and regional primary care associations, and others keeps our team abreast of the industry-wide conversation as legislation evolves, and aware of the many innovative ways that challenges are being addressed.

REFORM EXPERTISE

The practice stays abreast of regulatory changes as they happen and can strategically advise on Accountable Care Organizations (ACOs), Patient-Centered Medical Homes (PCMH), Independent Practice Associations (IPAs), Medicare and Medicaid Value Based Payment (VBP), and other operating models.

CohnReznick’s accounting, tax, and advisory services help healthcare organizations make the strategic transition required for them to survive and thrive. As part of this, we provide services specific to the healthcare industry:

STRATEGIC/BUSINESS PLANNING

Positioning healthcare organizations for success is critical during these changing times. Our team develops business plans and financial projections that are fully aligned with the organization’s strategic initiatives, putting into place financial management systems that can adapt to change under health reform.

MEDICAID AND MEDICARE RATE SETTING AND COST REPORTING

Our professionals assist with rate negotiations and regulatory reporting relative to the FQHC Medicare and Medicaid Prospective Payment Systems (PPS). This includes developing the initial PPS rate setting system including the Medicaid managed care supplemental payment program (“wraparound”).

REVENUE CYCLE AND VALUE-BASED PAYMENT READINESS

Given the complexities of today’s third party reimbursement protocols and system configurations, CohnReznick’s revenue cycle team works with healthcare providers in improving billing system efficiencies and collections. At the same time, members of our team are consulting with providers across the country on strategizing for participation in VBP. We’ve created a proprietary tool that identifies any gaps your organization has in requirements for transition to various VBP models, and prioritizes implementation.

IMPLEMENT FEDERAL COMPLIANCE PROGRAMS

We assess high risk areas and provide audit services and reporting as required for Section 330 of the Public Health Service (PHS) Act, Federal Financial Reports (FFR), and Federal Single Audit Requirements (Uniform Grant Guidance subpart F, formerly OMB Circular A-133). We also conduct annual independent audits and agreed-upon procedures for compliance with the federal 340B drug pricing program.

Hospital Price Transparency

CohnReznick supports hospitals as they not only work through the complexities of price transparency, but also align pricing and charging strategies for improved charge capture. Fusing industry insight and compliance and regulatory proficiency, we go beyond technical requirements to help you enhance strategies and identify opportunity to improve revenue. Learn more.