Certain healthcare employees who work consecutively between October 1, 2023 and March 31, 2024 may be eligible for a New York Health Care Worker Bonus of $500, $1,000 or $1,500. Between April 1 and May 1, eligible employers can submit a claim for all eligible employees.

In 2022, New York Governor Hochul launched the Health Care and Mental Hygiene Worker Bonus program to support eligible employers’ efforts to recruit, retain, and reward staff, and ultimately increase the state’s healthcare workforce by 20% in five years. Four vesting periods have been completed and bonuses paid; this is the final bonus payable under the program.

Who’s an eligible employer?

As noted in the program’s FAQs as of July 27, 2023, you must have at least one employee; bill for services under the Medicaid state plan or a home or community-based services (HCBS) waiver; have a provider agreement to bill for Medicaid services arranged through a managed care organization or a managed long term care plan; or be an eligible education institution or other eligible program.

Eligible employers include “certain providers, facilities, pharmacies, and school-based health centers licensed under the state Public Health Law, Mental Hygiene Law, and Education Law, as well as certain programs funded by the Office of Mental Health (OMH), Office for the Aging, Office of Addiction Services and Supports (OASAS), and the Office for People with Developmental Disabilities (OPWDD).” This includes staff at hospitals and nursing homes; psychiatric centers; OASAS addiction treatment centers; residential programs operated or certified by OPWDD, OMH and OASAS; Medicaid assisted living programs; hospice residences; and more.

Who’s an eligible employee?

An employee must hold an eligible job providing patient-facing care. There is a long list of positions eligible – see job titles here. In general, to be eligible an employee must earn less than $125,000 annually; work consecutively for the employer during the six-month vesting period that began October 1, 2023 and ends March 31, 2024; and must not be excluded or suspended from Medicaid during the vesting period. The employee can be part-time, full-time, temporary or an independent contractor.

How much is the bonus worth?

Bonus amounts depend on the number of hours worked per week during the vesting period and can be in the amount of $500, $1,000, or $1,500. An employee can be eligible for up to two vesting periods and receive a maximum of $3,000 in bonuses. If the employee is a New York State resident, the bonus will not be subject to NY personal income taxes and any local income tax.

To take advantage of the program, an eligible employer must apply at www.nysworkerbonus.com between April 1 and May 1 for the final vesting period. You’ll need an active MMIS ID with eMedNY or a Statewide Financial System (SFS) ID. For complete program details, visit the NYS Department of Health website.

For information on tax implications, RBT CPAs professionals are available to help (we are also available to support your accounting, tax, and audit needs). To learn more, give us a call today.

RBT CPAs is proud to say all our work is prepared in the U.S.A. – we never offshore. As a result, you get peace of mind that your operation’s financial and confidential information is handled by full-time, local staff who have met our high standards for quality, ethics, and professionalism.

IMPORTANT NOTE! This article provides highlights of the Health Care Worker Bonus program. Complete program details are available at the NYS Department of Health website. If there is any discrepancy between the information in this article and the website, the website’s content governs.

No doubt, artificial intelligence (AI) has been one of the most talked about topics of the year, especially with the release of Chat-GPT-4 in March.

Suddenly, it seemed everyone became aware of the very real possibility of AI replacing humans in a variety of professions, prompting a plethora of discussions about everything from ethics and global regulations to societal impacts and future industry disruption.

While the initial hype has evolved into an ongoing drumbeat of multi-faceted discussions, AI is moving forward and when it comes to healthcare, there are opportunities to transform virtually every aspect of the industry. Now, governments worldwide are stepping up to address how AI will be monitored and regulated.

On December 8, European Union officials announced a provisional deal finalizing what will become the world’s first comprehensive laws regulating artificial intelligence. Called the AI Act, it seeks to regulate uses for AI rather than the technology itself. It also strives to protect democracy and uphold the law and fundamental rights, while encouraging innovation and investment.

The Act’s rules work along a risk spectrum, with lighter rules for low-risk applications like content recommendations and stricter rules for high-risk applications, like medical devices. Violations could result in fines up to the equivalent of $38 million or 7% of a company’s global revenue.

The Act won’t take effect until two years after final approval, which is expected early next year.  Still, many believe it will serve as a global framework for classifying risks, ensuring transparency, and penalizing non-compliance.

What about the U.S.? On October 30, President Biden issued an Executive Order (EO) on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. Its purpose, as noted in Section 1, is as follows:

“Artificial intelligence (AI) holds extraordinary potential for both promise and peril. Responsible AI use has the potential to help solve urgent challenges while making our world more prosperous, productive, innovative, and secure. At the same time, irresponsible use could exacerbate societal harms such as fraud, discrimination, bias, and disinformation; displace and disempower workers; stifle competition; and pose risks to national security. Harnessing AI for good and realizing its myriad benefits requires mitigating its substantial risks. This endeavor demands a society-wide effort that includes government, the private sector, academia, and civil society.”

Interestingly, within the EO, an entire section (Section 8) is devoted to safe, responsible deployment and use of AI in healthcare, public health, and human services. Among other things, it includes key deadlines and deliverables (mostly driven by the Secretary of Health and Human Services):

• Within 90 days of the EO, create an HHS AI Task Force. Within 365 of creating the task force, develop a strategic plan including policies and frameworks, and possible regulations, on AI and AI-enabled technologies in the HHS sector, including research, discovery, drug and device safety, healthcare delivery, finance, and public health.
• Within 180 days of the EO, develop an AI assurance policy to evaluate important aspects of AI-enabled healthcare tools’ performance, as well as infrastructure needed for pre-market and post-market oversight of algorithmic system performance against real-world data.
• Within 180 days of the EO, consider actions to advance understanding of and compliance with Federal nondiscrimination laws related to AI by HHS providers receiving Federal financial assistance.
• Within 365 days of the EO, establish an AI safety program with a common way to identify and capture clinical errors resulting from AI in healthcare settings. Create a central repository for incidents that cause harm – including through bias or discrimination. Analyze data and outcomes to create recommendations and best practices for avoiding harm, and processes for disseminating them to stakeholders.
• Within 365 days of the EO, develop a strategy to regulate the use of AI or AI-enabled tools in drug development processes.
• Ongoing: create incentives under grantmaking authority to promote responsible AI development and use.

So, it looks like 2024 is going to be a landmark year for AI frameworks, potential regulations, and more. Stay tuned. As you consider what AI and related applications may mean to your organization, please remember RBT CPAs is here to provide accounting, audit, tax, and business advisory services. Interested in learning more? Give us a call today.

RBT CPAs is proud to say 100% of its work is prepared in America. Our company does not offshore work, so you always know who is handling your confidential financial data.

Would you like to give your employees a bonus without paying a dime? Now may be your chance!

Certain healthcare employees who worked consecutively between April 1 and September 30 of this year may be eligible for a New York Health Care Worker Bonus of $500, $1,000 or $1,500. Between October 1 and 31, eligible employers can submit a claim for all eligible employees.

In 2022, New York Governor Hochul launched the Health Care and Mental Hygiene Worker Bonus program to support eligible employers’ efforts to recruit, retain, and reward staff, and ultimately increase the state’s healthcare workforce by 20% in five years.  Following are some highlights.

Who’s an eligible employer?

As noted in the program’s FAQs as of July 27, 2023, you must have at least one employee; bill for services under the Medicaid state plan or a home or community-based services (HCBS) waiver; have a provider agreement to bill for Medicaid services arranged through a managed care organization or a managed long term care plan; or be an eligible education institution or other eligible program.

Eligible employers include “certain providers, facilities, pharmacies, and school-based health centers licensed under the state Public Health Law, Mental Hygiene Law, and Education Law, as well as certain programs funded by the Office of Mental Health (OMH), Office for the Aging, Office of Addiction Services and Supports (OASAS), and the Office for People with Developmental Disabilities (OPWDD).” This includes staff at hospitals and nursing homes; psychiatric centers; OASAS addiction treatment centers; residential programs operated or certified by OPWDD, OMH and OASAS; Medicaid assisted living programs; hospice residences; and more.

Who’s an eligible employee?

An employee must hold an eligible job providing patient facing care. There is a long list of positions eligible – see job titles here. In general, to be eligible an employee must earn less than $125,000 annually; work consecutively for the employer during a six-month vesting period between October 1, 2021 through March 31, 2024; and must not be excluded or suspended from Medicaid during the vesting period. The employee can be part-time, full-time, temporary or an independent contractor.

How much is the bonus worth?

Bonus amounts depend on the number of hours worked per week during the vesting period and can be in the amount of $500, $1,000, or $1,500. An employee can be eligible for up to two vesting periods and receive a maximum of $3,000 in bonuses. If the employee is a New York State resident, the bonus will not be subject to NY personal income taxes and any local income tax.

To take advantage of the program, an eligible employer must apply at www.nysworkerbonus.com between October 1 and October 31 for the latest vesting period. You’ll need an active MMIS ID with eMedNY or a Statewide Financial System (SFS) ID.  There are a series of videos on YouTube providing more information about the program and how to apply. For complete program details, visit the NYS Department of Health website.

For information on tax implications, RBT CPAs professionals are available to help (we are also available to support your accounting, tax, and audit needs). To learn more, give us a call today.

RBT CPAs is proud to say all our work is prepared in the U.S.A. – we never offshore. As a result, you get peace of mind that your operation’s financial and confidential information is handled by full-time, local staff who have met our high standards for quality, ethics, and professionalism.

IMPORTANT NOTE! This article is only intended to provide highlights of the Health Care Worker Bonus program. Complete program details are available at the NYS Department of Health website. If there is any discrepancy between the information in this article and the website, the website’s content governs.

Recently, a number of new and updated tools and projects have been launched by a variety of sources to help protect healthcare environments from cybercrime, and they couldn’t have come at a better time. According to one source, the number of security breaches appear to be slowing but the number of records impacted are increasing, indicating cyber criminals are becoming more sophisticated. (Vogel, Susanna. Scale of healthcare cyberattacks increase as criminals change tactics, report finds. August 22, 2023. Healthcaredive.com.)

Sharing learnings from cybersecurity firm Critical Insight’s 2023 Healthcare Data Cyber Breach Report,  HealthCare Dive notes,  “This year, 40 million people have been impacted by healthcare data breaches…Cyber attackers are now targeting vulnerable points in the supply chain, specifically the business associates or third-party companies that offer services to healthcare organizations.”

Just as criminals are getting smarter, so are the many organizations protecting health care practices, businesses and institutions and their patients. In recent weeks:

• The U.S. Department of Health and Human Services launched DIGIHEALS to protect healthcare’s electronic infrastructure. Proposals are being sought for proven technologies that can apply to health systems, care facilities, and health devices.
• An updated version of the Health Industry Cybersecurity Information Sharing Best Practices Guide (HIC-ISBP) – a compliment to the recently updated Matrix of Information Sharing Organizations – was released to help healthcare organizations create and maintain an information sharing program for cybersecurity threats. (McKeon, Jill. HSCC Releases Updated Guidance on Information Sharing Best Practices. August 24, 2023. com.)
• Beckers’ Hospital Review provided a list of over 100 healthcare security companies helping to protect from data loss, promote smooth operations, and safeguard patient information. (Falvey, Anna and Talian, Brendan. 121 Healthcare Cybersecurity Companies to Know. August 3, 2023. com.)

Earlier this year, the U.S. Department of Health and Human Services (HHS) 405(d) Program released new tools to help bolster healthcare cybersecurity, including Knowledge on Demand (free training to improve cybersecurity awareness); Health Industry Cybersecurity Practices (HICP) 2023 Edition (a publication outlining risks, best practices, and suggested standards); and Hospital Cyber Resiliency Initiative Landscape Analysis (a report on cybersecurity preparedness and hospital benchmarking).

In addition, the American Medical Association has created a “toolkit” of sorts, providing numerous resources for addressing cybercrime all in one place.

As your organization/practice determines its next steps for cybersecurity, you can count on RBT CPAs to handle your accounting, audit, tax, and advisory needs. We believe we succeed when we help our clients succeed. To learn more, give us a call.

RBT CPAs is proud to say all of our work is prepared in the U.S.A. – we never offshore. As a result, you get peace of mind that your operation’s financial and confidential information is handled by full-time, local staff who have met our high standards for quality, ethics, and professionalism.

Value-based care is being trumpeted as the panacea to cure all of the healthcare systems’ ills, and while it’s picking up momentum, to say there are a lot of different perspectives to this story is a gross understatement.

From medical and political organizations to investors and technology companies, value-based care is the talk of the town.

Value-based care was first introduced by Michael Porter and Elizabeth Olmsted Teisberg in their 2006 book, Redefining Health Care: Creating Value-Based Competition on Results. Since then, it has been embraced by some; criticized by others. Still, after almost 17 years, the discussion continues. In scouring numerous publications from several months, here’s a sampling of the discussions…

December 16, 2022. American Psychological Association

“The National Academies of Science, Engineering, and Medicine issued a report on implementing high-quality primary care stating that we should ‘pay for primary care teams to care for people, not doctors to deliver services.’ The report recommends a shift towards a hybrid model of payment; part fee-for-service and part capitated (per member, per month) as the default method to pay prospectively for interprofessional, integrated, team-based care rather than the fee-based system that undervalues the work reflected in primary care and behavioral health services.” (“APA advocates for value-based payment models.” December 16, 2022. APAServices.org.)

December 16, 2022. McKinsey & Company

“Providers specializing in value-based care have become attractive to investors because of the distinctive quality of care that they can provide and the investable opportunity they present, with a diversity of risk levels and business models. By building on a decade of increasing value-based payment adoption—combined with enhanced value-based capabilities across payers, providers, employers, and other healthcare stakeholders—continued traction in the value-based care market could lead to a valuation of $1 trillion in enterprise value for payers, providers, and investors.” (Abou-Atme, Zahy; Alterman, Rob; Khanna, Gunjan; and Levine, Edward. “Investing in the New Era of Value-Based Care. December 16, 2022. Mckinsey.com.)

February 7, 2023. The Commonwealthfund.org

“Studies of value-based care programs so far suggest that they can reduce costs and improve quality of care, although results have often been mixed and impact modest….Although participation in value-based care programs is on the rise in the U.S., many healthcare providers are still not in one. To encourage participation, future models in both the public and private sector would likely benefit from being more accessible and financially rewarding, particularly to those serving disadvantaged or rural populations. Moreover, further research is needed about how these programs impact patients, providers, and the health care system overall, as well as which factors are associated with success.” (Lewis, Corinne; Horstman, Celli; Blumenthal, David; Abrams, Melinda K. “Value-Based Care: What It Is and Why It’s Needed.” February 7, 2023. Thecommonwealthfund.org.)

Feb 10, 2023. Healthcare Dive

“With 48% of the eligible Medicare population enrolled in Medicare Advantage plans and, the CMS committed to having 100% of enrollees in a value-based care program by 2030, the tailwinds are pushing at-risk arrangements forward in a big way.” (Kirk, Liz. “Tipping point is in sight: Value-based care is driving meaningful financial results.” February 10, 2023. Healthcaredive.com.)

March 14, 2023. BenefitsPro

“Employers and their benefits consultants are increasingly embracing value-based reimbursement models as they – along with provider organizations, commercial payers, and government programs – seek more ways to improve health outcomes while reducing costs.” (Sharma, Rahul and Caroll, Lynn. Implementing value-based health care: Key trends shaping 2023.” March 14, 2023. Benefitspro.com.)

April 10, 2023. Bain.com

“There is still ample headroom for growth in value-based care adoption in the PCP space. As of 2021, nearly 60% of healthcare payments had at least some linkage to quality and value, but less than 20% incorporated two-sided risk (and capitated models are still under 8% of spending)…Our analysis suggests fee-for-value arrangements will capture 15%–20% market share from traditional FFS providers in primary care by 2030, creating strong macro tailwinds and supporting further investment in the space.” (Fry, Sharon; Nierenberg, Dave; Wynn, Grace; Murphy, Kara; and Jain, Nirad. “Value-Based Care: Opportunities Expand.” April 10, 2023. Bain.com.)

April 29, 2023. The American Journal of Managed Care

“…there have been many iterations of value-based programs sponsored by both government insurers and private companies… Among other challenges, a main issue that arises in value-based care surrounds attribution, meaning a patient is attributed to a provider and that provider is reimbursed based on the contract. But what is attribution? If a patient sees 2 primary care providers within a year, which provider is paid for their care?” (McNulty, Rose. “Value-Based Care: Is It Possible for All Providers to Succeed?” April 29, 2023. AJMC.)

May 8, 2023. The New York Times

“Large health insurers and other companies are especially keen on doctors’ groups that care for patients in private Medicare plans…Now, nearly seven in 10 of all doctors are either employed by a hospital or a corporation, according to a recent analysis from the Physicians Advocacy Institute…Insurers say their purchase of medical practices is a step toward what is called value-based care…” (Abelson, Reed. “Corporate Giants Buy Up Primary Care Practices at Rapid Pace.” May 8, 2023. NYtimes.com.)

May 23, 2024. Beckers ASC Review

“Three key driving forces behind the shift to value-based care are government programs and incentives, advancements in technology, and the use of data to gather information. The model has piqued the interest of companies such as CVS Health, Optum, and Amazon, as well as physician groups…Though value-based care’s popularity is growing, just 14 percent of physicians participate in the payment model, according to Medscape’s 2023 ‘Physician Compensation Report.’ The fee-for-service model is still the most popular payment model by a long shot, with 46 percent of physicians participating in it.”  (Hatton, Riz. “How value-based care is squeezing its way into every corner of healthcare.” May 23, 2024. Bekersasc.com.)

June 8, 2023. Center for Medicare and Medicaid Services

“Today, the Centers for Medicare & Medicaid Services (CMS) announced a new primary care model – the Making Care Primary (MCP) Model – that will be tested under the Center for Medicare and Medicaid Innovation in eight states… Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington.” (“CMS Announces Multi-State Initiative to Strengthen Primary Care.” June 8, 2023. CMS.gov.)

No doubt, this discussion is to be continued. While you are following the latest headlines shaping the future of healthcare in America, you can count on RBT CPAs to take care of your accounting, tax, audit, and advisory needs with the highest ethical and professional standards. To learn more, give us a call today.

RBT CPAs does not outsource work to any other country. All of our work is prepared in the U.S.A. 

In today’s media, it’s hard to tell the difference between news and marketing. Take 5G and healthcare as an example. Talk of the revolutionary nature of this next generation of wireless technology has been around for years, but in truth the uptake has been slow. So, I set out to see what I could learn about whether and how 5G is transforming health care. Here’s what I found…

First, what is 5G? It stands for the fifth generation of cellular wireless technology (1G allowed for voice; 2G – digital voice; 3G – data; 4G – streaming; and 4GLTE encompasses everything up to 4G, faster and better than ever).  5G will transmit data 20x faster than 4G; handle 100x more traffic so more devices can be connected and work more reliably; support wireless operations; speed up how quick data can be uploaded and transported; and dramatically increase the amount of data available for decision-making.

While Wi-Fi doesn’t have the bandwidth to support all of the leading-edge technologies – like the IoMT, edge computing, robots, augmented and virtual reality (AR/VR), and more – 5G can. It’s expected to transform how work gets done, driving productivity, competitiveness, quality, cost savings, profitability, smart decision-making, data security, and more.

As reported by ManagedHealthcareExecutive.com, the Cleveland Clinic Mentor Hospital – scheduled to open its doors to patients on July 11 – is the first U.S. hospital built with a private 5G network via a partnership with Verizon Communications, providing “an opportunity to explore how private 5G networks can help enable digital transformations in hospital settings.”

According to InsiderIntelligence.com, the Cleveland Clinic is already ranked fourth by Newsweek’s World’s Best Smart Hospitals 2023 (Mayo Clinic, Massachusetts General and John Hopkins take the top three spots). With 5G at Mentor Hospital, the clinic will be exploring potential use cases for asset tracking, digital displays, entertainment, check-in kiosks, AR/VR for education/assisted surgery/imaging, and more.

While looking forward to the learnings that will come from Mentor Hospital’s 5G capabilities, Samsung Medical Center (SMC) in Seoul, South Korea is already experiencing the benefits of integrating 5G with digital pathology.

HealthcareITNews.com reports 5G is helping to cut pathology time at SMC in half. They have three diagnostic reading rooms that received numerous “requests for frozen section tests.” It would take 15 to 20 minutes for someone to get to the rooms, until a scanner, analysis and interpretation software, a desktop computer, and 5G enabled access via mobile devices, reducing response time to 10 minutes. The result is quicker diagnosis and fewer surgical delays.

In April, The Wall Street Journal reported on how another hospital in Seoul is using AR technology to promote precision during surgery thanks to its private 5G network which can upload and transmit tremendous amounts of data without lags. The Ewha Womans University Mokdong Hospital’s 5G-enabled AR technology helps surgeons see the exact location of tissues and tumors when a tablet is placed above a patient’s chest. This replaces a surgeon making incisions based on CT scans.

The hospital also tested the system for a recent surgery where surgeons in different locations were able to join a procedure and exchange advice, setting the stage for remote surgeries and even physician training.

(FYI: The AR technology was developed by SKIA Co. which is applying for regulatory approval in South Korea for widespread use and subsequently plans to apply for approval from the U.S. Food and Drug Administration.)

No doubt, this is just the beginning. As The Wall Street Journal reported, “The 5G healthcare market—encompassing 5G-supported augmented-reality and virtual-reality technology services, virtual consultations, remote patient monitoring and more—was valued at $2.5 billion in 2021 and is expected to grow an average of more than 35% annually from 2022 to 2030, according to Global Market Insights, a market research firm.”

While you may be thinking about where and how 5G will impact your healthcare organization’s future strategy, please know that RBT CPAs can help free you up by handling all of your accounting, tax, audit, and business advisory needs. To learn more, visit us at RBTCPAs.com or give us a call today.

Originally, I was going to write about six technologies that are changing healthcare, but as I started researching the topic, I realized two things. One – I’m an accountant not a healthcare professional and no amount of research is going to ever position me to advise a doctor or a medical practice CEO on the latest in healthcare technology – the field is simply too vast and too complicated, and understanding it requires medical education, training, experience, and a lot more. And two – I think Elon Musk may be onto something.

Imagine having a Supreme Court Justice robot using AI to “hear” an important case and rendering a decision based on algorithms that helps it scour and analyze an abundance of historical data…A professional football coach robot quickly analyzes all of the data about the players and teams on a field to predict the next play, counter-play and game outcomes before the first whistle blows….An accounting robot automatically gathering data for tax season, synthesizing it, and generating your filing so it’s in your email for signing without you or any other human doing a thing. Actually, forget that last example. Just kidding, but also not kidding considering where AI is with the release of CHAT GPT, and where it may go.

Seriously, when researching health care technology trends, my heart started racing a bit and I began to give real consideration to Elon Musk’s recent call to pause artificial intelligence (AI) development until we understand it a little more and put some governance around it. What if people start querying symptoms, increasingly use it to self-diagnose, and follow outdated or wrong information?

I have learned when reading and researching topics like this that much of the talk about technology does focus on a future state that doesn’t exist yet, but may become reality sooner than we’d think or like. Even though we’ve been hearing about the potential of AI for years, at this point it feels like perhaps the pace of its development and potential is outpacing our ability to wrap our minds around such radical transformations and their broader implications.

Still, I have an article to write about technology and healthcare. Out of intellectual curiosity, I conducted a little experience. I gave CHAT GPT, the AI technology taking the world by storm this prompt: Write an article about six technologies that are changing healthcare. See below to see the results.

Without looking at the output, I continued working on the article the old-fashioned way, and after “following the story and research” found myself landing in a different place with a different discussion.

I realized there are two types of healthcare technology – one that can fall in the bucket of impacting health and outcomes, and one that falls in the bucket of running a health care related business.

As I said earlier, out of respect for health care professionals’ education, training, knowledge, abilities, and passion, I don’t even come close to being qualified to talk about healthcare technology as it relates to actual care and outcomes. It’s mind boggling to learn about things like using 3D print technology to create hearing aids or replacement joints faster and at lower costs; AR/VR to help doctors practice procedures; or smart bandages monitoring and promoting healing. I can even wrap my mind around technologies enabling collaborations, predictive analytics, data sharing, and care equity while reducing environmental impacts. However, when research starts leading to ideas about cutting out strands of DNA and things of that nature, the discussion is clearly over my head, and one better left to the experts. Still, there is a technology discussion to be had, and it falls into the second bucket: technology developments that are reshaping the business side of healthcare.

HealthcareDive.com reports, “As 2022 drew to a close, several factors suggested that technology adoption was slowing down, including a cooled landscape for digital health funding and a drop in virtual care utilization. In addition, a flurry of cyberattacks and concerns over the privacy of sensitive medical data highlighted the hazards of new technology adoption. Despite this, experts remain upbeat about the potential of technology to improve U.S. healthcare in 2023.”

The article goes onto predict that with so many individual technology solutions in the market, health care organizations are going to prioritize tech investments and strategies to focus on basics, like patient intake, revenue management, physician enablement, care coordination, patient engagement, and data security. Concurrently, there will likely be consolidation and integration among healthcare tech providers.

HealthTechMagazine reinforces a similar thought process, with predictions that 2023 healthcare technology uptakes will largely focus on security, data analytics, and workflow automation. I even came across one story talking about “robots” walking patients to exam rooms and handling the disposal of hazardous materials so medical staff can spend time on value added activities.

Now, I have to admit, after coming to this point in the thought process, I stepped back and looked at the content generated by CHAT GPT. I was pleasantly surprised by the clarity of its writing abilities. While I think it’s accurate, I’m not sure it would add much value to you – the content is pretty basic, and I fathom to guess most people reading it wouldn’t walk away with anything new. So, for now, at least, I’m going to stick to doing my articles the old-fashioned way (even if my son is telling me I’m wrong and it’s because I don’t understand prompt engineering – that’s another discussion for another day).

Now onto simpler things, like if you need accounting, tax, audit, or financial advisory services…You can continue to count on the humans at RBT CPAs to deliver an exceptional customer experience with the highest of ethics. If you’re interested, give us a call. A human will even answer the phone!

March 10 was the deadline for businesses to file an Abandoned Property Law Annual Report. Not filing potentially increases risk of an audit, but so does filing. What’s a business to do?

Healthcare organizations may be particularly vulnerable, considering the complexities surrounding costs, who is responsible payment, and more. Whether it’s a payment to a vendor that went out of business or a duplicative payment from a patient and insurance company for the same claim, the state where the property’s owner resides may have dibs on this and other types of found money including payroll checks, direct deposits, customer credit balances, and more.

The New York State Fiscal Year 2021-2022 Annual Report of the Office of Unclaimed Funds (OUF) explains the OUF is responsible for implementing the state’s Abandoned Property Law by ensuring abandoned funds are remitted to the state; conducting audits to recover funds; increasing public awareness of the funds; and protecting the rights of owners until funds are returned.

During FY 2021-2022, the OUF collected $980 million. The Voluntary Compliance Program resulted in $8 million being found. Audit collections totaled $93 million. $404 million was returned to rightful owners. $560 million was transferred to the state’s General Fund (the state holds over $17.5 billion in unclaimed funds dating back to 1943. The Hudson Valley had the third highest amount of funds paid (following NYC and Long Island), totaling $33 million.

As reported by TaxExecutive.org, “The importance of knowing and understanding unclaimed property laws has grown in recent years, because unclaimed property is now a significant revenue source for certain states…As a result, states now actively enforce these laws to capture unclaimed property in audits, voluntary disclosure programs, and litigation or through legislation.”

Audits can result in significant assessments, interest, and penalties. Voluntary compliance programs and agreements give companies a way to avoid interest and penalties in most states. That sounds good until you consider if your company doesn’t have records for the look back period, it must use the state’s mandated methodology to estimate liability. What’s more, you’ll still need agreement from a state appointed administrator or audit firm. Even after all of that, your firm can still be referred for an audit.  In recent years, more “holders” of unfound money have turned to litigation and increasingly found support.

If your company needs help understanding the laws, how they’re enforced, and your options for responding, RBT CPAs tax professionals can help. With state and auditing firms’ outreach efforts growing to uncover additional sources of potential revenue, should you receive any type of communication asking for self-disclosure or the like, be sure to give your RBT CPAs contact a call.

NOTE: RBT CPAs is providing this content for informational purposes only. It should not be construed as advice or direction. Should you need advice or direction, it’s in your best interest to talk to a tax professional (like those at RBT CPAs) or to contact your legal counsel.

Is your organization ready to “unwind” from the Public Health Emergency (PHE) and address the potential impact, financial or otherwise?

Just about three years ago, the U.S. Government issued a nationwide emergency declaration due to COVID. At the end of the day, May 11, 2023, the U.S. PHE expires, along with many temporary changes to health insurance, coverage, and care. This will impact health care providers, insurers, pharmaceutical companies, pharmacies and certain retailers, employers that provide health care coverage, and individuals.

Along with the end of the PHE comes the end of Medicare coverage for free COVID tests and testing, as well as the extra 20% payment for COVID care in the hospital; Medicaid and CHP free testing and COVID treatment services with no cost-share (the latter starts the first calendar quarter one year following the end of the PHE); continuous enrollment in Medicaid (as of March 31); private health insurance free tests and testing services, as well as mandatory out-of-network coverage for both; enhanced federal funding to states (effective December 31); and more.  (For more details, see “Key Flexibilities Triggered by Major Covid-19 Federal Emergency Declarations” at KFF.org.)

In February, the American Hospital Association sent a letter to U.S. Secretary of Health and Human Services Xavier Becerra asking the administration to consider PHE implications on our health care system’s stability. It noted, “The recent decision to sunset the COVID-19 public health emergency (PHE) is a testament to the progress we have made; however, as we prepare for that transition, we should not revert to care delivery as it was prior to the pandemic. Instead let us build on the lessons we have learned and the advancements in care delivery and access we have made. Let us use this crisis to create a more effective, equitable, patient-focused and stable health care system.”

During the PHE, health plans benefited from government coverage of COVID-related expenses, and relaxed HIPPAA and COBRA rules. Before the end of the PHE, they’ll have to negotiate with plan sponsors regarding how these expenses will be covered going forward, even as some prices are still being worked out (i.e., how much pharmaceutical companies will charge for vaccines and treatments). Finally, while significant premium increases didn’t materialize in 2023, there’s concern about the impact cost-shifting to insured patients may have in 2024.

GoodRx reports: “One of the most profound effects of the PHE ending is the potential number of people who will lose Medicaid coverage (5 million to 14 million according to some researchers and nearly 18 million according to the highest estimates).” (George, Cindy. “The End of the COVID-19 Public Health Emergency: What You Need to Know.” March 10, 2023. GoodRx.com.)

The U.S. Department of Health and Human Services (HHS) issued a roadmap for transition, highlighting what will change and what won’t with the PHE’s end. Among the changes is how lab results and immunization data will be reported. Once the PHE ends, the HHS won’t have the authority to require this reporting. The Center for Disease Control is encouraging states to continue sharing vaccine data. Also, hospital reporting will continue but likely at a lesser frequency.

The unwinding is occurring as the health industry faces an uncertain economic environment, supply chain issues, and the labor shortage, leaving questions about how all of this will impact demand for care; debt, liquidity and bond ratings; provider costs, cash, and funding; and more.

No doubt, all healthcare providers, health plans, employers offering coverage, and others will be on the receiving end of patient questions – and possible hostility – about coverage and cost changes. As noted on GoodHousekeeping.com, “It’s unclear just how expensive treating or preventing COVID-19 will be for most Americans currently — but a majority can expect to face new forms of co-pay for tests, treatment and medications starting in May.” (Krstic, Zee. “What Does the End of Covid Emergency Declarations Really Mean?” February 12, 2023. GoodHousekeeping.com.)

To prepare your organization for the unwinding, there are numerous resources available:

• gov Fact Sheet: COVID 19 Public Health Emergency Transition Roadmap
• American Hospital Association special bulletin outlining implications for hospitals and healthcare providers
• Kaiser Family Foundation (KFF) What Happens when COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access and Implications for Ending the COVID-19 Public Health Emergency
• CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency | CMS
• New York State of Health Communications Toolkit  and County Fact Sheets: Unwinding the PHE
• State Outlines Plans for Medicare Beneficiary Recertification: Leading Age New York
• Telehealth policy changes after the COVID-19 public health emergency | Telehealth.HHS.gov

Many variables will impact/determine the financial implications of the PHE ending on your organization. As with any legal matter, it’s always best to consult your legal counsel for advice and direction. At the same time and as part of your unwinding activities, you may want to evaluate data on hand to determine the potential financial impact. RBT is here to help guide you through the accounting and tax implications you may want to consider as part of your strategy. Give us a call today.

We can all agree there is a global talent shortage and, considering the U.S. population is shrinking along with the number of people in the workforce, the issue is only going to get worse. So, we scoured publications, websites, and more to learn how health care practices and hospitals across the country are addressing the challenge. Here is some of what we found…

Upskill your current workforce.

Nothing says you value your people more than when you invest in their future. A 55,000-person healthcare system in Cincinnati, called Beons Secours Merc Health (BSMH), created Called to Grow – a program consisting of tuition reimbursement and career pathways to help employees move into higher skilled roles.  BSMH partnered with a company specializing in upskilling employees. All employees – whether on-call or full-time – are eligible to participate starting their first day of work. (Hilgers, Laura. How One Healthcare System Is Addressing a Talent Shortage. February 7, 2023. LinkedIn.)

Provide 100% tuition assistance paid up front.

As part of the Called to Grow program, BSMH covers 100% of tuition – paid up front – for more than 120 clinical certifications, undergraduate and graduate degrees, and nursing degrees at 15 institutions. (Hilgers, Laura. How One Healthcare System Is Addressing a Talent Shortage. February 7, 2023. LinkedIn.)

Career planning.

BSMH has three HR internal mobility specialists to learn about employee interests, identify potential careers, layout career paths, and help employees follow them. “Someone in laundry and linen services, for example, could train to become a care companion on the nursing support team. A care companion could then train to become a patient care technician.” (Hilgers, Laura. How One Healthcare System Is Addressing a Talent Shortage. February 7, 2023. LinkedIn.)

Engage students to create a talent pipeline.

Three hospital groups in Chicago created Healthcare Forward, a program offering high school students in economically depressed areas training and the guarantee of a job interview for entry-level positions. (UChicagoMedicine. Chicago Health Systems join forces to promote careers in healthcare across West and South Sides. December 6, 2021.)

Mary Washington Healthcare in Virginia worked with a local community college to create a clinical education model that allows student nurses to support current nurses before graduation. Geisinger in Pennsylvania provides up to 175 employees $40,000 in support a year to pursue a nursing career in return for a five-year commitment to work as an inpatient nurse. (American Hospital Association. Senate Statement: Recruiting, Revitalizing and Diversifying – Examining the Healthcare Workforce Shortage. February 10, 2022.)

Children’s Hospital Colorado and Denver Health’s Medical Career Collaborative (MC2) gives high school students hands-on experiences to foster interest in healthcare careers. 96% of participants complete the program and over 70% go on to pursue a healthcare career. Some even end up working for one of the two institutions involved. (Davis, Carol. Stop Workforce Shortages: 3 Ways. June 2022. HealthLeadersMedia.com.)

Offer an Apprenticeship Program.

Trinity Health in Michigan addressed its medical assistant shortage by adopting an apprentice program that has trained 129 assistants since its start and improved retention by 76%. It pays students to go to school three days a week and work at the hospital two days. (American Hospital Association. How Some Hospitals Are Grappling with the Workforce Shortage. June 28, 2022. AHA.org.)

Succession planning & promotion from within.

Indiana University Health places great emphasis on the talent review process. Staff record short- and long-term career goals on talent profiles, their dreams, and where they are willing to live. Each employee’s leader completes a talent assessment. Then senior leaders turn to the talent pool to fill manager and senior-level positions. Two out of every three promotions go to an existing employee. (Davis, Carol. Stop Workforce Shortages: 3 Ways. June 2022. HealthLeadersMedia.com.)

Use artificial intelligence (AI) for greater accuracy in staffing needs and scheduling.

Sanford Health’s previous nurse staffing plans were accurate about 60% of the time. Its AI driven tool enables data analytics that increased nurse staffing plans to 90% accuracy. As a result, patients were cared for, and staff didn’t burn out from being overworked or unable to take time off. (Davis, Carol. Stop Workforce Shortages: 3 Ways. June 2022. HealthLeadersMedia.com.)

There is one other thing you can do – engage RBT CPAs for all of your accounting, tax, audit and business consulting needs so your staff is freed up to focus on attracting and retaining the talent needed to provide care today and in the future. To learn what RBT CPAs can do for your organization, click here.