THIRD PARTY REIMBURSEMENT
Examples of two frequent requested services are cost reporting and cost report audit adjustment appeals.
The Lancaster Group, LLC assists its clients in the preparation of Medicare and various state Medicaid Cost Reports. Using the cost reporting process to enhance reimbursement (e.g., through Medicare bad debts, Medicaid capital, where applicable) and to identify opportunities for operational improvement (e.g., through benchmarking) allows our clients to benefit from the ideas and experiences we bring to these engagements.
The Lancaster Group, LLC assists its clients in the appeal of Medicare and Medicaid Cost Report audit adjustments made both to cost reports prepared by clients themselves and by external advisors. Working with both client representatives and legal counsel, we analyze the financial impact of the adjustments, consider the effect of Medicare adjustments on Medicaid, develop strategies for negotiation, consider the future financial and compliance impact of any settlement terms and act as expert witness in testimony.
Examples of two frequent requested services are contract analysis and negotiation and budgeting.
The Lancaster Group, LLC assists its clients in the analysis and negotiation of vendor and third party payer contracts. Identifying competition for supplies and services (i.e., alternate vendors) and analyzing quoted rates and required outcomes (e.g., Medicare Part A therapy utilization) from our experience, we enable our clients to negotiate favorable cost and production standards from vendors. With respect to third party payer agreements we assist our clients in developing favorable rate structures and ancillary carve-outs. Additionally, we assist our clients (or client counsel) with negotiating contract terms.
The Lancaster Group, LLC assists its clients in budgeting. Developing revenue (volume and pricing) assumptions using our third party reimbursement experience and expense assumptions we assist clients in producing budgets for future ongoing operations (“same store sales”) and new developments, acquisitions or programs. Our budgeting engagements assist clients who are in need of a third party to evaluate internally-prepared operating budget assumptions or who require assistance in developing assumptions for financial projections.
SYSTEMS IMPLEMENTATION AND ONGOING PERFORMANCE
Our clients benefit from our knowledge of software systems or “packages”, both healthcare-specific and general.
The Lancaster Group, LLC assists its clients by identifying ways in which software systems (e.g., general ledger and accounts receivable packages) can be more effectively utilized. Healthcare providers typically upgrade or change software systems approximately every five years. Although funds are expended on necessary hardware upgrades and the software itself, oftentimes training is an afterthought. The challenges of employee turnover and increasing complex regulations make use of software more critical, but more difficult to understand. Our clients benefit from our approach when we “stay involved” to ensure effective, ongoing use of the software packages.
The Lancaster Group, LLC assists its clients by identifying ways in which spreadsheet and word processing software can enhance business processes. Healthcare providers generally perform a number of repetitive tasks or “business processes” in a variety of manual and automated ways. Multi-site providers often are not consistent from site to site in the manner in which the processes are performed. Our clients benefit from our industry experience when we bring efficiency enhancing ideas on the way in which processes can be automated and made more consistent through the effective use of spreadsheet and word processing software.
FINANCIAL, OPERATING AND REGULATORY DUE DILIGENCE
Our clients benefit from our knowledge of the long term care and senior housing industries when contemplating an acquisition or divestiture.
The Lancaster Group, LLC assists its clients in performing due diligence on acquisition candidates. Third party reimbursement (past, current and expected future), volume and rate analysis, expense assumptions, assumption of liabilities, regulatory compliance issues, vendor and third party payer contracts and staffing analysis are some of the areas that our buyer/lender clients utilize on single site and multi-site acquisitions.
The Lancaster Group, LLC assists its clients in performing divestiture analysis. Identifying and screening acquisition candidates and negotiating sales agreements are two of the more common services we provide to our clients that are considering a strategic divestiture.