Every month Becker's Hospital Review publishes their list of hospitals that have received credit downgrades. The list can be excruciating to look at because of the mighty repercussions that come from a downgrade. This is especially true if the hospital was about to launch a new construction project or look to expand through acquisition. Even a slight downgrade can deliver a mighty blow to a hospital's ability to obtain and/or service debt.

The Centers for Medicare & Medicaid Services (CMS) published a report outlining the projected national health expenditures through 2025. “From 2015 to 2025, health spending is expected to grow an average of 5.8 percent a year — 1.3 percentage points faster than the economy, measured by the gross domestic product,” according to Robert Pear in a NY Times article. The Obama Administration said, “National health spending will average more than $10,000 a person this year for the first time.”

The Consumer Financial Protection Bureau (CFPB) continues to encourage financial institutions to help those with limited or no credit histories. This group, referred to as credit invisible, represents one in every ten adults in the United States. These individuals have not had the opportunity or ability to build enough credit to generate a score with any of the nationwide credit reporting companies. In a CFPB article, the bureau recommends ways for individuals to begin building their credit in order to gain access to the numerous opportunities in life that have a credit requirement for participation.

Investigations into hospital debt collection practices continue to be a growing concern. With the increase in patient responsibility, more and more consumers are struggling to pay their medical bills. These unpaid bills are then reported to credit agencies, which results in angry consumers that seek legal counsel. A Missouri hospital was recently investigated over concern that the debt collection practices were too aggressive and sufficient information about financial assistance was not provided to the patient. An HFMA article stated that only 42% of hospitals notified patients of financial assistance policies prior to attempting to collect unpaid medical bills. The Missouri hospital investigation concluded with a range of policy changes implemented, including a direct notification of financial assistance 180 days prior to sending bills to collections.

I had a conversation with a local medical provider this morning and after we talked I was more sure than ever that if you're a community bank or a regional bank, the community or communities you serve need your help. Please.

As 2017 draws to an end, most medical providers are facing two challenges - an influx of procedures from those that have met their deductibles for the year and the dreaded dip in procedures at the start of 2018 as deductibles reset. While the end of year increase can have a positive impact on the revenue cycle, the scheduling and logistics for the unpredictable number of patients is difficult to manage. All of the adjustments for the high volume will then have to swing drastically the other direction at the start of the year. Not only are more and more patients burdened with high-deductible plans, but the coverage of these plans is expected to decrease while the cost continues to rise. A recent article from HealthiPass outlines the budget difficulties of patients and the impact to the medical provider's revenue cycle.

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The other night I received a phone call that pointed out an approach that companies commonly take when talking to their customers that I don't understand. My trial period of XM radio was about to expire, so I was contacted to renew my subscription. I answered the phone and was pleasantly surprised when it was a person, for a minute, then he proceeded to read a script about how awesome their product is and what a deal it would be to renew the subscription. I told him I wasn't interested, which prompted him to read another, very similar, script. Again I told him I wasn't interested and that was the end of the call.

Banking has never been synonymous with innovation and change. Banks have long made their mark as being safe, trusted pillars of the community. However, a recent market review by Onovative has found something interesting. While customers still want their bank to be safe and trusted, it appears that the most successful banks are willing to step out of their comfort zone and into innovative new products.

Full disclosure, breakfast meetings are my favorite. Something about sitting down to comfort food in a day that has not yet been tarnished that causes me to go into breakfast meetings with an off-the-charts positivity. All of this is to say, I was probably particularly receptive to new concepts when Jessica Toney, Product Manager here at Epic River, and I sat down with Todd Gentry, the Director of Software Development for D+H, at a cool little breakfast joint in Portland.