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RWJBarnabas Health CFO: Pandemic Financial Update and M&A Expectations

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RWJBarnabas Health CFO: Pandemic Financial Update and M&A Expectations


John William Doll, CPA, CFO of RWJBarnabas Well being, detailed the place the well being system stands financially, why it hasn’t but reached a ‘new regular,’ and the way it will navigate a altering trade.

For RWJBarnabas Well being, the 11-hospital system based mostly in West Orange, New Jersey, rising from the pandemic is difficult.

On the finish of April, there have been solely 350 sufferers contaminated with COVID-19 throughout the group’s services and properly under expectations, in keeping with John William Doll, CPA, CFO of RWJBarnabas.

Doll mentioned that the supplier group utilized predictive modeling in anticipation of a troublesome Q1 and “ready for the worst.” Nonetheless, RWJBarnabas has benefited from a better understanding of the way to deal with the virus, developments in-home monitoring care, and a robust nationwide vaccination effort.

“We have been in a position to deal with if you wish to name the ‘second wave’ of the pandemic in New Jersey way more effectively than we have been a 12 months in the past,” Doll mentioned. “So, we’ve had an identical variety of sufferers, however so much much less ventilator utilization and so much [fewer] sufferers within the hospital.”

Related: 4 Questions with RWJBarnabas Health CFO John William Doll

Nonetheless, RWJBarnabas, like different well being techniques throughout the nation, has endured greater than a 12 months of medical, monetary, and operational challenges associated to the pandemic. Doll pointed to staffing up for acute care and the ICU, which resulted within the group counting on costly company sources that exacerbated monetary strains.

“For the primary quarter, all in, we’re nearly to interrupt even from operations, which is properly under our historic efficiency,” Doll mentioned. “Nonetheless, we predict it’s fairly good given the continued slowdown of restoration efforts and after funding within the infrastructure essential to take care of that second wave and a bunch of different elements.”

In a latest dialog with HealthLeaders, Doll detailed the place the well being system stands financially, why it hasn’t but reached a ‘new regular,’ and the way it will navigate a altering trade.

Balancing long-term and short-term priorities

When wanting on the group’s technique going ahead, Doll burdened that there’s “no crystal ball.”

Within the short-term, RWJBarnabas has dedicated to sustaining staffing ranges with out large-scale reductions, Doll mentioned, noting that the group doesn’t know when volumes will return to regular and that the medical crew was dependable in the course of the pandemic.

Doll mentioned one of probably the most insightful discoveries is that from July 2020 to the tip of the 12 months, RWJBarnabas noticed progressive enhancements in exercise, trending again to historic ranges. Nonetheless, he acknowledged declines from November via January as COVID-19 instances spiked nationwide, adopted by a rebound in February.

Doll mentioned that management is making an attempt to grasp the patterns related to the coronavirus, noting that there’s variability by facility and never a transparent stabilization of historic actions.

“What we now have deduced is that we’ve not but reached ‘a brand new regular;’ there’s nonetheless quite a lot of volatility and we should be versatile in response to that,” Doll mentioned. “Lengthy-term, I might say it is most likely not till the tip of this 12 months earlier than we get an actual sense of what ‘regular’ seems like.” 

Doll outlined a number of indicators throughout the enterprise that RWJBarnabas executives are following to find out when tendencies normalize.

In acute care, there’s a better deal with whole surgical exercise, he mentioned, in addition to go to volumes in key areas such as oncology, radiation remedy, infusion therapy, cardiac catheterization procedures, and the “key drivers” of the in-person hospital enterprise.

Doll talked about that he’s analyzing the system’s free-standing imaging volumes and making an attempt to correlate that to routine doctor workplace visits. He added that RWJBarnabas is monitoring its telehealth choices, noting that digital care utilization has stabilized to about 30% of the group’s exercise.

What’s going to drive M&A?

Whereas many anticipate that COVID-19 will accelerate provider consolidation, Doll mentioned believes that what makes transactions profitable is cultural and strategic alignment. Even when well being techniques of an identical measurement pursue a mega-merger, Doll mentioned the transaction can in the end fail as a result of an absence of complementary cultures.

Popping out of the pandemic, Doll acknowledged that having a scale as a corporation shall be essential, including that he thinks smaller suppliers will look to bigger techniques for help.

Doll additionally referenced a Kaufman Hall report launched final month that discovered there have been fewer healthcare M&A transactions in Q1 2021 in comparison with Q1 2020 however the measurement of the offers was bigger.

He mentioned it was “outstanding” to see the tendencies of diminished ER volumes and various restoration by service line throughout the trade, reiterating the necessity for scale to beat these obstacles whereas emphasizing the significance of cultural alignment.

Related: Coronavirus: How RWJBarnabas Health is Administering Monoclonal Antibodies

When requested what influence elevated supplier consolidation might imply for the trade total, Doll highlighted the native nature of healthcare and the challenges dealing with small hospitals that fold into a bigger system. Nonetheless, he additionally mentioned that being affiliated with a system might make sense for rural hospitals that have to present the proper help to superior care in ways in which the group could not do by itself.

Wanting on the New Jersey market, Doll mentioned that the majority smaller healthcare acquisitions have “come and gone,” leaving competition mainly among the systems. He added that past provider-provider mergers, well being techniques have an incentive to scale up and associate with firms that may improve the alternatives to leverage large information in care supply.

“I feel larger-scale organizations fascinated by [the] supply of service is in the end a part of the answer,” Doll mentioned. “When it comes to entry, availability of high-end specialists, and rationalization of these issues, you want a coordinated method. That usually is best addressed by a bigger supplier protecting a bigger area.”

“Now, it is onerous to say, ‘Does that enhance in scale have the identical influence as a few small suppliers coming collectively,’ if you have a look at multi-state organizations which are pushing collectively throughout state strains,” Doll mentioned.  “I feel time will inform.”

“My opinion is that if you consider well being insurers, they’ve rolled up nationally and a supplier community that is complementary of that would make quite a lot of sense.”

Recommendation for friends

Past the continuing efforts to ramp up vaccinations and curb the unfold of COVID-19, Doll mentioned that his CFO friends ought to stay targeted on the reemergence of tendencies that have been going down previous to the pandemic, comparable to value and entry points.

He pointed to the impact of the price transparency rule that presently applies to suppliers and can have an effect on payers in the beginning of 2022, in addition to the “unsustainable” nature of the price curve in healthcare.

“I feel because the nation and world strikes to restoration, we’re going want to deal with the final word value of care and that is one thing that I feel will proceed to be on the forefront,” Doll mentioned. “We have misplaced deal with it for a short while, appropriately in order we handled a disaster, however I feel we’re getting again into the actual want to alter that as an trade.”

Related: RWJBarnabas Health Exec: How We End Racism Together

Jack O’Brien is the Content material Workforce Lead and Finance Editor at HealthLeaders, an HCPro model.



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Easy Balsamic Glaze

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Easy Balsamic Glaze


Years in the past I assumed I didn’t like balsamic vinegar and would all the time go for different salad dressing choices. After lastly giving it an opportunity, I found not solely did I prefer it, however it’s downright scrumptious! This balsamic glaze is extra concentrated than a French dressing and even easier to make. We find it irresistible on veggies, meat, and even recent fruit

What’s Balsamic Glaze?

First, let’s begin with defining what (actual) balsamic vinegar even is. Aged balsamic vinegar is made in Italy from grape should and aged for no less than 12 years in wood barrels. The ensuing vinegar has a naturally candy taste… and it’s extremely costly. The Italians are very strict with their meals {qualifications}! That’s why many grocery retailer manufacturers add caramel coloring and sweeteners to common wine vinegar for balsamic look-alikes.

There’s one other classification of balsamic referred to as balsamic vinegar of Modena that’s simpler to search out. Simply search for one thing that doesn’t have added colours, sweeteners, or flavors, and has been barrel aged for no less than a number of years. The very best balsamic glaze is made with good high quality vinegar.

Tips on how to Make Balsamic Glaze

Making the balsamic glaze actually couldn’t be any simpler! Unlike a vinaigrette which is a mix of vinegar, oil, and spices, a glaze is only a discount. Some recipes name for brown sugar or white sugar, however I like to make use of honey in mine. Maple syrup additionally works properly. Or maintain it even easier and skip the sweetener totally!

The glaze is of course gluten-free, dairy-free, grain-free, and provides a tangy enhance to a lot of totally different meals. Simply make sure you regulate it because it cooks to stop burning. There’s nothing sadder than a burnt balsamic glaze. And make sure you take a look at an inventory of the way to make use of your new balsamic glaze under the recipe.

Balsamic_Glaze

Easy Balsamic Glaze Recipe

This balsamic glaze makes an incredible drizzle over salads, roasted veggies, meats, and even recent fruit!

  • Pour the aged balsamic vinegar right into a small saucepan over medium warmth. Add honey or maple syrup if utilizing.

  • Deliver to a delicate boil, then cut back the warmth to low and let it simmer for 10–quarter-hour, stirring often.

  • It’s prepared when the combination has diminished by about half and coats the again of a spoon. Don’t over-reduce—it can proceed to thicken because it cools.

  • Use instantly or cool to room temperature and switch to an hermetic container. Refrigerate for as much as 1 month.

Diet Details

Easy Balsamic Glaze Recipe

Quantity Per Serving (1 tsp)

Energy 11

% Every day Worth*

Sodium 2mg0%

Potassium 11mg0%

Carbohydrates 2g1%

Fiber 0.002g0%

Sugar 2g2%

Protein 0.1g0%

Vitamin C 0.004mg0%

Calcium 3mg0%

Iron 0.1mg1%

* P.c Every day Values are primarily based on a 2000 calorie weight-reduction plan.

The glaze will naturally thicken because it cools. If it turns into too thick, merely reheat it with a bit water to succeed in the specified consistency.

Storage Suggestions:

  • Glass jars or bottles work finest to keep up freshness.
  • Keep away from contamination by utilizing a clear, dry spoon every time you scoop some out.
  • If it turns into too thick, merely reheat it with a splash of water to revive consistency.

The vinegar’s pure acidity helps protect the balsamic discount, however for those who discover off smells, mildew, or separation, it’s time to discard it.

Tips on how to Use Selfmade Balsamic Glaze

In search of some new recipes to attempt or methods to make use of your home made glaze? Some widespread choices embrace conventional Italian burrata cheese on bruschetta bread. We don’t eat loads of bread round right here, so I’ve collected another choices under as properly.

Attempt balsamic glaze drizzled on:

Have you ever ever used balsamic glaze earlier than? What are your favourite methods to make use of it? Go away a remark and tell us!

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MyFitnessPal Information: Dietary Fiber Version

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MyFitnessPal Information: Dietary Fiber Version



MyFitnessPal guide: Fiber edition

Dietary fiber doesn’t all the time get the eye it deserves. In accordance with a survey conducted by MyFitnessPal, most customers affiliate fiber with bowel actions. However fiber is definitely much more than that—it’s an important nutrient that helps digestion, coronary heart well being, and even weight administration.

This information brings collectively expert-backed insights and MyFitnessPal instruments that will help you benefit from fiber in your weight loss plan.

Brookell White expert bio

An Important Information to Day by day Fiber Necessities

In comparison with protein or omega-3 fatty acids, fiber could not all the time be essentially the most thrilling matter on the planet of diet. It’s a extremely essential one, although. As a result of most of us eat so little fiber, it’s been a “nutrient of concern” in line with the USDA since 2005. Right here’s what you want to find out about dietary fiber and tips on how to ensure you get sufficient in your every day weight loss plan.


7 of the Finest Meals for Intestine Well being, In accordance with a Gastroenterologist

Good intestine well being is intimately linked to dietary fiber. And, regardless of your weight or well being targets, understanding tips on how to assist your digestive system with a nutritious diet generally is a game-changer. On this article, you’ll discover out the very best fiber-rich and probiotic-packed meals for intestine well being and which of them could do harm.


8 Excessive-Fiber Meals that Help Weight Loss

When individuals begin a weight-loss journey, they usually fear that slicing energy will go away them hungry and irritable. And being hangry (aka, hungry and offended) isn’t enjoyable for anybody.

However, if you eat the appropriate meals, that doesn’t should be the case. Enter: fiber. In case you’re having bother reaching your targets, you possibly can discover success with high-fiber meals that assist weight reduction.


Caroline Thomason expert bio

5 Indicators You’re Not Consuming Sufficient Fiber

In case you’ve ever felt bloated, sluggish, or continuously hungry regardless of consuming common meals, you could have skilled a number of the signs of low fiber. 

And also you’re not alone.  In actual fact, in line with a survey performed by MyFitnessPal, 88% of members surveyed say they do not know how a lot fiber, protein, carbs, sugar, or salt they eat every day. Solely 52% of individuals surveyed take note of how a lot fiber they’re consuming every single day. 

Able to concentrate on fiber and reap the advantages?  We’re right here that will help you spot the indicators of low fiber consumption—and tips on how to repair it. 


Different Instruments for Success

  • Tracker Tip: Log your meals in MyFitnessPal to trace your fiber consumption. Seeing your progress towards your every day fiber purpose helps you make smarter selections.
  • Interactive Software:  Take MyFitnessPal’s Are You Getting Enough Fiber? quiz to get your fiber rating and discover out what you are able to do subsequent to fine-tune your fiber experience.

The submit MyFitnessPal Guide: Dietary Fiber Edition appeared first on MyFitnessPal Blog.

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Making sense of the GOP’s proposed Medicaid cuts, which may depart 8.6 million folks uninsured

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Making sense of the GOP’s proposed Medicaid cuts, which may depart 8.6 million folks uninsured


Republicans within the Home of Representatives have released their proposal to chop an estimated $715 billion in funding for Medicaid. If it turns into regulation, the plan would end in 8.6 million extra uninsured Individuals within the subsequent decade, in line with an evaluation by the nonpartisan Congressional Finances Workplace.

Congressional Republicans argue that the cuts are essential to remove “waste, fraud and abuse” and that they offset the prices of what President Trump has called a “large, stunning” authorities spending invoice that may seemingly embody trillions of {dollars} in tax cuts.

Well being care coverage is tremendously sophisticated, and it may be very simple to get misplaced within the particulars, partisan spin and legislative maneuverings. So right here’s a easy rundown of what the GOP plan goals to do and what it would imply for you.

What’s Medicaid?

Medicaid is a authorities medical health insurance program that covers greater than 70 million low-income and disabled Individuals, about one-fifth of the overall U.S. inhabitants. It is likely one of the largest and most costly federal authorities applications. In 2024, Medicaid spending totaled $618 billion, making it the fourth-largest supply of direct spending, behind Social Safety, Medicare and protection.

Enrollment in Medicaid has practically tripled over the previous three and a half a long time, thanks partly to components of the Inexpensive Care Act which have helped most states increase eligibility for this system.

Trump has repeatedly insisted that cuts to Social Safety, Medicare or the army are off the desk. That left Medicaid as the primary goal for the GOP to fulfill its spending discount targets.

What the GOP plan would do

There are two primary classes of reforms included within the 160-page proposal.

The primary is a set of recent procedural guidelines that may improve the variety of hurdles that individuals might want to clear to obtain or keep Medicaid protection. It will create work necessities for able-bodied adults with out dependents, who would lose their protection if they will’t show that they labored or volunteered for a minimum of 80 hours monthly. Folks receiving Medicaid must confirm their eligibility each six months as an alternative of annually. They’d additionally must confirm their citizenship or authorized immigration standing with their state in an effort to be eligible to obtain federal Medicaid spending.

Whereas these provisions could appear to be little greater than additional paperwork, many experts imagine that the primary results of growing what’s often called the “administrative burden” for public help is that people who find themselves eligible to obtain advantages fall by way of the cracks.

Some Medicaid recipients may also see their out-of-pocket prices go up. Underneath the plan, anybody with an earnings above the federal poverty line would pay the next “value sharing” price — as much as $35 per go to.

The second, and largest, supply of Medicaid cuts would come from adjustments to how the federal authorities helps states. A lift in funding for states that was put in place through the COVID-19 pandemic can be eradicated. The proposal would put strict limits on a tax work-around often called “supplier taxes” that almost each state makes use of to extend the quantity of well being care cash it will get from the federal authorities.

Some hard-line Republicans in Congress had referred to as for much more aggressive cuts, together with a per-person cap on federal spending. These provisions have been ignored in what’s being framed as a win for moderates inside the celebration.

Which states depend on Medicaid essentially the most?

Medicaid is vital to each state, however the federal authorities’s function varies from state to state. California is dwelling to 12 million Medicaid recipients, greater than twice as many as another state. Uncooked totals solely inform a part of the story, although. New Mexico has the very best price of Medicaid enrollment as a share of its population. In 2023, 38.5% of New Mexico residents have been insured by Medicaid, in line with the well being coverage analysis group KFF.

The federal authorities supplies a lot of the funding for Medicaid, however states choose up a part of the tab as properly — about 30% on average. Some states are much more reliant on the federal government than others and would presumably really feel a higher impression of any cuts handed by Congress. Seven states (New Mexico, Mississippi, Oklahoma, West Virginia, Kentucky, Arkansas and Arizona) bought 80% or extra of their Medicaid funding from the federal authorities in 2023, in line with KFF information.

Republicans have little or no room for error. They’ve slender majorities in each homes of Congress and might seemingly count on unified opposition from Democrats on any spending package deal that comes up for a vote.

The cuts to Medicaid are only one piece of an enormous spending plan that’s nonetheless coming collectively, and dissent on any piece of that invoice may sink your complete factor. Some centrist GOP members have mentioned they won’t back steep cuts to Medicaid, nevertheless it’s unclear whether or not they are often satisfied to get behind this new, much less drastic, set of reforms. The celebration may face some hassle if the plan passes by way of the Home. Republican Sen. Josh Hawley referred to as slicing Medicaid “each morally incorrect and politically suicidal” in an op-ed revealed within the New York Occasions on Monday.

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