Where’s My Cash?


Are you often asking yourself this question? You know your operations are well-run, you assume your facility is financially secure and profitable, yet you’re tight on cash. Why?

You’re not alone. Many owners and operators are tossing and turning at night with this very question running through their minds.

Enter LTC Financial Advisory Services, and the outsourced CFO solution.

An outsourced CFO gives you access to just the right amount of senior financial talent, providing high-level oversight and big-picture answers. Small to mid-sized companies can access an experienced financial mind at a cost that matches the needs and budget of their business, and eliminate many worries and headaches.

Through a team of experienced CPA’s, LTC obtains a thorough understanding of your financial picture. Although not physically on hand, the Financial Advisory team is in complete control of your company’s financials.

Imagine having a senior CFO on standby.

  •  Worried about next week’s call with your bank or lender?
  • Struggling with financial projects and accounting decisions?
  •  Are my expenses in line with industry averages?
  •  Going through a merger or acquisition?
  •  Need help developing an accurate budget?

Get some peace of mind! Count on LTCFAS to focus on your complete financial picture and to jump on tough calls with your banks and lenders. Free up your precious time and focus your energy on business development and growth.

The accounting world is evolving, and you need an objective CFO on the leading edge.

An outsourced CFO contributes a broad wealth of knowledge and best practices based on their experiences. This independent viewpoint brings a fresh perspective to the difficulties your staff may be too entrenched in.

Objectivity makes an outsourced CFO solution much more than a financial advisor. They can pinpoint gaps and inefficiencies in your workflow. They make suggestions for streamlined processes and systems. LTC has experience using various technology solutions and programs, giving them the knowledge to recommend and implement new technology that will best benefit your business. The Financial Advisory Services team at LTC oversees your business’ financial and accounting departments, including high-level oversight of these employees.

It just makes sense.

Outsourcing a CFO provides your business with access to just the right amount of senior talent without the full-time price tag. Outsourced CFO services are a function of the Financial Advisory Services division at LTC Consulting Services.

Learn More About Our Financial Advisory Services

LTC Consulting Lens: The 5 letter word shaking up PA

This is a another great clip from our Vlog!

Find out about the MLTSS changes in Pennsylvania from LTC Consulting’s very own Steve Shain.

Stay informed with LTC’s outlook on the Healthcare business world, our AR collections, receivables financing and collection of receivables processes. News, upcoming changes, and policy updates. A great way to keep on the pulse of our industry, without searching further than YouTube.

Subscribe to our You Tube Channel so you don’t miss the next one! Get in touch with us about a free evaluation!


Steve Shain: Hi, welcome back. Today I’d like to talk more about the Pennsylvania rollout of MLTSS beginning in January 2018, right around the corner for the more rural areas and then January 2019 and January 2020 for the more urban areas. MLTSS as you know stands for Medicaid’s little trick saving shekels, right? That’s what they try to do, they try to save money. No, it really stands for Managed Long-Term Services and Supports. The insurance companies that are participating are Amerihealth, PA Health and Wellness and UPMC. The eligibility process – the same as – it’s basically going to be the same as Medicaid. The application process – basically gonna be the same as Medicaid, same forms submitted. Billing process – the basics can be the same as well. There’s gonna be a little bit of a difference when somebody’s pending Medicaid in regards to their coverage, which will be Medicaid at first and then the insurance company, but overall not much is changing. So what really are you gonna see as a difference? Well, aside for a slower cash flow and a more unpredictable cash flow, probably you’re gonna see a more frequent denials on your claims and a more fragmented process from the insurance companies, especially in the beginning while they’re trying to figure things out. A couple of differences between each of these insurers that is worth noting; No. 1 is that the insurance are not requiring the custodial authorization for coverage similar to what a managed care usually would require. Amerihealth is the only one that’s asking for an authorization but they’re gonna be the ones that are going to be covering that process. They’re not gonna put that burden on the facility to make sure that authorization is in place. In contrast to maybe New Jersey for example, where all of the managed MLTSS insurers do require a custodial authorization be obtained by the facility. Another interesting difference is that the other insurance are giving basically a lock-in of your Medicaid rate for the last 4 quarters, and that goes to the extent of the contract. PA Health and Wellness is giving an option; either you can get your rate similar to those other insurers or you can base it off of CMI, your case mix index. So obviously if you feel your CMI is going to be going up or has been on a trend to go up, you probably want a contract with them on that structure that way your rate has a better chance of being higher, if on the other hand you feel that your CMI is not that awesome, you want to lock in your rate as per the last four quarters of your Medicaid rate in order to make sure that you’re getting decent reimbursement. I also wanted to point out if any of you are going to be at the AJAS conference in February, February 13, I will be there speaking on managed care for everybody at the conference. Would love to see there, if you’re going to be there awesome, if you’re not going to be there and you’d like to ask me questions about managed care or about this specific thing, MLTSS, please reach out. If you’d like to talk to your organization, please reach out, I’ve been happy to talk to you if it helps I’m there. Thank you so much for listening take care.

LTC Consulting Lens: The Healthcare Double Whammy

This is a great new clip from our Vlog!

The President was on fire last week, rolled out 2 potential plans an executive action and
change to cost share reductions. This would mean major changes in health insurance…if it goes through.

Find out about the ramifications and what to expect from LTC Consulting’s very own Steve Shain.

Our mission is to support the Long- Term Care Profession with expert billing and business office services and
enable improved financial performance for our clients.

Stay informed with LTC’s outlook on the Healthcare business world, our AR collections, receivables financing and collection of receivables processes. News, upcoming changes, and policy updates. A great way to keep on the pulse of our industry, without searching further than YouTube.

Steve Shain: Hey everyone, welcome back! So as you’ve heard, the efforts to repeal and replace
Obamacare didn’t really work out too well; they were close but no cigar. Repeal and replace didn’t have
enough votes so therefore Obamacare is back as the law of the land. Everybody said – OK, that’s how
things are going to be for now. Well that’s what we thought, but last week all of a sudden the president
drops these bombshells. An executive action that he’d like to put in place, the changes in the cost-
sharing reduction. Two bombshells in one week…Mr. President, I think you’re the one that should be
called Rocket Man. But anyways, these changes. What are these changes exactly? The executive action
is basically trying to make everyone currently in the healthcare marketplace under Obamacare to see
some much prettier options out there that they would want to join for insurance plans and insurance
coverage instead of Obamacare. These are association health plans, which are health plans that can be
run by small businesses that will allow them not to be held down by many of the state guidelines and
state minimums, they won’t even be held down by state borders. They can cross state borders and
therefore make the healthcare marketplace much more competitive, with many more options out there.
Short term plans that used to only be working for about 90 days would now be able to be extended to
about a year. So again, these plans were not ones that were held down to the same guidelines that
other health insurance plans were and therefore, they’re going to be the ones that are more appealing.
They’re going to be cheaper and they would have better options again, for the healthier population. So
with these kind of options coming up it’ll make a decision for many of the people who are currently in
the marketplace not to really jump in there. And the second thing is this cost-sharing reduction, which
basically is a subsidy that the government was giving to insurance plans in order to help keep down co-
pays, deductibles and premiums that they were offering to their members. Now that that subsidy would
go away, it would make it that much more difficult for the insurance plans to keep these plans active.
So, with open enrollment coming up in a couple of weeks, it’s something that really blows things up and
it’s interesting to see that the timing of this was so interesting how it’s played out but no need to worry
it’s probably not going to make any changes today or tomorrow, it’s probably going to be six months to
nine months before we hear anything. We’re already hearing from the attorneys general in New York
and California – yes attorneys general, that’s how you say it – but these attorney generals are already
working on a lawsuit to go against any of these decisions that they may want to put in place. So there’s
definitely going to be push back, and probably expect that there’s going to be some push back, or a lot
of push back, and therefore nothing is going to happen overnight. And as the former CEO of Aetna, Mr.
Ron Williams was quoted saying in the news that nothing drastic can really happen because there are
many federal reviews that need to go into place in order to see that this law or potential law is
something that could be feasible and something that’s not going to leave anybody high and dry without

any real feasible options so you should expect probably that it’s not going to be as drastic as the
president wants and it’s not going to be as toned down necessarily as the Democrats want, probably
something in the middle. We will be obviously following this to see how it turns out. I’ll keep you posted
and of course you have any comments or feedback let me know so we can make this better for you.

Subscribe to our You Tube Channel so you don’t miss the next one! Get in touch with us about a free evaluation!