Reprising a $1 billion infusion to tribal entities last fall, the federal government is allowing tribes to issue another $1 billion in low-interest bonds that can be used for a wide range of projects, including health care centers.

According to the New Mexico Business Weekly, "The pueblos of Acoma and Ohkay Owingeh have been awarded bond allocations totaling about $29 million under the federal stimulus act." Acoma is using the new funds to build a wind farm. Ohkay Owingeh will use some $22.9 million for "refinancing, as well as recreational, government and commercial facilities."

Other tribes or pueblos helped by the program include Isleta, Santa Clara and the Navajo Nation.

Our Tribal Services team can help with a wide range of issues relating to financing. We've helped many clients approach these questions with creativity and insight. If you have questions, please contact us today.

The Lovelace Clinic Foundation of New Mexico will receive more than $13 million as part of stimulus funds designed to "advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future," according to a Health and Human Services Department press release.

The awards are intended to make health IT available to more than 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and IT.

Of the more than $750 million being awarded by the Department of Health and Human Services, $386 million will go to 40 states and qualified state-designated entities to facilitate health information exchange at the state level, and $375 million will go to an initial 32 not-for-profit organizations to support the development of regional extension centers that will help health professionals as they work to implement and use health IT. This assistance at the state and regional levels will facilitate healthcare providers' efforts to adopt and use electronic health records in a meaningful manner.

The more than $225 million being awarded by the Department of Labor will be used to train 15,000 people in job skills needed to access careers in health care, IT, and other high-growth fields. Through existing partnerships with local employers, the grant recipients have identified about 10,000 job openings for skilled workers that likely will become available in the next two years in areas such as nursing, pharmacy technology, and IT. The grants will fund 55 separate training programs in 30 states to help train people for secure, well-paid health jobs and meet the growing employment demand for health workers.

We wrote recently about a proposed 8 percent increase for the Indian Health Service in President Obama's Fiscal Year 2011 budget. It appears the healthcare sector is one the federal government intends to invest heavily in. Our Healthcare Services team is staying abreast of these developments and can assist you in navigating these uncertain times. Please call today.

The Healthcare Financial Management Association is noting several encouraging signs for not-for-profit healthcare organizations in recent news.

First, though bond rating downgrades were still more common than upgrades in 2009, the rate of downgrades slowed significantly in the second half of the year, according to Moody's. Last month, the debt of the parent company of Blue Cross and Blue Shield plans in Illinois, Texas, Oklahoma and New Mexico was downgraded, but only slightly; the company remained in the upper tiers.

Second, a new Standard & Poor's Ratings Services report says "the sector is showing signs of stabilization." The report said credit solidification began at the end of 2009, and ratings and outlooks are expected to settle this year.

Though neither piece of news answers longer-term questions about the healthcare environment, these positive developments can give leaders of not-for-profit healthcare organizations reason to take a new look at their broad assumptions. Our Healthcare Services team can help dig into these findings to look for new opportunities so you can be one of the first back in as the economy returns. Please contact us today.

New data reported by the Healthcare Financial Management Association show that Medicare not only pays for a larger percentage of patient visits to rural hospitals but also pays a higher rate of aggregate costs than in urban hospitals. According to the Agency for Healthcare Research and Quality, Medicare paid for:

• 45 percent of all stays in rural hospitals in 2007 vs. 35 percent in urban hospitals.

• 55.7 percent of aggregate costs in rural hospitals vs. 44.3 percent in urban hospitals.

The statistical brief also found that patients from the lowest income bracket accounted for more than half of all stays in rural hospitals. The study also noted that average costs per stay are lower in rural hospitals ($6,500) than urban ($9,000) and that the length of a stay in rural hospitals is almost a full day shorter on average.

New Mexico has a relatively high rural population – 25 percent in the 2000 Census, which gives the question particular importance in our home state, but most states have sizable numbers of residents living outside urban areas. REDW has worked in this area for years and can help your healthcare organization successfully manage its accounting for federal reimbursement programs. Please contact our Healthcare Services team today for more information.

The move to International Financial Reporting Standards (IFRS) will necessitate significant changes in how financial professionals approach their work, according to renowned panelists at a recent industry forum.

One panelist compared Financial Accounting Standards Board Statement No. 133 – an 800-page guide on "Accounting for Derivate Instruments and Hedging Activities" – and the U.S. Constitution as examples of rules-based vs. principles-based approaches. IFRS represents a more principles-based approach to reporting.

Though IFRS could reduce the number of rules financial professionals must be familiar with, the new standards will also create a greater responsibility and require new ways of analyzing choices, the panelists noted.

The shift could place a greater emphasis on experience in the industry. To learn more about what these changes could mean to your company or organization, please call our experienced Audit Services team today.