Physicians and advanced practice providers are crucial to every performance, quality, safety, care utilization and patient satisfaction goals. These factors significantly affect an organization's financial viability, which is why providers' compensation must be aligned with them.
Frost & Sullivan’s award was bestowed on GE’s Centricity Financial Risk Manager which enables healthcare systems to reduce the cost of administering risk-based contracts, thus improving profitability and maximizing efficient workflows.
Providers face an onslaught of daily practice management challenges. In this MGMA Body of Knowledge (BOK) brochure, uncover relevant and practical essentials to improve any medical practice. Explore areas such as operations and financial management, governance, patient care and adverse legal events. The MGMA Body of Knowledge helps you easily define improvement areas within your medical practice. It also assists all employees in building a sustainable business plan and optimizing daily operations for better performance.
Published By: MedAssets
Published Date: Nov 05, 2015
The shift to value-based care is one of the most significant financial, cultural and technological challenges ever faced by the U.S. healthcare system—and it will affect every stakeholder in the system. Healthcare providers can no longer focus solely on process-oriented measures and instead need metrics that gauge progress to deliver high-value care. This healthcare executive report provides three steps hospital executives can take now as they transition from volume to value and break down silos to create the infrastructure, processes and workflows required to succeed.
Published By: McKesson
Published Date: Jul 09, 2015
When it comes to making decisions that positively impact care delivery and business outcomes, great leaders will tell you it’s better to rely on data than on myth. Through healthcare analytics, the clinical and financial leadership at Regions Hospital in Saint Paul, Minnesota used data to do just that—and set a strong course for reliable, trusted decision-making that helps address their most pressing issues. Using strong IT systems, accompanied by a cooperative and inquisitive organizational culture that brings together clinical and financial decision makers together to address pressing issues, put Regions on the path to create powerful healthcare analytics that fuel organizational change.
Nearly six years after passage of the Patient Protection and Affordable Care Act, the healthcare industry is in the midst of a massive retooling that is dramatically altering the way we think about cost management, strategic partnerships, and customer service.
Fee-for-service reimbursement is giving way to new models of care delivery and payment to support a system based on pay-for-value. With financial risk or payments tied to value measures (such as patient satisfaction, clinical performance, and population health), compensation and reimbursement will increasingly be tied to value-based incentives.
The annual Truven Health 100 Top Hospitals® identifies U.S. hospitals with the best overall performance across multiple organizational metrics, including clinical, operational, and financial. The ability of some hospitals to adapt as the industry is changing demonstrates leadership as the winners set the standards their peers seek to achieve. Study projections indicate that if the new national benchmarks of high performance were achieved by all hospitals in the United States, nearly 126,500 additional lives could be saved, almost 109,000 additional patients could be complication-free, and $1.8 billion in inpatient costs could be saved.
Healthcare organizations with strong bond ratings are regarded favorably from a financial perspective, of course. In addition, research by the Truven Health AnalyticsTM ActionOI® program shows that such organizations tend to excel in other categories, such as average length of stay and results of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.
The median fiscal and operational performance of U.S. hospitals over the past year remained relatively flat, despite expectations to the contrary. The data spans a four-year period from 2009Q4 to 2013Q4. Overall, hospitals saw flat or no growth in utilization, but major teaching hospitals saw steady utilization growth.
The annual Truven Health AnalyticsTM 100 Top Hospitals® identifies U.S. hospitals with the best overall performance across multiple organizational metrics, including clinical, operational, and financial. The ability of some hospitals to adapt as the industry is changing demonstrates leadership as the winners set the standards their peers seek to achieve. The study revealed that the nation’s best hospitals had a lower mortality index, considering patient severity; had fewer patient complications; followed accepted care protocols; had lower 30-day mortality and 30-day readmission rates; sent patients home sooner; provided more timely emergency care; kept expenses low, both in-hospital and through the aftercare process; and scored better on patient surveys of hospital experience
The changing healthcare environment has put pressure on healthcare organizations to deliver top-quality care while keeping costs under control. Superior operational and financial performance can be measured by high margins and low costs. But there are significant operational indicators that differ between high- and low-performing hospitals, depending on whether performance is defined by expense or by margin. Often, hospitals with the lowest costs are considered the most successful. But low-cost hospitals do not necessarily behave the same way as hospitals with healthy margins. Low-cost hospitals can include both efficient hospitals and hospitals that are in dire financial circumstances that have forced them to even eliminate expenses necessary for their long-term fiscal health.
Published By: Parallon
Published Date: Sep 16, 2015
A recent HealthLeaders Media Intelligence survey asked respondents to rank their top challenges impacting financial performance and to identify specific areas of concern within each of those issues. Their top three issues were system implementation and interoperability, recruiting and retaining talent, and reengineering the revenue cycle. On the surface, it’s tempting to think these findings aren’t surprising. Yet emerging external factors, including the cumulative effects of the HITECH Act (meaningful use), the Affordable Care Act, and an aging U.S. population, are creating new frameworks in which to view and solve these traditional problems.
Published By: Parallon
Published Date: Dec 18, 2015
Download the free, on-demand version of this webcast that took place on December 16, 2015.
Change is commonplace within the healthcare industry. Executives are faced with many of the traditional challenges of operating hospitals. Now emerging external factors like the HITECH Act (meaningful use), the Affordable Care Act and an aging U.S. population are pushing providers to change the frameworks in how they view and solve these traditional problems.
Creating a state-of-the-art clinical documentation improvement (CDI) program isn’t just about boosting coding accuracy. It’s a key strategy in managing the transition from volume-based to value-based care, say healthcare leaders. That transition is a risky endeavor that is putting hospital and physician financial performance to the test. As hospitals participate in new care and business models aimed at improving value, leaders must ensure that their organizations are able to maintain reimbursement levels, effectively treat the chronically ill—especially in outpatient settings—and gather accurate data that will allow them to assess performance and segment their varying populations. While some organizations often believe they are leaving revenue on the table because of documentation and coding issues, CDI offers numerous opportunities for improving financial performance, finds a recent HealthLeaders Media survey of 149 healthcare executives at provider organizations.
Providers are increasingly making the leap and investing in their organizations in preparation for value-based care. However, while no one wants to be behind the competency curve when it arrives, it can be expensive to build competency for a new model before it is financially viable, causing providers to remain cautious.
Registered nurses, with targeted training, are the secret weapon in the race for comprehensive care coordination.
Accountable care organizations. Patient-centered medical homes. Value-based reimbursements. Bundled payments. Healthcare is experiencing a revolution brought on by the Patient Protection and Affordable Care Act that aims to put patients squarely in the middle of all their clinical and financial decisions. Payers, including government agencies and insurers, are tying the quality and safety of patient care to reimbursements, making patient-centered care a necessity in all settings.
Driving financial performance in the outpatient setting is a top-of-mind priority among senior health system leaders. But managing the differing clinical documentation methodologies and risk assessment strategies present the greatest challenges to optimizing this important source of revenue, according to a recent HealthLeaders Intelligence survey. Provider organizations are finding the ambulatory setting is still a ‘Wild, Wild West’ in terms of assessing risk, clinical documentation, coding billing and medical record keeping practices. Download this report to discover key targets to improve ambulatory revenue.
For a non-profit enterprise seeking to design effective investment portfolios for its asset pools, understanding the role of each of those asset pools is a crucial first step.
The organization's goals and exposures can impact all parts of its portfolio construction process, from initial broad decisions on risk tolerance to more targeted decisions on asset-class exposures and investment vehicle preferences.
In many aspects of healthcare, we see indications of change, with movement toward new payment models and investments in infrastructure to support the delivery of value-based care. Cost control remains a top financial lever, but the discipline is becoming more complex. From a brute-force perspective, controlling cost has a direct effect on operating margin, which provides the classic move of cost control through cost cutting. Now, though, organizations need new command over cost factors themselves.
Provider organizations can realize tremendous gains in financial performance by integrating electronic health record (EHR) and revenue cycle management (RCM) systems. Especially in the face of the transition to ICD-10, results include optimizing revenue streams directly at the point of care, maximizing and speeding reimbursement, minimizing denials and streamlining the collection process.
Healthcare organizations are facing uncertain times, which is putting strains on their revenue cycle management. Automation can help lower staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt.
Healthcare organizations are facing uncertain times, which is putting enormous strains on their RCM. This white paper will show how you can lower your staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt.