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.
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.
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.
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.
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.
Best-in-class firms have realized that budgeting, planning and reporting can't ALL be done with Excel.
And running a successful business starts with effective planning and performance management, and the data you generate during these critical processes is among the most important and sensitive in your organization. A miscalculation, oversight, or a security breach could be financially devastating.
By recognizing the 5 signs of Excel abuse, and making the necessary changes, best-in-class organizations can:
-streamline planning and performance management
-keep sensitive data secure
-significantly reduce the potential for human error
For financial business leaders and other c-level executives, moving away from unclear or ambiguous “improvements” to quantifiable measurements is crucial to the overall organization. Hard, meaningful data substantiates the execution of strategic, long-term business decisions. As technology is rapidly changing, executives can be challenged to find the right systems that drive business performance, provide competitive advantages, and increase the bottom line.
Predictive analytics is powerful. It can help drive significant improvement to an organization’s bottom line. Look for ways to use it to grow revenue, shrink costs and improve margins.
Provide a platform that enables your data scientists to work efficiently using tools and algorithms they prefer. Enhance your analyses with internal and external data, structured and unstructured data. Then make the analytics accessible in order to reap the full benefits of these valuable analyses.
Stay ahead of the curve in your market with predictive analytics, and give your organization a competitive advantage and an improved bottom line.
Procurement is a risky business. Procurement managers are responsible for obtaining materials, goods, and services at the lowest reasonable cost—and they are responsible for ensuring that the supplier or vendor reliably provides high-quality goods, in both the present and the future. They must make sure that the organization does not knowingly or unknowingly engage in, support or turn a blind eye to criminal behavior, like bribery. They must negotiate contractual agreements that protect the company against possible disputes, and much more.
Add to those responsibilities and risks the expectation that organizations will commit themselves to corporate social responsibility (CSR), embracing business practices that value and account for more than just short-term financial performance.
But procurement managers are unlikely to have extensive expertise in EHS issues, so EHS professionals have an important role to play in identifying and mitigating the environmental, health, and safety-relat
In the financial services industry (FSI), high-performance compute infrastructure is not optional; it’s a prerequisite for survival. No other industry generates more data, and few face the combination of challenges that financial services does: a rapidly changing competitive landscape, a complex regulatory environment, tightening margin pressure, exponential data growth, and demanding performance service-level agreements (SLAs).
A company's products needed constant updates due to changing business rules and regulations, as well as new functionality. However, tasks such as regression testing took too long and consumed too many resources. Collaborative helped to dramatically speed up the process through automation and process analysis, leading to increased customer satisfaction.
Creating predictive analytics from alternative data has become the current focus of the biggest quant trading firms in the industry
The democratization of financial services data and technology, together with more intense competition, makes the needs of today’s market participants vastly different from those of previous generations. Firms must locate untapped sources of data for both public and non-public companies. This alternative data, such as payment data and other non-public information, from sources beyond the common channels, can be a predictive indicator of market performance; a difference maker in assisting firms as they develop models to evaluate their investments.
By combining our unique data sets with advanced analytics, traders, analysts and managers can seek predictive signals and actionable information utilizing their own models.
View our research report to learn how alternative data, our 'Information Alpha,' can help you earn differentiated investment returns.
Many industry experts advise financial services institutions (FSIs) to embrace digital transformation. At the heart of that mandate is the need to satisfy rising customer expectations for fast, secure, always-on services delivered seamlessly across all channels and devices. While it’s important to harness the digital technologies today’s customers turn to — especially when it comes to engaging the millennial generation — FSIs need to optimize web and mobile performance to deliver exceptional end-user experiences. Here are eight considerations.
Get started on your journey – download the whitepaper today
Healthcare organizations are facing uncertain times, which are putting enormous strains on their revenue cycle management (RCM). Automation is proven to improve RCM measures, and even small improvements can significantly impact the bottom line. This whitepaper details how providers can embrace automation to help drive financial performance.
This paper will explore some of the market dynamics driving the financial volatility in healthcare and will explore how advanced analytics, with the right IT backbone and organizational competencies, can help organizations successfully identify ways to manage revenue cycle profitability.
This study was conducted with independent global research firm Wakefield Research between November 24 through December 14th, 2015. The data was based on an online study of 20 content questions, plus screeners and demographics of 2704 respondents, in 8 markets: US, China, Australia, Japan, India, UK, Germany, and France. All respondents were restricted to the following industries: service provider organizations, healthcare, retail, and financial services. In this case, the definition of service provider includes companies offering web content services, cable, internet service providers, or telecom.
Juniper Networks challenges the status quo with products, solutions and services that transform the economics of networking. Our team co-innovates with customers and partners to deliver automated, scalable and secure networks with agility, performance and value.
Visit www.juniper.net for more information.
Published By: Prophix
Published Date: May 31, 2016
Financial consolidation is a process that is usually used to aggregate financial results from multiple legal entities and to make adjustments to the results. However, many financial professionals regard it as a necessary evil that can be handled either in a “hit and miss” way using spreadsheets or comprehensively with software that can handle extremely complex situations but that is also expensive. Prophix provides a third alternative that is easy to use, has a low cost of ownership and is attractive to mid-market companies.