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
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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.
Published By: Anaplan
Published Date: Mar 29, 2018
The concept of integrated business planning — closing gaps in an organization’s various planning functions and aligning operations and strategy with its financial performance — has existed in various forms for decades. What has changed is creation of planning platforms that can handle the fluidity of data to erase silos and enterprise borders where once there were multiple geographies, departments, time zones, languages and currencies. All elements of business are managing the avalanche of information coming to them. Just like connecting disparate people, we also must connect data that resides in various systems, applications and tools.
Published By: Anaplan
Published Date: Mar 29, 2018
Finance has a mandate to become a strategic business partner. Integrated business planning offers organizations the ability to align operations and sales strategy with the company’s continuous financial performance. An increasing number of organizations have shown that even small steps toward integrated business planning have helped them deliver immediate benefits to the business, including light-touch forecasts, rapid “what-if” analyses, and more accurate budgets. Improved collaboration between departments, driving more awareness and shared understanding of potential issues, allows the business to take the prompt and incisive actions needed to keep performance on track. The question to consider is not “When are we going to do this?” but “Why don’t we start now?” because time is ticking away.
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.
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.
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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.
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.
Published By: Prophix
Published Date: May 31, 2016
To have the greatest impact within your company, you need to contribute to strategy rather than focusing on tactical issues. But, to accomplish this means that you have to tap into your company's financial performance and unearth insights that will help senior leaders make better decisions. This “From Tactics to Strategy” webinar focuses on helping you play a more critical role in your organization’s success. The fast-paced session reveals how you can capture and leverage the data gathered from across your financial systems to help senior management make better and faster strategic decisions.
Published By: UNIT4 CODA
Published Date: Jul 13, 2011
This paper will explore the common Retail KPIs used today across all sales channels, define the formula, discuss potential ways to improve them, and explain their use in the routine management processes of the business.