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.
As the healthcare industry shifts focus from volume to value, standardization is needed to accurately benchmark labor resource utilization. This is the premise of a survey conducted by HealthLeaders Media and sponsored by Kronos.
What constitutes direct patient care? Hands-on patient assessment, administering medications, and performing procedures clearly top the list. But can other activities be considered direct care too—even those not conducted in a patient’s presence?
Download the free report to get statistics and analysis from the survey questions below and much more
- Which of the following actions are considered direct patient care in your organization?
- Which of the following actions are considered indirect patient care in your organization?
- Which of the following actions are considered neither direct nor indirect care but are categorized separately as non-patient care in your organization?
Partners HealthCare has implemented a program that helps surgeons and other clinicians easily apply best practice guidelines to a patient’s unique status. In this case study executives share the secret to boosting rates of appropriate use of high-cost procedures, and eliminating medical necessity reviews.
ICD-10 has presented monumental preparation challenges to U.S. healthcare providers, who have had to overhaul their billing departments and systems and retrain their staffs. And many may now think the heavy lifting is done, according to a recent survey of industry executives conducted by HealthLeaders Media and The SSI Group, Inc. But while providers may successfully get a bill out the door with a valid ICD-10 code, they may not be prepared for a payment delay or an actual drop in revenue when the payer sends it back for more details.
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.
While we must continue to emphasize to all members of the care team that they are the front line to preventing errors, taking a systems or holistic approach will greatly assist in making adverse events rarer. Aiding in the implementation of the latter are many companies that provide incident reporting, analysis, and review systems.
Download the free, on-demand version of this webcast that took place on December 8, 2015.
Leaders from Beaufort Memorial Hospital and Influence Health discuss the challenges providers face and the skills they must acquire to increase patient engagement. In the coming era of accountable care, providers will finally have something to gain by actively engaging patients in taking care of their health—and a lot to lose by not doing so. Increasingly, providers will receive a fixed sum to care for each patient attributed to them by payers, and they will be able to make an overall profit only by keeping those patients as healthy as possible.
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.
We know that primary care is challenging today, but these challenges don’t have to derail your practice’s success. This resource from Greenway takes the top three challenges in primary care and explains how specialty-specific tools can help you meet them by achieving better clinical outcomes, improving population health, lowering costs and increasing practice profitability, while still providing compassionate care to patients.
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.
In late August 2014, the Centers for Medicare and Medicaid Services (CMS) announced plans to reinstate the Recovery Audit program on a limited basis. CMS reports the delay in restarting the Recovery Audit program was to enable the various RAC regions to restructure, allowing time for the appeals to catch up. Soon, however, the hiatus will end and RACs in all regions will resume automated reviews; these will be in addition to select complex reviews based on topics chosen by CMS.
Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.
HealthLeaders' survey on workforce management queried leaders from a cross-section of U.S. healthcare organizations, including hospitals, health systems, physician organizations, and long-term care/skilled nursing facilities. The 150 respondents represent executives across all disciplines — administration, clinical, operations, finance, marketing, and information. In the next three to five years, hospitals, health systems, and other patient service providers expect to augment their time-and-attendance and payroll systems with integrated applications that enable more sophisticated data crunching around labor analytics, acuity management, and staffing assignments. The goal? To convert the workforce from overhead to asset — a flexible, agile asset that will help organizations succeed in an increasingly demanding regulatory and competitive environment.
How can providers and insurers reduce costs and increase patient satisfaction? In the evolving value-based care (VBC) model, better healthcare IT is a must have. L.E.K.'s Joseph Johnson and Harsha Madannavar identify key success strategies in our latest Executive Insights.
Improving Patient Care and the Bottom Line is a whitepaper from Capella University. Discover key research findings on how BSN degrees impact patient care. In reading this whitepaper you will uncover the benefits of a more educated nursing staff–including lowering the cost of care by over $5M annually, reducing annual readmissions by 248 days, improving patient mortality rates, and lowering their length of stay. Learn how BSN-qualified nurses can improve care for your patients–and allow you to meet your organizational goals.
Download this whitepaper to learn the following:
1. Background and basis of decreasing payments and increasing risks
2. Challenges and opportunities associated with the trend
3. How to thrive versus simply survive in this new healthcare environment
Industry leaders are striving to create a culture of safety within their organizations that extends to all employees, according to an Intelligence Buzz Survey conducted recently by HealthLeaders Media.
In October 2013, S&P Dow Jones Indices (S&P DJI) launched the S&P Healthcare Claims Indices (the indices). This new index series is designed to provide an independent, timely measure of the changes in healthcare expenditures and utilization for individuals enrolled in commercial health insurance plans in the United States.
S&P DJI developed these new indices in conjunction with healthcare professionals at Health Index Advisors (HIA), a joint venture between the premier actuarial and consulting firms Aon Inc. and Milliman Inc. S&P DJI combined its knowledge and experience in developing leading indices with HIA’s experience in the healthcare market to develop the first index series of its kind, based on actual healthcare claims data. These indices seek to increase transparency in the healthcare market and enable the analysis and tracking of changes in healthcare expenditures.
In the rough-and-tumble world of community and rural hospitals, the phrase “innovate or get left behind” is no longer a scary suggestion thrown out by expensive consultants, but a daily reality for CEOs. Rocked by reform and big changes in areas including financing, care models, and population trends, chief executives are getting used to making bold leadership decisions on a regular basis.
A decade ago, hospital leaders viewed cost containment as a distant option to that of building topline revenue through increased volumes and rates. But with the road to profitability choked off by a recession, the ACA, and double-digit increases in healthcare inflation, most have been left pursuing a flurry of initiatives to cut operational costs and maintain positive margins.