The changes in healthcare delivery that hospitals and health systems seek in today's market cannot be accomplished without the cooperation of physicians. Conversely, many physicians find that they need relationships with hospitals to guarantee patient volume and income. Physician-hospital alignment is the phrase used to describe the ideal state of physicians in lockstep with strategic goals. But achieving alignment is complex. The trend of employing physicians continues, yet employment does not necessarily lead to integration. Whether employed or independent, and...
As healthcare margins tighten and cost-cutting takes center stage, professionally run healthcare organizations seek efficiency gains in their financial operations. Large cost-saving opportunities lie in the revenue cycle and vendor management. Financial officers must learn to work smarter with a range of vendors, contractors, and outsourcers; with payers; and with self-pay patients through revenue cycle and payment channels. From high-deductible health plans that cause bad debt problems to Recovery Audit Contractors to coding changes to medical necessity judgment...
Hospitals and health systems increasingly must work with providers across the continuum of care to meet the demands of value-based purchasing, reduced reimbursements, new payment structures, and readmissions penalties. Postacute care is the subject of increased interest and focus because it holds the dual promise of improved clinical care and cost containment. Many healthcare providers are purchasing or partnering with a range of postacute facilities such as long-term acute care hospitals, inpatient rehabilitation facilities, and skilled nursing facilities, as...
Healthcare delivery and financing models are evolving rapidly as healthcare reform means hospitals and systems need a sharpened focus on the healthcare trifecta—the patient experience, operational efficiencies, and financial health. Unfortunately, many are faced with gaps in operational knowledge as they reinvent themselves. Never has the call for strategic collaboration been stronger, but as hospitals redirect their time and resources to unfamiliar areas, success hinges not only on their ability to start or change initiatives, but also on targeted operational and...
The healthcare industry is experiencing a dramatic shift in key competencies with the advent of new incentives and requirements, and new skills are needed to engineer the merger of clinical and financial priorities. Leaders must delegate risk management, case management, and medical informatics, among other priorities, while staying on course with strategic goals. Thinner margins mean that CEOs must take an active role in maintaining a healthy balance sheet. Top executives need to broaden their capabilities and serve as a bridge between clinical and financial...
Hospitals and health systems increasingly must work with providers across the continuum of care to meet the demands of value-based purchasing, reduced reimbursements, new payment structures, and readmissions penalties. But replacing the current fragmented system of care will require nothing less than a business and clinical transformation. Healthcare executives say that care coordination and the care continuum represents their single greatest organizational challenge (HealthLeaders Media Industry Survey 2013, CEO Report). Executives and physicians must work...
