Meet MedeAnalytics’ new CEO, Paul Kaiser
Last month, Paul Kaiser was appointed as the new CEO. In his first few weeks, he focused on meeting with our teams and clients. We caught up with Paul to hear more about his background, what he’s observed so far and what he hopes to accomplish in the year ahead:
Can you share more details about your experiences prior to Mede?
Over the past 14 years, I’ve held several roles on the provider (Cerner), payer (TriZetto) and middle (TriZetto Provider Solutions) sides of healthcare. This afforded me a unique first-hand view of the healthcare value-chain, and where that chain diverges and converges. Having both perspectives is enormously important in a market where these sides come together to administer better healthcare in a value-based reimbursement market. Mede has long served both markets so I’m thrilled that I get to share my experience as well.
In the first month that you’ve been at Mede, what have you seen and what are you most excited about?
The commitment of our team is unparalleled. The desire to make a difference and contribute to our client’s success is nothing like I’ve ever seen. This is what makes Mede a truly exciting place. When you combine really smart people with a commitment to make a difference, the possibilities are endless.
It has also been incredible to see and hear about the immense value we’re driving for our clients. The feedback about our technology, the business impacts we are having within our client’s organizations and the future vision for how they will be using MedeAnalytics to create analytics-driven culture change is overwhelmingly positive. We have an incredible client base. It’s very exciting to see the value in the data we’re providing clients and how that is helping them cross the chasm to performance-based management cultures.
Finally, the product and technology teams’ work to develop a world-class big data platform is amazing. The amount of data we process and turn into value-driving data visualizations and actionable workflow is incredible. To be at a company capable of making such material contributions to our clients’ success is energizing.
What do you see as the biggest opportunity for Mede clients?
From my years seeing both the provider and payer perspectives, it is clear to me that very few organizations are driving their businesses and operations from an enterprise, data-driven level. For example, you often see C-suite leadership in a hospital or health system establish a vision for the enterprise and from that direction, teams will create initiatives designed to achieve those goals. But once goals are established, there is little real-time intervention or progress monitoring. This means that organizations typically don’t realize something is off-course until the reporting phase. However, if an organization can tie data analytics from across the enterprise together, it can observe and influence results in real-time, allowing the organization to course-correct and deliver on initiatives from the department to the individual level. Data-driven performance management is the only route to optimal success in today’s market.
What are Mede’s top priorities in the coming year?
We work with the largest healthcare solution providers and health systems in the country, and they are depending on us. We need to be stellar and deliver on our commitments.
We also want to ensure scalability and stability for our clients via our platform. As we look towards Mede’s next phase, our focus will be to continue delivering a high-performing technology platform that can scale in the market. We also want to enable client-led innovation by extending configuration and integration layers to our clients as well as third-party certified business partners.
How do you see MedeAnalytics growing and/or evolving to support clients amidst an everchanging healthcare landscape?
Change is the one constant in healthcare. Whether it is through government or regulatory shifts, moving away from fee-for-service to alternative payment models or performance-based reporting with MACRA and MIPS, change is certain. Whenever an organization tries to respond to change and create new business strategies, it needs data and analytics to make smart decisions. Organizations also need to be more performance oriented to optimize health outcomes based on real data. Mede can be a part of that. Regardless of whether the government decides to keep the Affordable Care Act in place or implement some other version, from a data analytics perspective, we are in a great positon to support our clients with the tools to be nimble and make strong, smart, data-driven decisions.
Why CFOs and CIOs Need to Collaborate at HFMA ANI
The upcoming HFMA ANI conference (June 25-27) in Orlando, FL, will bring together thought leaders in the healthcare finance space to connect, discuss and explore the opportunities ahead. This year’s show theme – collaborating for the future – is particularly timely since the healthcare industry continues to rapidly consolidate, and the fate of the Affordable Care Act still hangs in the balance. The Trump administration’s potential new healthcare bill increases the likelihood that there will be a rise in uninsured patients, high-deductible plans and a continued focus on cost-cutting and value-based reimbursement for healthcare providers.
The lack of clarity and fast-paced changes in the market places even more pressure on Chief Financial Officers (CFO), whom are already challenged with juggling the transition to value-based care while managing fee-for-service (FFS). In addition to these pressures, many CFO’s feel like their issues are often de-prioritized in the long list of tech projects led by Chief Information Officers (CIO), who are more focused on clinical initiatives. With so much technical effort and budgets directed toward clinical transformations and electronic medical record (EMR) installations over the past 10 years, the financial analytics tools required to thrive under payment reform have been neglected.
Building a better community through better health with Mede/ACTS
Interest in employee-sponsored volunteering programs is on the rise. According to a 2016 National Study on Satisfaction at Work, employees are drawn to employers who support charitable causes and community volunteering. In turn, employers are recognizing their role in spearheading philanthropic efforts. We recently connected with our very own Eric Roth, VP of Human Resources, to hear how MedeAnalytics approaches volunteerism in the workplace.
As a company dedicated to promoting employee wellness, MedeAnalytics launched Mede/ACTS in 2016, an initiative that helps give back to local, charitable organizations. Building off a previously existing wellness program, Mede/ACTS combines physical and community wellness into one. The premise is simple, but powerful: for each physical activity Mede employee’s complete – whether it’s yoga, biking, or kickboxing – senior leadership matches their efforts by contributing $1 for every 10,000 steps and for every 60 minutes of exercise that has been logged into wearables, fitness apps and FitBliss, a health & wellness technology platform available to all Mede employees. All the raised funds are donated to the charity of Mede/ACTS’ choice. Each quarter the charity varies; the Mede/ACTS committee selects charities that are nominated by Mede employees.
Driving Enterprise-Wide Change by Breaking Down Data Silos and Creating a Data-Driven Culture
This year’s Big Data & Healthcare Analytics Forum brought together payers, providers, government and academia decision-makers who shared their successes and lessons learned from their transition to value-based care. Of the many thought leaders who participated in the discussion, our client, Soyal Momin, Vice President of Data & Analytics at Presbyterian Healthcare Services (PHS), presented his abstract, “Eliminating Data Silos and Driving ROI.”
As a large integrated healthcare system consisting of eight hospitals, a statewide health plan and a growing multi-specialty medical group, PHS found it increasingly challenging to oversee its entire business from one integrated view. After investing in an enterprise data warehouse (EDW), PHS continued utilizing several reporting tools from different vendors for each of its business lines that created data silos. For PHS to thrive under the value-based care model, the organization knew they needed to balance their costs, utilization, quality, risk and outcomes. During Soyal’s presentation, he outlined how through their partnership with MedeAnalytics they could strategically differentiate themselves and add value within their integrated data analytics model. To achieve this success, PHS focused on three distinct categories:
- Creating Value for Key Stakeholders – Creating an integrated, enterprise approach, extends meaningful, actionable insights across PHS and to their business users so they’re able to access content, business rules, benchmarks, best-practice analysis and views.
- Integrating Payer and Provider Analytics – Through an enterprise approach to analytics, PHS has an integrated overview into their provider groups and health plan. The insights are extended across financial, operational and clinical areas throughout the provider-side of the organization. For the health plan, they can analyze payer data for cost and utilization.
- Promoting a Data-Driven Culture – Data literacy and data democratization is the foundation for creating a data-driven culture. A key component in creating this was tapping data analysts whose sole job is to gather data and analyze it in a meaningful way to generate results. PHS gave their analysts the appropriate training and mentoring to ensure they were developing a consultative skillset that met the needs of their diverse organization.
PHS has achieved ROI in its clinical, operational and financial areas within their enterprise. Additionally, PHS recognized operational efficiencies by replacing seven analytics vendors with MedeAnalytics, reducing redundancies and achieving quick wins with business stakeholders. More so, PHS expects to save millions in 2017 by improving collection for Medicaid encounters and increasing business development revenue.
Putting a stop to revenue cycle leaks and tracking towards MACRA goals
Performance measurement under MACRA has started in 2017, but only one-third (33 percent) of hospital-affiliated physicians have reported feeling prepared for its implementation, according to a recent Black Book Research survey. With several payment pathways to choose from, providers and their physicians have an added layer of complexity around clinical documentation, which increases their reimbursement risk. Though many providers feel strapped for time as more of their attention needs to be spent on properly categorizing claims data, analytics can help those organizations have a better grasp of their revenue cycle, especially as it ties back to value-based care goals.
Our very own Tom Schaal, director of product management, recently spoke with Jeff Lagasse at Healthcare Finance News to discuss the common revenue cycle management (RCM) challenges and opportunities as they relate to preparing for MACRA. One such challenge is the lack of time to consider revenue cycle leaks. Schaal shares three key takeaways that can help healthcare organizations have a better grasp of their revenue cycle and measurement:
- RCM shouldn’t be a second job – However, many times it feels like it. Physicians want to focus on providing the best quality care to their patients. Focusing on the minutia of RCM draws their attention away from their primary job. Technology and data can turn the RCM job into a seamless task that can be incorporated into their everyday workflow.
- Revenue leakage can happen at any stage of the care continuum – From registration to insurance verification to billing. Data analytics can help you identify where the biggest opportunity for improvement lies. Are patient no-shows causing you to lose money? Data analytics spots these trends and help you course correct the problem (i.e. set up appointment reminders for patients).
- Physician quality is the biggest opportunity for RCM – As Schaal noted in his interview, “as we look toward patient satisfaction and payment structures around things like lack of readmissions, physician quality really becomes a focal point in terms of maximizing revenue.” Ultimately, physician quality measures are going to be a “cornerstone when it comes to any enterprise's [financial] health,” and data analytics helps physicians make meaningful decisions that will impact their bottom line and future.
As MACRA moves full steam ahead, providers will need to have a good understanding of their clinical, financial and operational data to succeed. Implementing revenue cycle data analytics helps providers track towards value-based goals, while minimizing their reimbursement risk.