Looking Ahead: Analytics for Tomorrow’s Healthcare Economy
While there’s still a lot of uncertainty in the healthcare atmosphere, tracking towards value-based care (VBC) will remain an unchanged goal, according to Rick Pollack, president and CEO of the American Hospital Association who spoke at the 18th Annual Citi Not-for-Profit Health Care Investor Conference. Healthcare organizations that are cognizant of this journey to value are beginning to invest more in data analytics to help support them. In fact, by 2021 the healthcare analytics market is projected to reach $24.55 billion according to a Research and Markets report.
With the continued focus on value, it’s no surprise that at the recent HFMA ANI conference, many speakers on the agenda addressed just that, as well as highlighted the role data and analytics will play. In fact our very own customer, Wise Health System presented on their revenue cycle and compliance analytics partnership. Beyond the fruitful insights provided from the show, we’ve outlined three general themes that are resonating in the healthcare market:
- The steps to value – At HFMA ANI topics ranged from finding the path to value to simply growing your value. The topics – like providers’ readiness for the transition– vary widely. According to a HealthLeaders Survey, providers are still in the very early stages of the transition. If they haven’t begun the transition already, the time to start is now. The journey may seem arduous, but with the help of analytics tools, providers can understand where they stand in the process and how best to prepare for the steps ahead.
- Reimbursement under value – Providers will need to implement supporting payment programs. In a recent blog post, we outlined how providers feel unprepared for the implementation of programs like MACRA, citing time and complexity as the top concerns. Similarly, some providers may find themselves unaware of the other payment options available. For example, the often-forgotten MIPS-APM track helps physicians shift to VBC without taking on too much financial risk – but this track isn’t as well known, and thus not as frequently utilized. To succeed under value initiatives, providers ultimately need a good understanding of their clinical, financial and operational data. Revenue cycle data analytics helps providers understand these areas, all while minimizing their reimbursement risk.
- Approaching value holistically, not piece-meal – Take for example quality improvement programs. Hospitals implement these programs hoping to reduce their hospital readmission rates, and in turn save money. However, just implementing one quality program isn’t enough. A new study from the Journal of the American Medical Association shows that quality improvement programs don’t necessarily translate into big financial savings. Providers need to see the entire picture of their organization to pinpoint where revenue improvement opportunities lay. Implementing analytics can help organizations figure out if they’re on track to overall financial value, or not.
Regardless of the changes and the in-flux state of healthcare now, tracking towards value-based care will remain a constant initiative. Providers must have a holistic view of their enterprise to figure out where they can mitigate risk and optimize value. To learn more about the analytics tools that can support you in your transition to value-based care, visit our solutions page here. If you are interested in learning about additional ways to amplify your analytics journey check out our latest white paper here.
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.
Taking a Look Back - Our Top Webinars From 2016
At MedeAnalytics, we pride ourselves on acting as a resource for the health IT community. From case studies to webinars, we strive to provide our customers and the overall industry with the information they need to excel in the changing healthcare landscape. As we enter 2017, we are taking a look back and counting down our top three webinars from 2016.
3.) In third place is ICD-10 Analytics, which offered an overview on how to leverage data from peer organizations to execute CDI strategies. The webinar included insight from Trevor Snow and Adrienne Younger of Ardent Health Services. They both shared Ardent’s success story and explained how they were able to use our Revenue Integrity solution to identify documentation trends, pinpoint and address coding issues and more.
2.) In second place is Value-Based Contracting: Ease the Transition to Accountable Care. The November webinar highlighted how St. Joseph Hospital, part of Covenant Health, was able to use our Population Health solution to reduce their employee health plan costs in the first eight months of 2016. It also identified best practices that organizations can follow to efficiently transition to VBC.
1.) In first place is, Get Big Picture Insight into Your Revenue Cycle, which demonstrated how to leverage analytics to gain insight into the revenue cycle. The webinar highlighted how our customer, West Tennessee Healthcare, took control of their financial operations to improve AR days, reduce bad debt, understand denial root causes and more.
As we march forward into the New Year, we are excited to continue on as a go-to resource for the health IT community. Make sure to check back weekly for new blogs on pressing healthcare issues and the latest news from MedeAnalytics.
How West Tennessee Improved its Revenue Cycle with MedeAnalytics
Last week, Bart Teague, executive financial director of patient financial services at West Tennessee Healthcare, connected with Joe Goedert of Health Data Management. In the article, Tennessee health system seeks revenue cycle improvement, Bart shares insight on how the MedeAnalytics partnership has aided the health system in their efforts to improve their revenue cycle. Bart highlights how analytics has allowed them to do the following:
- Analyze 4,000 record reviews
- Find $3.7 million in refunds owed
- Win $900,000 in payment appeals
He also discusses what the organization hopes to gain through the continued partnership. In particular, West Tennessee plans to leverage MedeAnalytics’ solutions to improve revenue cycle workflows and develop a more centralized process as patients move through the system. Analytics will also allow the organization to assess the process of creating HIPAA transactions and ultimately, improve point of service collections.
Three Tips to Keep You on Track with Revenue Cycle Management
As healthcare organizations track towards value-based reimbursement models, analytics will continue to play an important role to keep them financially viable. However, many healthcare organizations struggle to make the most of their data and tackle revenue cycle management (RCM).
We recently spoke with Tom Schaal, director of product management at MedeAnalytics, to gather insight on how healthcare organizations can master RCM through their available data. Below are his tips:
1. What end goals should healthcare organizations keep in mind when addressing RCM?
Tom Schaal (TS): Ultimately, the end goal in RCM is working smarter, not harder. Hospital staffs are routinely stretched thin. Intelligently designed analytical tools can be used to highlight opportunities and outliers, and focus staff attention to the most impactful workflow and resolution strategies.