How to Address Financial Challenges in Healthcare Today

Eleven hospitals filed for bankruptcy in 2013. Eighteen other hospitals actually closed their doors last year. A substantial number of organizations have reported losing hundreds of millions of dollars due to operational and financial liabilities. Too many of these healthcare organizations have even succumbed to fire-sales of their companies. It’s not a surprise to hear that the main source of their financial struggles involved reimbursement cuts. It goes to show that even with sophisticated management teams and enormous amounts of resources invested in technology, many organizations are facing significant financial pressures. Although many organizations will be able to continue to keep the doors open, they cannot continue to operate the way that they have been in the past - if nothing changes, more organizations will face significant repercussions.

Healthcare organizations now need many of the tools that other industries have been utilizing to manage their business. For example, business intelligence (BI) solutions are used across industries to not only help organizations grow, but also identify risks and issues before it’s too late. Healthcare organizations need to adopt business intelligence and analytics solutions in order to operate in an optimal business-oriented manner to ensure long-term success and survival. However, you need a solution catered for the systems, requirements and budgets for healthcare organizations. Healthcare focused BI solutions, such as Viewics Health Insighter (VHI), can help your organization scale its capabilities to strategically place itself ahead of these torturous reimbursement cuts and value-based financial models. The VHI solution can help steer your organization away from incurring debt and fines, so that your organization can respond before it’s too late.

Ways We Can Help: Deal with Reimbursement Cuts

Reimbursement cuts continue to haunt organizations today. Centers for Medicare and Medicaid Services (CMS) released its Final Rules for the 2014 Physician Fee Schedule (PFS) and the Hospital Outpatient Prospective Payment System (OPPS) late last year. The overall outlook of these payment cuts are bleak. Particular tests or services that were once primary profit drivers for healthcare organizations now receive a fraction of previous reimbursements. For example, a severe reimbursement cut occurs to the immunohistochemistry (IHC) payment schedule, where the various staining components have been reduced by upwards of 70%. It’s obvious that this reimbursement cut is massive, but organizations must understand the exact impact it will have to their bottom line. Insight into what tests may now be unprofitable, enables healthcare leaders to make decisions about their test directory, substitute offerings, and better understand their cost structure. By understanding the exact impact, businesses can be more proactive to these reimbursement changes, and strategically restructure their organization.

The severity of reimbursement cuts may not be as apparent as IHC, and in fact, most of the items in the fee schedules are reduced by a few cents or dollars. However, the impact of these many small cuts can be tremendous on the enterprise. Organizations can utilize BI solutions to quantify the impact of these changes at both an aggregated and detailed level. In addition, having insight into the true costs of particular tests or services, provides a clear picture of the potential bottom line impact. Utilizing timely, accurate and detailed information, organizations can determine whether to provide the test or service and what the impact of each decision would be.

Ways We Can Help: Maintain Profitability

Comparing profit versus revenue is a common method to track and monitor the financial health of businesses. VHI provides comprehensive dashboards, like the sample view below, which shows more than just a basic comparison.

This dashboard compares top clients by revenue and percent profitability, as well as details behind the revenue per unit to pinpoint profitability gaps. Organizations currently have methods to compare how revenue correlates to actual profitability levels. However, without understanding why top clients are not producing as much profit as expected, organizations may struggle to adapt their business to these monetary changes. This VHI dashboard view helps leaders make better business decisions with the right clients – if the cost of business exceeds the return on investment, leaders may want to rethink continuing business with certain clients. Healthcare organizations can no longer afford to have declining profitability, especially with the increase of reimbursement cuts as well as penalties and fines. Leaders need to focus on all aspects of their business to address potential short-comings, which includes rethinking their financial situation altogether, not just from a reimbursement and or revenue standpoint.

Ways We Can Help: Improving Quality of Care

On top of dealing with declining reimbursement rates, existing organizations will require strategic approaches to quality of care delivery. Fortunately, hospital departments already have a wealth of data that can be shared with concerned constituents in order to improve both individual patient and overall community health. Information-driven approaches to sharing key insights from this data can ensure an organization’s success and survival.

Viewics Health Insighter is able to cull data from hospital EMR systems and individual departments in order to create a comprehensive view of patients and patient populations, such as the diabetes population health view to the right. The view is able to partition safe, at-risk, and high risk diabetes populations so that organizations can more deeply understand the overall community health.

However, the solution does more than tracking and monitoring specific populations with chronic diseases – VHI is able to access data across the entire continuum of care to improve all facets of health. These healthcare providers are now armed with information about their patient populations and can implement appropriate care interventions to ensure preventive care and treatment adherence. VHI is able to set up alerts for organizations to better track and monitor these treatment changes and patient results. For example, the solution alerts care providers on patients due for follow-up tests, pharmacy prescriptions, and imaging/radiology scans. By being able to provide this proactive quality of care, organizations improve both clinical and financial outcomes of their business. Improved methods of tracking and maintaining quality help reduce errors, which helps eliminate waste and unnecessary costs.

We Can Help Your Bottom Line

You can no longer operate without visibility into every area of your business. You can no longer afford to evaluate your performance at face value, and healthcare leaders must recognize the fundamental shift in what is required for a sustainable healthcare business model. Business intelligence solutions are vital to positioning your organization to succeed today. By being able to analyze historical health records, understand current performance, and predict future outcomes, businesses can thrive. With Viewics Health Insighter, organizations no longer have to rely on good fortune to keep their doors open, but can be empowered with information to affordably deliver quality care. If you would like to know more about how VHI can help your team navigate today’s financial challenges, visit www.viewics.com today.