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Top 7 Financial Healthcare Trends
and Challenges for 2016 – Bobbi Brown
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst ci...
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Top 7 Financial Healthcare Trends and Challenges for 2016

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Healthcare financial leaders will encounter a myriad of challenges and improvement opportunities in 2016.

2016 will force health system financial leadership to focus and prioritize, with challenges including increased healthcare spending, continued momentum toward value-based care, and the need to reexamine the revenue cycle after years of focusing so intently on ICD-10.

But 2016’s financial healthcare trends include more than just challenges; exciting opportunities abound, from using technology to engage patients to a national focus on population health.

Engaged healthcare financial leaders—particularly those with the characteristics of effective leaders (resilient, collaborative, and inspirational)—are positioned to stay ahead of the curve in 2016.

Veröffentlicht in: Gesundheitswesen

Top 7 Financial Healthcare Trends and Challenges for 2016

  1. 1. Top 7 Financial Healthcare Trends and Challenges for 2016 – Bobbi Brown
  2. 2. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Common Leadership Traits On a recent “Face the Nation,” episode there was a panel discussion about former presidents who were skilled at helping their country overcome challenges in the 21st century. The discussion noted traits, common to effective leaders: • Resilient • Inspiring • Collaborative • Great communicators
  3. 3. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Healthcare Financial Trends for 2016 Those same attributes, paired with an in-depth understanding of financial healthcare trends, will help financial leaders overcome challenges and make improvements in 2016. What follows are seven financial healthcare trends for 2016, including action-oriented strategies that will help healthcare financial leaders stay ahead of the curve.
  4. 4. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. More Data Sharing As health systems improve their analytics capabilities and the quality of their healthcare data, sharing it with clinicians will become increasingly important. Sharing data has a proven impact on accountability, productivity, care quality, and innovation. Lead the way: Financial Trends For 2016 1 Share data with your clinicians: Stop hoarding data. Stop waiting for perfect data. Share data with your clinicians often.
  5. 5. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Continued shift from volume- based care to value-based care CMS announced its goal: by 2018, 50% of fee-for-service payments will move to alternative payment models, such as bundled payments and accountable care organizations. CMS also issued final regulations for joint replacement (published November 2015), starting the mandatory movement to bundled Medicare payments in 67 metropolitan areas. Financial Trends For 2016 2
  6. 6. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Continued shift from volume- based care to value-based care Financial Trends For 2016 2
  7. 7. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Continued shift from volume- based care to value-based care Lead the way: Financial Trends For 2016 2 Understand clinical measures: healthcare financial leaders need to get a handle on clinical quality and how much it costs to achieve a unit of healthcare outcome and quality. Develop cost systems to quantify your margins: develop new, automated systems that show costs for activities across all sectors Create your risk vision: we’ve been under various CMS quality programs for years. If you aren’t improving yet, then you need to prioritize helping your teams improve.
  8. 8. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. We’ve recently seen three large insurance mergers: According to a recent Health Affairs blog, Georgia, Connecticut, and Colorado could experience a 40 percent or more commercial insurance concentration. Industry consolidation (and alternative delivery models) Financial Trends For 2016 3
  9. 9. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Industry consolidation (and alternative delivery models) We’re also seeing a spike in alternative delivery models, including retail space. In October 2015, Walgreens announced they were acquiring Rite Aid to broaden their expanse into retail health. Both Walgreens and Rite Aid are very active in the walk-in health clinic business. Lead the way: Financial Trends For 2016 3 Update your marketing/contracting plan: determine what consolidation means for your contracting strategy. Assess what you’ve lost to the retail movement. Have you seen a decrease in urgent care and physician office visits? Decide if it’s a market you should compete in.
  10. 10. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Population health is a top priority Population health is the recurring theme in a recent interview of healthcare leaders from the 21 winning Healthcare IT News’ 2015 Best Hospital IT Departments. Fort HealthCare’s Senior Director of IT effectively summarized the increasing prioritization of population health: Financial Trends For 2016 4 Population health is 100 times bigger and the road isn’t yet paved; it isn’t just about the data or the tools used by clinicians, it really is about changing the way healthcare organizations think about practicing medicine.”
  11. 11. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Population health is a top priority Lead the way: Financial Trends For 2016 4 Get comfortable with blurred lines: provider and payer roles will become less obvious, and we’ll continue to rely less on four-walled structures. Learn the new terminology: Are you familiar with Return on Engagement? In a PMPM capitated environment, you must budget time and resources for all patients. Know how to treat a population: and take risk for that population. Load claims data and analyzing physician, diagnosis codes, and treatment pattern data.
  12. 12. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Population health is a top priority Lead the way: Financial Trends For 2016 4 Learn new measurements: with 23.5 ACO and 7.8 million Medicare ACO patients, you must know your population to define how to measure success. Collaborate to improve the care continuum: identify partner organizations and stakeholders you’ll need to collaborate with to achieve a broader definition of care. Study patient flow: start by identifying the bottlenecks at your hospital or clinic. Use data to study patient movement and focus on improving the admission/discharge process.
  13. 13. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Engaging patients through technology Using technology to engage patients will be a focal point of patient engagement conversations in 2016. Half of patients hospitalized in the last year started using wearable technology after their hospital stay. Lead the way: Financial Trends For 2016 5 Understand how different patient segments use technology: technology is not a one-size-fits-all solution. Understand how different patient segments use technology. Attend the International Consumer Electronics Show: CES is a global consumer electronics tradeshow that takes place every January in Las Vegas.
  14. 14. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Revive the analytics around revenue cycle The first month of CMS claims processing didn’t show any huge spikes in denials. Now that ICD-10 is in place, we need to revive the analytics around revenue cycle. Lead the way: Financial Trends For 2016 6 Put the right analytics tools in place: Don’t get too comfortable in that false state of tranquility based on high-level metrics. Make sure cash is still flowing at the same rate. Implement frequent reporting so you can quickly and efficiently identify trend
  15. 15. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Increased healthcare spending Healthcare spending increased by 5.3% in 2014—a significant increase compared to previous years, when it was closer to 2.5%. We’re spending $9,523 per person for healthcare. To contain increases we must be vigilant about costs. Lead the way: Financial Trends For 2016 7 Take a leadership role in reducing waste, overtreatments, and unnecessary variation: you can’t tackle everything at once. Work with clinicians to do the right thing for your patients/members.
  16. 16. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. 2016: The Year of the Consumer Healthcare spending increased by 5.3% in 2014—a significant increase compared to previous years, when it was closer to 2.5%. We’re spending $9,523 per person for healthcare. To contain these increases we must be vigilant about costs. Lead the way: Take a leadership role in reducing waste, overtreatments, and unnecessary variation: you can’t tackle everything at once. Work with clinicians to do the right thing for your patients/members.
  17. 17. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. More about this topic Top 7 Healthcare Trends and Challenges for 2015: From Our Financial Expert Bobbi Brown – Vice President of Financial Engagement 10 Trends in Healthcare Data Warehousing That Every Health System Needs to Know Dale Sanders – Executive Vice President, Software Understanding the Market Trends and Business Drivers of a Complex Healthcare Organization – Health Catalyst success story Implementing 4 of AHA’s Must-Do Healthcare Transformation Strategies Scott Holbrook – Strategic Advisor Why An EMR Can’t Solve Your Most Important Healthcare Transformation Challenges Dan Burton – Health Catalyst CEO Link to original article for a more in-depth discussion. Top 7 Financial Healthcare Trends and Challenges for 2016
  18. 18. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. For more information:
  19. 19. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Bobbi Brown is the Vice President of Financial Engagement for Health Catalyst. Ms. Brown started her healthcare career at Intermountain Healthcare supporting clinical integration efforts before moving to Sutter Health and, later, Kaiser Permanente, where she served as Vice President of Financial Planning and Performance. Ms. Brown holds an MBA from the Thunderbird School of Global Management as well as a BA in Spanish and Education from Misericordia University. She regularly writes and teaches on finance-related healthcare topics. Other Clinical Quality Improvement Resources Click to read additional information at www.healthcatalyst.com

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