Forward thinking providers should consider not just which data to analyze, but in what context and with what goal(s) in mind in order to accommodate the shift to value-based reimbursement.
Taking a holistic approach to denials management will help your organization mitigate the impact of denials and truly refine your cash flow and overall financial performance.
As providers begin to see the effects of ICD-10, it becomes more important than ever to review your Clinical Documentation Improvement (CDI) program. The increased specificity that ICD-10 demands, along with the productivity concerns, provides the impetus to not only improve your documentation, but also all your processes around CDI. Succeeding now means we need to work smarter, and that reinforces the need for a multi-faceted approach to maximize our CDI results. Whether you have a well-established CDI program, are just getting started or somewhere in between, here are five areas to review to ensure you’re getting the most out of your CDI efforts.
Healthcare is moving quickly and irreversibly into a new era of risk-based accountable care. This business model will leverage predictive analytics on big data as a primary conduit to adapting and eventually succeeding in value-based purchasing programs. As such, it’s critically important to bring together traditional clinical and financial data in meaningful ways. However, there are many other sources of data available that can be factored into analysis. If properly collected and processed, this can provide valuable insight into managing care and aligning resources in ways that improve outcomes while also achieving value metrics.
As provider organizations adapt to the new realities of healthcare delivery in the US, the need has never been greater for an integrated view of not only the care delivery enterprise but also the interdependencies between the financial and clinical operations.
As we wrap up NHIT Week, I’d like to offer some perspective on how healthcare in America is evolving and how health IT will move it forward. Our market is undergoing unprecedented change in how we manage and pay for care, and technology will drive this transition and help us all realize its benefits.
Within the Healthcare Finance community it is often said: “No Margin, No Mission”, which acknowledges that although many providers bear a non-profit status, the role of healthy financial performance is still important. Without it, the organization cannot carry out its mission of providing high quality clinical care to the community it serves.
There are many factors that hospital CFOs must deal with, including the financial impact of such regulatory initiatives as Meaningful Use and ICD-10. But another common challenge that can make or break an organization is significantly declining reimbursements. CFOs that are unable identify root causes and head off declines at the pass may soon be searching for another job.