Hospital leaders are increasingly turning to automation to streamline revenue cycle operations, but should some processes be left behind?
Welcome to our June 2024 cover story. Each month, our editors will be taking a deep dive into the topics that matter most to you in our cover story series. From ways to win the payer/provider war to taking back your physician practice, we have a lot of stories up our sleeves this year.
So what did we look into this month? Well, hospital leaders are facing increasing pressure to streamline operations and optimize efficiency to keep pace with the industry's dynamic changes.
This pressure is particularly acute in the revenue cycle, where the implementation of automated solutions has become a must. But while automation offers numerous benefits including improved accuracy, speed, and efficiency, can there be too much of a good thing?
By identifying which aspects of the revenue cycle are best suited for automation and which are not, hospital leaders can effectively optimize their revenue cycle operations and position their organizations for success.
HealthLeaders' revenue cycle editor Jasmyne Ray spoke with four revenue cycle leaders to find out what has and has not worked for them when it comes to implementing revenue cycle automation.
The old ways of growing the nursing workforce are no longer working, so it's time to usher in some new strategies before it's too late.
Welcome to our May 2024 cover story. Each month, our editors will be taking a deep dive into the topics that matter most to you in our cover story series. From ways to win the payer/provider war to what not to automate in the revenue cycle, we have a lot of stories up our sleeves this year.
So what did we look into this month? Well, the greatest challenge facing nursing leaders today is workforce development. Health systems are in dire need of solutions that improve both recruitment and retention.
HealthLeaders' CNO editor G Hatfield spoke with four nurse leaders to find out what workforce growth strategies need to be put to rest and explore four ways CNOs can move forward and build a strong, healthy, and happy workforce.
Did you miss our April cover story on three major ways private physician practices can fight back against extinction and ensure survival? No worries, you can read it here.
CFOs are battling a multitude of challenges, but there are four that are not only top of mind but make-or-break for hospitals and health systems.
Hospital and health system CFOs are constantly facing pressure to reduce costs while maintaining high quality patient care especially as labor costs are skyrocketing and margins are being squeezed.
This means CFOs must carefully analyze cost structures and look for opportunities to improve operational efficiencies in order to remain financially viable.
To talk strategy and find solutions to these challenges, dozens of finance leaders from across the country recently met in San Diego for our HealthLeaders CFO Exchange. During the event, attendees discussed four main ways they are securing that financial viability.
15-months ahead?
One key takeaway from the event is the importance of starting negotiations with payers early—very early.
Many health system CFOs at the event said they are beginning their discussions on renewals and contract negotiations as early as 15 months in advance. When a few months out was once the norm, CFOs say starting yearly ensures they can get the terms they really want.
“Starting those payer contract negotiations early has been imperative for our system,” Hannah Jacobs, senior VP and CFO at Frederick Health said at the event.
Thinking this far ahead is crucial for CFOs to ensure that they are securing favorable terms and reimbursement rates from payers, which directly impacts their organization's financial health. By initiating these conversations early, CFOs have a greater opportunity to advocate for fair payment rates and avoid unnecessary financial strain.
Budgeting for AI, And Doing it Wisely
Another critical pain point for hospital and health system CFOs is budgeting for AI.
It’s essential for CFOs to carefully consider their organization's specific needs and goals when investing in AI technology, especially as every department in the hospital is likely coming to you looking for some sort of solution.
Simply purchasing AI tools for the sake of staying current with technology trends can lead to wasteful spending and inefficiencies, the attendees said.
So, the best solution for both of these challenges? Creating a consolidated, organizationalwide AI policy.
“We have leaders in every pocket of the system asking for AI in their department, but there is no overarching AI strategy in place which makes budgeting disjointed,” said Donna Wallace, VP of financial accounting from Integris Health.
Once the budgeting can be streamlined, leaders must then evaluate how AI can be effectively utilized to improve revenue cycle management, operational efficiency, and patient care outcomes.
By budgeting wisely for AI technology that aligns with their strategic objectives, CFOs can maximize ROI and drive sustainable growth for their organization.
Pictured: Attendees discuss major pain points during the 2023 CFO Exchange.
Where Have All The Hospitalists Gone?
Yes, nursing recruiting and retention is still a huge pain point for CFOs, but don’t forget about the physicians.
As more physicians transition to the ambulatory setting in search of more pay and better hours, hospital and health system CFOs say they are dealing with the challenge of retaining these providers both at the bedside and within the network.
Reassessing retainment strategies is obviously the best place to start, the CFOs at the event said. And on the same hand, it’s crucial for CFOs to develop a strategy for accommodating physicians who may want to return to the system in the future. This includes exploring alternative incentive models, such as value-based care arrangements, to attract and retain providers without solely relying on monetary incentives.
By proactively addressing the evolving needs of physicians and adapting to changes in the market, CFOs can strengthen their organization's position and foster long-term relationships with healthcare providers.
Does a Decrease in LOS Mean More Revenue?
Lastly, CFOs must be cautious about assuming that a decrease in length of stay (LOS) automatically translates to increased revenue.
Attendees agreed that it’s imperative for CFOs to assess the true ROI of their technology solutions and initiatives, especially since many vendors don’t come armed with any data.
Implementing technology that streamlines workflows and enhances patient care may lead to shorter LOS, but CFOs must evaluate the financial impact of these efficiencies.
“At our hospital, we implemented new technology that reduced our LOS, but I had to add 20 other FTEs to accommodate for the tech,” Wallace said. “So, CFOs need to be aware that a reduced LOS does not always equal an increase in revenue.”
By conducting thorough financial analyses and performance evaluations, finance leaders can ensure that their technology investments are generating sustainable revenue growth and improving overall financial performance.
So, what did we take away from this year’s event?
Well, hospital and health system CFOs are addressing the complex and rapidly evolving healthcare environment by executing early payer negotiations, strategic budgeting and planning for AI technology, physician retention strategies, and ROI assessments for technology investments that look beyond LOS; and you should be doing the same.
Our Spring 2024 CFO Exchange is taking place until May 10 at the Fairmont Grand Del Mar in San Diego.
Are you a CFO or finance leader interested in attending an upcoming event? To inquire about attending the HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Technology is everywhere in healthcare, but budgeting for it lands on the shoulders of the CFO.
Healthcare organizations are at the forefront of technology. From clinical areas to the revenue cycle, every facet of an organization is seeing some sort of new technology or AI. While technology and innovation are needed, CFOs are the ones left to figure out how to pay for it all.
As reducing costs is a top concern for CFOs, especially since bottom lines have been severely stressed and new technology costs are adding up—what are the solutions?
This has been one of the challenges at the forefront of conversations so far at the HealthLeaders CFO Exchange, as dozens of finance leaders from across the country are currently talking shop in San Diego.
Why AI?
Changes in the workforce landscape are forcing CFOs to be more creative, meaning many are looking toward AI and other technology to fill those workforce gaps and optimize processes.
“AI is great, especially for our workforce issues, but how do we pay for it and redeploy resources?” Jim Wilson, CFO at Mayo Clinic Health Systems, asked the crowd during the morning’s general session.
This is a complex question that explains why it will take more time for healthcare leaders to add in more AI.
And How?
Speaking of budget, budgeting for automation and the impact on future work demands is crucial for preparing for technological advancements, but it’s not as easy as it sounds. And since using AI to automate workflow in clinical and non-clinical departments can lead to improved efficiency and accuracy, CFOs need to prioritize this cost. But how?
Well, many CFOs at this event are starting to figure it out.
A good place to start? Creating a consolidated AI plan. “We have leaders in every pocket of the system asking for AI in their department, but there is no overarching AI strategy in place which makes budgeting disjointed,” said Donna Wallace, VP of financial accounting from Integris Health.
It’s not all bad, though. In fact, one CFO at the event is piloting AI for physicians that creates clinical notes based on the verbal conversations the physician has with patients. The added AI saves so much time for physicians that it allows them to see more patients in a day, helping to pad that bottom line.
This is just a sliver of conversation at this year’s event, so stay tuned as the Exchange continues to unfold over the next two days.
Our Spring 2024 CFO Exchange is taking place until May 10 at the Fairmont Grand Del Mar in San Diego.
Are you a CFO or finance leader interested in attending an upcoming event? To inquire about attending the HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
CFOs need to fight back on excessive labor costs, manual processes, and declining reimbursement, but how?
CFOs have been getting the short end of the stick in 2024. What has pushed health system margins to the breaking point has been an unprecedented rise in the cost of labor, coupled with narrow operating margins.
But what can CFOs do about it?
Well, there are four main challenges that CFOs are facing head on, and next week at our HealthLeaders CFO Exchange, dozens of finance leaders from across the country will meet to talk strategy, workarounds, and solutions all four of them (and more):
Financial stewardship
Ensuring daily management of labor productivity and staffing to demand is crucial for cost control and efficiency, but CFOs have struggled with excessive labor costs due to inefficiencies in scheduling and staffing, and it’s only getting harder.
How can these costs be controlled?
Well, holding leaders accountable for their department performance is essential for driving a culture of continuous improvement. In the past, lack of accountability has led to stagnant performance and missed opportunities for labor cost savings.
On top of labor costs, we can’t forget about those other expenses. Streamlining supply expenses and purchased services, particularly physician preference items, is a common pain point for healthcare organizations looking to reduce costs without sacrificing quality of care.
Pictured: Attendees of the 2023 CFO Exchange in Napa California talk shop.
Achieving efficiencies in portfolio management, service line assessment, and conducting P&L analysis for programs and service lines can help identify areas for optimization and cost savings.
Historically, healthcare organizations have struggled with outdated financial management practices that hindered effective portfolio management, so CFOs need to optimize to save.
Revenue Cycle
CFOs are well aware that implementing technology in the revenue cycle space can lead to streamlined processes and improved efficiency since manual processes and outdated systems are hindering performance.
But, it’s not as easy as it sounds, so how are other CFOs getting this done?
Another area in the revenue cycle that CFOs need to be tackling are payers.
Using statistical data to tackle cost control and combat payers is a strategic approach to managing revenue. Historically, CFOs have struggled with mounting costs and shrinking reimbursements from payers, so fighting back is necessary but not easy.
Marketplace
Identifying growth opportunities in the market and reinvesting resources strategically is key to helping healthcare organizations stay competitive.
As CFOs know, market expansion has been a driver of growth for healthcare organizations, but how can it be done at a time when margins are already so thin?
On the same hand, healthcare organizations have faced challenges with leakage of referrals to external providers, so CFOs are challenged with keeping referrals for specialty care within the system as it’s an essential step for capturing revenue and maintaining patient volume.
Another marketplace challenge for CFOs has been addressing resource-intensive services with low reimbursement rates. Healthcare organizations have struggled to balance the financial viability of certain services with quality of care, so how do CFOs combat this?
Technology
Leveraging legacy technology with new-age technology can help drive innovation and efficiency in healthcare organizations, but a lot of CFOs are still struggling with outdated systems and siloed technology platforms.
So, how do you update and streamline on a budget?
Speaking of budget, accounting for automation and the impact on future work demands is crucial for preparing for technological advancements but not as easy as it sounds. And since using AI to automate workflow in clinical and non-clinical departments can lead to improved efficiency and accuracy, CFOs need to prioritize this cost.
But how? CFOs at the event will find out next week. Stay tuned for more coverage
Are you a CFO or finance leader interested in attending an upcoming event? To inquire about attending the HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
CFOs are seeing more resource-intensive services that do not reimburse well, or at all.
There are a multitude of challenges that have pushed health system margins to the breaking point, but one is the unprecedented rise in the cost of services coupled with low reimbursement for those services from payers.
But what can CFOs do? Solutions may fall back to some tried and true strategies: play hard with payers and take risks on new revenue streams.
How to attack these hard decisions requires some careful planning, and some advice. We asked the members of the HealthLeaders CFO Exchange for the top issues they are facing, and low reimbursement rates—especially for those more resource-intensive services—are top of mind.
As this will be one of the many challenges addressed at our upcoming HealthLeaders CFO Exchange in May, HealthLeaders met up with CFO Exchange member, Bill Pack, CFO at Conway Regional Health System, to give us a preview of how this challenge—and his solutions—affect his health system.
The challenges
According to Pack, there are three main resource-intensive services that the health system sees that are not reimbursed well, or at all are, he says.
First are chronic disease management programs. According to Pack, these services require continuous monitoring, follow-up, and coordination among caregivers and providers, but are not adequately reimbursed by most payers at his organization.
Pictured: Bill Pack attends the 2023 CFO Exchange in Napa Valley, CA. Photo courtesy of HealthLeaders.
Mental health services are also on the list for the health system.
“Mental health treatment often requires extended ER wait times, specialized staff that is not always readily available, and challenges with appropriate patient placement,” Pack says. “The reimbursement rarely covers the cost of psychiatric patients presenting in the ED.”
Another culprit for the health system? Complex surgical procedures with longer recovery times.
Some surgical procedures, especially those involving complex cases or patients with multiple comorbidities, usually require longer hospital stays and more intensive post-operative care along with higher resource utilization with nominal additional reimbursement, Pack says.
The solutions
So how does Pack—and how can other CFOs—address these challenges? There are four main strategies that Pack has deployed:
Cost-Reduction
“We work to streamline operations (such as ED throughput, bed turnaround times, post-acute patient placement), and ensure contract compliance for supplies, and optimize resource allocation (right patient, right place, right time) to reduce expenses without compromising patient care and quality,” Pack says.
Comprehensive Payer Strategy
“Negotiating with payers for fair and equitable reimbursement for services that are resource-intensive, partnering with payers for care coordination and improving quality metrics, and providing evidence of the cost-effectiveness and positive patient outcomes have all been key in our payer strategy for proper reimbursement,” he says.
Diversification of Services
“We are also expanding and adding services that include higher-reimbursed procedures or specialties to offset the lower margins of resource-intensive services,” Pack says.
Utilization Management and Efficiency Improvements
“We are implementing utilization management processes to ensure that resources are used efficiently,” Pack says. “We are also identifying areas for improvement in care delivery, which lowers costs and improves patient care.”
The event
Pack is attending our Spring 2024 CFO Exchange on May 8-10 at the Fairmont Grand Del Mar in San Diego.
Are you a CFO interested in attending our event and hearing more from Pack and other attendees? To inquire about attending the HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Pictured: CFOs from across the US met at the 2023 CFO Exchange in Napa Valley, CA. Photo courtesy of HealthLeaders.
Competing with the giants of the industry is more than possible with the right approach, and there are three pivotal ways private physician practices can fight back against extinction and ensure longevity.
Welcome to our April 2024 cover story. Each month, our editors will be taking a deep dive into the topics that matter most to you in our cover story series. From ways to win the payer/provider war to what not to automate in the revenue cycle, we have a lot of stories up our sleeves this year.
So what did we look into this month? Well, as healthcare has evolved over time, so has the prevalence of private physician practices. What was once a common occurrence for patients—heading to the family-owned doctor’s office—has in many cases been replaced by the experience of seeking care at a network of physicians employed by large organizations.
In this cover story, HealthLeaders' Jay Asser spoke with healthcare executives on three major ways private physician practices can fight back against extinction and ensure survival: partnering, solving for reimbursement woes, and expanding revenue streams.
Did you miss our March story on the three negotiation trends that will be the difference between a deal, termination, or walk out in your next payer/provider negotiation? No worries, you can read it here.
Whether you are a payer or provider, there are three important strategies that will be key in working through successful contract negotiations this year.
I am proud to introduce the first edition of our newly launched cover story series. Each month, our editors will be taking a deep dive into the topics that matter most to you. From taking your physician practice back to what not to automate in the revenue cycle, we have a lot of stories up our sleeves this year.
So what did we look into this month? As we know, the tug-of-war between payers and providers hits the precipice at the negotiating table. Contract negotiation is more than just tough business, and the strategies each party takes to the table can be do or die for any organization.
Portals, portals everywhere. Patient payment portals are great, but there's something to be said about too much of a good thing.
Technology is the cornerstone of any successful revenue cycle, especially when it comes to patient payment portals. But at a time when patients expect the Amazon payment experience, how can leaders pair down their options to create a seamless experience for patients?
The answer may be more “simple” than you think.
Hear from Brandon Burnett, Vice President of Revenue Cycle at Community Health Systems, and Heather Dunn, Vice President and Chief Revenue Cycle Officer at Vanderbilt University Medical Center, in this week’s HealthLeaders Shorts on how to keep payments simple.
Pictured: Attendees discuss major pain points during the 2023 CFO Exchange.
Pictured: Attendees of the 2023 CFO Exchange in Napa California talk shop.
Pictured: Bill Pack attends the 2023 CFO Exchange in Napa Valley, CA. Photo courtesy of HealthLeaders.
Pictured: CFOs from across the US met at the 2023 CFO Exchange in Napa Valley, CA. Photo courtesy of HealthLeaders.
