Question

What topics are interested and apprehensive to learn about in healthcare financial practices and why?

Answer 1

how reimbursement models are evolving, but that can be a distraction, and the reason for that is … how are you getting paid today? Some CFOs say case mix index is old school, but it is important today. If you lose sight of your CMI, the carpet can be pulled out from underneath you. Although you look at keeping an eye on pay for performance, you also have to keep eye on what's keeping your doors open today, and that's fee for service and quality — your fundamentals. If your coding is not accurately representing the care provided, that is going to impact your cash flow. If you lose sight of compliant coding, you'll have harder denials — you'll spend more money fighting for the little amount of money you're getting."

The link between revenue cycle and clinical operations. Quality should be a huge focus because it's going to influence reimbursement and where patients and physicians want to go. You're so far behind the times if you're not focused on this."   Pricing strategy.measured four different elements: patient experience, access considerations, using customer insights to drive strategy, and pricing. It was fascinating because in terms of real-time importance of each of those dimensions, pricing came out last. Thirty percent of organizations saw it as a priority and 10 percent were addressing pricing strategy actively. With high-deductible health plans, certain services will be viewed by consumers as commodities, and that needs to be filtered into the thinking when developing pricing strategy. There is a lack of understanding about demand elasticity for different providers in their marketplace. What kind of brand premium does a leading academic medical center carry in a marketplace where they can demand pricing over a community hospital or freestanding center? Pricing strategy is either not being addressed or being addressed with intuition." optimizing how the organization works with physicians; looking for scale in revenue cycle automation; focusing on better negotiations with payers. These four are evergreen."   Value-based reimbursement. It's a lot closer than people think or are prepared for. We see a lot of organizations that don't have the IT infrastructure they need for value-based care." While areas of patient access and lowering expenses are of top importance, CFOs are keeping a close eye on the shifts and dynamics around cost and reimbursements. A recent study shows 35 percent [of CFOs] said collections were their primary concern. Health systems need to be methodical when including the patient payment experience in client satisfaction scores. Tools and processes related to price transparency, charity and payment options are a must in today's environment. Any time the patient payment process can be handled prior to care, the better. Build in proactive workflows and conversations toward making every visit about the care of the patient."