Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Hospital CEOs Share 3 Ways to Ensure Value-Based Care Success

Senior hospital executives share three methods for being financially successful while dealing with the transition to value-based care, hospital management challenges, and lack of health data interoperability.

To support hospital revenue cycle management during the transition to accountable care, hospital executives are calling on their organizations to embrace the opportunities - and challenges - that come with the move towards value-based care models, stated Huron Consulting Group’s annual Healthcare CEO Forum Report.

Revenue Cycle Management and value-based care

During a recent conference in New Orleans, senior executives from multi-hospital systems, academic medical centers, and community hospitals worked together to identify specific strategies for improving revenue cycle management.

Three major themes emerged from their conversations: healthcare providers should aim to optimize benefits for current and future payment models, establish resilience in hospital management, and support interoperability advances.

Delivering benefits for current and future payment models

The participating CEOs believe that the transition from the fee-for-service payment method to value-based reimbursement has not progressed as quickly as anticipated, leaving healthcare providers operating under both payment models simultaneously - a pain point that can significantly impact healthcare organizations doing their best to embrace accountable care, noted April Wortham-Collins, Manager of Customer Segment Analysis at Decision Resources Group in a separate interview with

“We've got one foot in fee-for-service and one in value-based reimbursement, whether it be ACOs, bundled payments, or patient-centered medical homes with pay-for-performance components,” she said. “That's kind of a painful place to be if you're a provider because you’re following all these quality metrics for different populations.”

The CEOs who participated in the Huron Consulting meeting stated that to stay ahead of this predicament, top executives should continue to maximize benefits from the fee-for-service model while developing and implementing infrastructure for future payment models.

To do so, healthcare organizations need to establish broader cost-of-care solutions and expand healthcare networks.

They should also try to re-think their care processes to prepare for value-based reimbursement. Care models should be patient-centered and use population health management strategies to concentrate on improving care for patients with chronic conditions.

In addition, C-suite executives should consider joining forces with other healthcare providers to form integrated care networks. Accountable care networks allow several hospitals to share risk and savings while becoming more efficient at providing value-based care.

Boosting resilience in hospital management

A top priority for financial success is creating resilience and avoiding burnout in hospital management. In the midst of constant and continuous change, CEOs stated that hospital management and physicians feel a loss of control.

Top executives can improve managerial resilience by emphasizing what can be controlled, providing leadership training to ensure that middle managers feel a sense of urgency and engagement, and encouraging staff to take on leadership roles.

Developing physician leaders can raise morale and help to foster meaningful change, says ACPE President and CEO Peter Angood, MD, FRCS(C), FACS, FCCM.

“Physicians who are well-respected clinically, and have also received some good education and experience with leadership and management, have a double-edged advantage,” he said.  “They know and understand clinical care, and they know and understand the management or administrative side of care, and so they provide significant added value in creating better systems, better processes, more efficiencies overall.”

Supporting interoperability advances

A major concern across the healthcare industry is how to enable different health technologies, such as EHR systems and clinical devices, to communicate with each other.

Right now, top executives are uncertain about the return on investment for systems that cannot communicate. Teri Fontenot, President and CEO of Woman’s Hospital, stated that her organization’s IT-related costs account for more than half of the capital budget.

CEOs suggest establishing close relationships with the vendor community to foster innovation. They also recommend investing in innovation teams that stay on top of the evolving health IT industry.

By cutting the costs of maintaining health IT systems, healthcare providers can funnel that money back to improving patient care.

As the healthcare system transitions to value-based care and increased interoperability, providers have the opportunity to improve their revenue cycle management strategies. Hospital executives agree that healthcare organizations need to invest in the future of value-based care and health IT.

Continue to site...