Three Strategies to Deliver Patient-Centered Care in the Next Normal

Juggling financial demands, uncertain healthcare legislation, and COVID-19 can distract healthcare leaders from the most important aspect of care—patients. Delivering patient-centered care in this volatile market can be challenging, especially when traditional healthcare methods (e.g., in-person visits) are on hold. These sudden disruptions to routine care have highlighted the importance of keeping patients at the center of care, whether care delivery is in-person or virtual. Health systems can manage competing priorities, adjust to pandemic-induced changes, and deliver patient-centered care by focusing on three strategies: Improve the patient experience. Implement the Meaningful Measures Initiative. Transition in-person visits to virtual.

Innovative Healthcare Partnerships: Making the Most of Merging Resources and Capabilities

Healthcare mergers and acquisitions performed solidly in 2020, despite the downturn in the U.S. economy and healthcare in general. Organizations responded to new challenges by partnering with each other to build core business strengths, address gaps in care delivery the pandemic exposed, and enhance their resources to navigate current and future crises. Realizing the potential of emerging healthcare partnerships requires an open and scalable analytics infrastructure plus a cultural and contractual openness to allow innovation to flourish. Organizations that have adopted an open analytics platform have the data operating advantage to form partnerships, efficiently and smoothly bring best-of-breed solutions to market, and enable the innovative potential of collaborations.

2021 Healthcare Trends: What Leaders Need to Know from COVID-19 to New Administration Policies

While much of the healthcare industry was eager to put 2020 behind it, the new year brings its own challenges, concerns, and promises. Trends in the three main categories of new Biden administration policy, care delivery, and healthcare technology will shape 2021, with key issues including the long-term effects of COVID-19, future emergency preparedness, and the outlook for the Affordable Care Act (ACA). Healthcare leaders can prepare for this pivotal year by understanding critical areas to watch within these categories and how events, activities, and political appointments will affect the healthcare ecosystem.

Shifting to Value-Based Care: Four Strategies Emphasize Agility

As the healthcare payment shift from fee-for-service (FFS) to value-based reimbursement takes longer than expected, health systems must balance existing volume-based models with a growing emphasis on value. Organizations are in different phases of the journey from volume to value, and policies continue to evolve. In response, the industry’s best stance is to sustain FFS revenue while following guidelines and strategies to be increasingly ready for value. Organizations can use four methods to remain agile as they navigate the limbo between volume and value: Understand the first ten years of value-based care and prepare for what’s next. Identify essential strategies for shifting from volume to value. Leverage the Medicare Shared Savings Program. Use population health management as a path to…

How to Build a Healthcare Data Quality Coalition to Optimize Decision Making

Healthcare data-informed decision making’s complexity and consequences demand the highest-quality data—a relationship that COVID-19 has amplified. Decision-making challenges associated with pandemic-driven urgency, variety of data, and a lack of resources have made it more critical than ever that organization’s build a data quality coalition and strategy to ensure systemwide data is fit for purpose. Having the people, processes, and technology necessary to define, evaluate, and monitor data quality allows for a quick, effective, and sustained response at an organizational scale. The coalition keeps all resources working together on the task at hand within a well-defined structure.

Data Science Reveals Patients at Risk for Adverse Outcomes Due to COVID-19 Care Disruptions

One of the biggest challenges health systems have faced since the onset of COVID-19 is the disruption to routine care. These care disruptions, such as halted routine checkups and primary care visits, place some patients at a higher risk for adverse outcomes. Health systems can rely on data science, based on past care disruption, to identify vulnerable patients and the short- and long-term effects these care disruptions could have on their health. Data science can also inform the care team which care disruptions to address first. With comprehensive information about care disruption on patients, health systems can apply the right interventions before it’s too late.

The Key to Better Healthcare Decision Making

When healthcare leaders make data-driven decisions, they often think they see the same thing in the data and assume they’re drawing the same conclusions. However, decision makers often discover later that they were looking at the data differently and didn’t derive the same insights, leading to ineffective and unsustainable choices. Healthcare leaders can manage differing data interpretations by using statistical process control (SPC) methodology to find focus, avoid divergent data interpretations, make better decisions, and monitor change for a sustainable future. By deriving concise insights, SPC separates the signal from the noise, augmenting leaders’ decision-making capabilities.

Artificial Intelligence and Machine Learning in Healthcare: Four Real-World Improvements

As COVID-19 has strained health systems clinically, operationally, and financially, advanced data science capabilities have emerged as highly valuable pandemic resources. Organizations use artificial intelligence (AI) and machine learning (ML) to better understand COVID-19 and other health conditions, patient populations, operational and financial challenges, and more—insights that are supporting pandemic response and recovery as well as ongoing healthcare delivery. Meanwhile, improved data science adoption guidelines are making implementation of capabilities such as AI and ML more accessible and actionable, allowing organizations to achieve meaningful short-term improvements and prepare for an emergency-ready future.

The Three Essential Responsibilities of a Nurse Informaticist

With data driving decisions at every level of a health system, healthcare organizations must have data experts who can understand and communicate the technological processes and the reasons behind them to clinical staff. Nurse informaticists bridge the gap between data and nursing practice by combining clinical experience and data expertise. They fulfill three pivotal responsibilities: Understand and communicate the “why” behind new processes. Implement new processes. Validate data quality. With a nurse informaticist guiding data-driven processes, educating nurses, and validating data quality, health systems advance data beyond the data platform so it reaches the nursing workforce to inform decisions at the frontlines of healthcare delivery.

Why Data-Driven Healthcare Is the Best Defense Against COVID-19

COVID-19 has given data-driven healthcare the opportunity to prove its value on the national and global stages. Health systems, researchers, and policymakers have leveraged data to drive critical decisions from short-term emergency response to long-term recovery planning. Five areas of pandemic response and recovery stand out for their robust use of data and measurable impact on the course of the outbreak and the individuals and frontline providers at its center: Scaling the hospital command center to pandemic proportions. Meeting patient surge demands on hospital capacity. Controlling disease spread. Fueling global research. Responding to financial strain.

A Sustainable Healthcare Emergency Management Framework: COVID-19 and Beyond

With an ever-changing understanding of COVID-19 and a continually fluctuating disease impact, health systems can’t rely on a single, rigid plan to guide their response and recovery efforts. An effective solution is likely a flexible framework that steers hospitals and other providers through four critical phases of a communitywide healthcare emergency: Prepare for an outbreak. Prevent transmission. Recover from an outbreak. Plan for the future. The framework must include data-supported surveillance and containment strategies to enhance detection, reduce transmission, and manage capacity and supplies, providing a roadmap to respond to immediate demands and also support a sustainable long-term pandemic response.

Healthcare Process Improvement: Six Strategies for Organizationwide Transformation

Healthcare processes drive activities and outcomes across the health system, from emergency department admissions and procedures to billing and discharge. Furthermore, in the COVID-19 era’s uncertainty, process quality is an increasingly important driver in care delivery and organizational success. Given this broad scope of impact, process improvement is intrinsically linked to better outcomes and lower costs. Six strategies for healthcare process improvement illustrate the roles of strategy, skillsets, culture, and advanced analytics in healthcare’s continuing mission of transformation.

The Healthcare Cybersecurity Framework: A Top Defense Against Data Breaches and Attacks

Between 2017 and 2020, more than 93 percent of healthcare organizations experienced a data breach. While digital technology and connectivity is increasingly critical in meeting operational and clinical challenges, such as COVID-19, more integration also enables increased exposure to cyberattacks that can impact care delivery, safety, and privacy. In response to healthcare’s significant and growing cybersecurity threats, vendor organizations and their health system partners need a security framework. A defensible protocol holds vendors accountable to routine audits and compliance measures at a regular cadence, ensuring both parties keep cybersecurity programs active and optimized.

The 2021 Healthcare Financial Forecast: What to Expect, How to Prepare

As healthcare financial leaders plan for 2021, they can expect COVID-19 to shape their strategies. Pandemic response and recovery will continue to dominate the industry, inform new perspectives on existing issues (e.g., the shift to value-based care and health equity), and shape priorities. Meanwhile, the Biden administration will start to puts its stamp on U.S. healthcare, further making 2021 a pivotal year for the industry. Healthcare finance teams can best navigate 2021 by monitoring and preparing to take action in five prominent areas: Election impact. Price transparency. Financial forecasting. Value-based care. Health equity.

Healthcare Data Quality: Five Lessons Learned from COVID-19

Healthcare providers knew that COVID-19 would threaten the lives of their patients, but few understood the greater ripple effects across their business and industry as a whole. For providers, two significant COVID-19-induced challenges arose: analytic strain and resource limitations. These challenges highlighted the critical importance of data quality. Healthcare leaders can improve data quality throughout their organizations by understanding the data quality lessons learned from COVID-19. Five guidelines from these lessons will help organizations prepare for the next pandemic or significant analytic use case: Assess data quality throughout the pipeline. Do not leave analysts to firefight. Look outside the four walls of the organization. Data context and purpose matters. Use a singular vision to scale data quality.

Safeguarding the Ethics of AI in Healthcare: Three Best Practices

As artificial intelligence (AI) permeates the healthcare industry, analytics leaders must ensure that AI remains ethical and beneficial to all patient populations. In absence of a formal regulatory or governing body to enforce AI standards, it’s up to healthcare professionals to safeguard ethics in healthcare AI. The potential for AI’s use in support of the pandemic response can have enormous payoffs. However, ensuring its ethical implementation may prove challenging if healthcare professionals are not familiar with the accuracy and limitations of AI-generated recommendations. Understanding how data scientists calculate algorithms, what data they use, and how to interpret it is critical to using AI in a meaningful and ethical manner to improve care delivery. By adhering to best practices for healthcare…

The 100-Percent Solution to Improving Healthcare’s Operating Margins

Healthcare organizations face unparalleled pressure to increase operating margins as they adapt to the revenue compression from COVID-19 and growing competition from insurers and digital disrupters. Yet, many health systems rely on outdated, revenue-centric cost accounting solutions that are ill equipped for strategic financial decision making. As a methodology for today’s complex healthcare environment, activity-based costing (ABC) can capture healthcare resource use at a granular level. With this service-level insight into clinical cost, ABC provides actionable intelligence to help organizations improve profitability and make strategic cost-reduction decisions. These comprehensive costing solutions give health systems a full understanding of cost across the care continuum—the only level of insight that will enable strategic cost transformation in the industry’s new normal.

Three Analytics Strategies to Drive Patient-Centered Care

The cost of uncoordinated care that fails to prioritize patient needs is estimated to be over $27.2 billion. One of the primary reasons behind these wasted healthcare dollars is a failure to effectively leverage data to understand patient needs—a must-have to deliver patient-centered, value-based care (VBC). Three analytics strategies enable health systems to focus on patients while also meeting the financial standards for VBC delivery: Prioritize patient outreach by risk level. Deploy data tools to combat COVID-19. Promote data literacy. Detailed information from comprehensive data sets allows health systems to understand patient needs at a granular level and then use that insight to drive care decisions. More informed care ensures health systems are also meeting the core elements of VBC—managing…

To Safely Restart Elective Procedures, Look to the Data

Many health systems have realized they lack the data and analytics infrastructure to guide a sustainable reactivation plan and recover lost revenue from months of halted procedures due to COVID-19. However, with operational, clinical, and financial data, augmented by analytics tools, leaders have the visibility into hospital and resource capacity to guide a safe, sustainable elective surgery restart plan. The first step on the road to recovery for health systems is access to robust analytics to understand the full impact of COVID-19 on clinical, financial, and operational outcomes. Second, organizations need data-sharing tools, like data displays and dashboards, allowing leaders to make decisions based on consistent data that support the organization’s reactivation goals. Leaders can even take the data one…

Using Data to Ensure a Safe Return to School During COVID-19

With limited information about the novel coronavirus, industries are scrambling to create an effective response to more quickly and safely return to life before the pandemic. Data has proven to be the best way to capture information about the developing virus. With access to the latest, comprehensive COVID-19 data, decision makers in any industry—from education to healthcare—can develop a sustainable, viable approach to pandemic-era operations. In the education sector, leaders can use accurate, up-to-date COVID-19 data to make decisions about implementing in-person or virtual learning. When states across the country instituted virtual learning as a stopgap until it was safe to resume in-person education, the most vulnerable students experienced the greatest disadvantages. As these disparities grow with continued virtual learning,…

2021 Changes to the Quality Payment Program: Must-Know Guidelines for ACOs

In 2021, CMS proposes the following four key changes to the Quality Payment Program (QPP) that will impact quality measurement for ACOs and ACO participants: The discontinuation of the CMS Web Interface. The introduction of the alternative payment model (APM) Performance Pathway (APP). The discontinuation of the APM scoring card. The addition of the APM entity as a submitter type for MIPS. Each change will create new challenges for ACOs and ACO participants. Organizations can successfully navigate these shifts by partnering with a robust quality measures solution that creates a complete picture by combining comprehensive data and measures information in performance visualizations. An inclusive quality measures solution also creates a thorough workflow by combining the monitoring and improving processes, then…

Medical Practices’ Survival Depends on Four Analytics Strategies

With limited resources compared to large healthcare organizations and fewer personnel to shoulder burdens like COVID-19, medical practices must find ways to deliver better care with less. Delivering quality care, especially in a pandemic, is challenging, but analytics insight can guide effective care delivery methods, especially for smaller practices. Comprehensive data combined with team members who can turn numbers into real-world information are essential for medical practices to ensure a strong financial, clinical, and operational future. Independent medical practices can rely on four analytics strategies to survive the uncertain healthcare market and plan for a sustainable future: Prioritize access to up-to-date, comprehensive data sources. Form a multidisciplinary approach to data governance. Translate data into analytics insight. Invest in analytics infrastructure…

Shifting to Virtual Care in the COVID-19 Era: Analytics for Financial Success and an Optimized Patient Experience

The COVID-19 era has seen a decline in visits to ambulatory care practices by 60 percent and an estimated financial loss for primary care of over $15 billion. Shutting down elective care is financially unsustainable for health systems and for patients, who continue to need non-pandemic-related care. While virtual medicine has emerged as a viable and mutually beneficial solution for patients and providers, the shift from in-person to virtual health is logistically and financially complicated. Processes and workflows from in-person care don’t directly translate to the virtual setting, and a financially successful shift requires deep understanding of the factors driving patient engagement and revenue in the new normal. As such, meeting patient needs and financial goals requires robust enterprisewide analytics…

Healthcare Financial Transformation: Five Leading Strategies

Healthcare financial transformation—improving care delivery while lowering costs—has been an ongoing challenge for health systems in the era of value-based care and an even more prominent concern amid COVID-19. While better care and reduced expense to organizations and consumers might seem like opposing goals, by understanding the true cost of services and other drivers of expense, organizations can successfully manage costs while maintaining, and even improving, care delivery. To that end, health systems can use data- and analytics-driven tools and strategies to addresses financial challenges, including uncompensated care, prolonged accounts receivable days, discharged not final billed cases, inefficient resource use, and more.

Reduce Bad Debt: Four Tactics to Limit Exposure During COVID-19

Health systems have always faced bad debt—from charity care to insurance claim denials—and COVID-19 has exacerbated its impact on revenue. While hospitals and clinics are responsible for providing care to populations, they can still generate revenue from care delivery without compromising care accessibility or quality. An effective bad debt management approach provides the patient with every financial resource possible and allows the health systems to focus less on payment and more on delivering the best care. With four tactics, health system leadership can identify bad debt and implement effective processes to minimize it without undue burden on patients: Identify bad debt exposure early. Educate patients about alternative payment options. Leverage technology within the workflow. Understand the true cost of care.