As health systems and physicians strive to provide better quality and more cost-effective care, it is imperative that they scrutinize all aspects of their operations and care delivery processes. Organizations must continually evaluate their infrastructure, operational procedures, and clinical outcomes that ultimately impact financial performance to succeed in an environment of changing reimbursement. Tough decisions are routine for leadership in the evolving industry, and success will depend on being well-informed and data-driven. The key derivative is to deliver their services with high efficiency while not compromising quality. These two traits do not have to be mutually exclusive.
Our team of experienced consultants provides customized solutions for health systems and providers to address complex challenges in this uncertain healthcare environment. We understand the unique circumstances and objectives of our clients, partnering to identify critical issues and implement sustainable results. We leverage analytical and operational expertise to add value as objective advisors, outsourced support, or shoulder-to-shoulder teammates. We understand the requirements of clinical and administrative efficiency while not jeopardizing highly responsive and quality care.
Projects typically begin with a comprehensive analysis followed by detailed recommendations on both the macro and micro components of the organizations’ current operating structure. Our partnership often continues by supporting and/or managing the implementation of our recommendations. Our scope includes performance improvement opportunities across the hospital, business office, and clinic/medical group operations.
An assessment of Physician Group/Physician Enterprise performance improvement opportunities typically includes:
- Organizational structure, reporting relationships, span of control, and leadership proficiency
- Patient throughput and operational workflows in both the clinic and hospital setting
- Patient access/demand, provider schedules/templates, and services metrics including, but not limited to no shows, wait times, and cancellations
- Revenue cycle structure and processes, focusing on accounts receivable, denials and claims processing; revenue maximization while maintaining total compliance
- Physician productivity based on work relative value units (wRVUs), visits, slot utilization, and patient contact hours
- Physician compensation levels relative to productivity
- Coding proficiency and processes, which may indicate the need for a formal coding audit
- IT functionality and utilization to support efficient operations
- Non-provider staffing levels and division of responsibilities
- Compliance reviews, balancing regulatory adherence with appropriate revenue cycle processes
- Personnel/management evaluation and training
- Executive coaching and organizational structure enhancements
- Consultative education and “cutting edge” updates regarding industry trends
- Dyad leadership (clinical and administrative) consultation
An assessment of Hospital enterprise performance improvement opportunities typically includes:
- Workforce—staffing ratios, flexing, supplemental pay, scheduling analysis
- Clinical performance—care management, excess/avoidable days, length of stay/discharges
- Supply chain
- Pharmacy
- Laboratory
- Service Lines (e.g., musculoskeletal, emergency department, cancer care, heart, etc.)
- Ancillary entities (e.g., home health, hospice, assisted living, etc.)
- Revenue cycle (central business office, etc.)
- Departmental reviews
- Inpatient coding and documentation
- Compliance reviews, balancing adherence with appropriate revenue cycle processes
- Departmental/service line consultation/education
- Strategic planning (overall and by service line)
- Executive coaching and organizational structure enhancements
- HIT functionality and throughput
- Capital and operating budget analysis; financial performance evaluation
- Board of director consultation, strategic planning, etc.
- “C”-Suite consultation
- Executive recruitment services
- Merger and acquisition consultation
- Physician alignment strategies and/or transactions advisory services
- Community relations/focus group reviews
- Physician needs analyses (supply/demand studies)
- Medical staff development planning