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[Article] Healthcare Practices: Navigating Through Turbulent Times

Managing medical practices is challenging even in the best of times. But what happens when situations outside of our control force temporary but significant changes upon us? Health systems, hospitals, and clinics need to be among the most stable of businesses no matter what the circumstances in order to best serve patients and the community’s urgent needs. The recent events of COVID-19 have illustrated the need to be adaptable in times of crisis. External changes may force us to modify how we do business for several days, in the case of extreme weather or natural disasters, to several months, in the case of the current pandemic. As leaders in these organizations – and indeed, in our communities – how can we best position ourselves to navigate through these turbulent times?

The key to being able to lay out a path forward, and to predict the obstacles that lie ahead, is leveraging analytical tools to help understand the wealth of data contained within a practice’s systems. Good strategy comes from good information and through analysis of just a few key metrics, we can forecast the road ahead and plan the most effective route. The following is a discussion of the key measures to understand when formulating your strategy.

Scheduling Statistics:

Critical events will likely cause a great deal of variability in your schedules. In many cases, no-shows and short-notice cancellations will spike as patients are unable to get to the clinic. In other cases, emergency demand for care will go up. Often, different specialties will see widely varied impacts. Understanding each provider’s availability per session, or in some cases, even by hour, is the key to setting clinic staffing ratios to maximize throughput while minimizing exposure, understanding which non-urgent appointments can be delayed to free up emergency appointment time, and maintaining that critical and comforting presence for patients who depend upon your services.

Key patient access metrics to pay attention to include:

  • Percentage of provider’s templated time booked and time available by hour
  • Provider frozen/held time by hour
  • Upcoming counts of scheduled appointments by visit type
  • Same Day cancellation rates and no-show rates
  • Average clinical cycle times (to minimize waiting room exposure)

Cashflow and Reserves:

No matter the impact crisis situations have on patient volumes, these events almost always place a strain on the organization’s cash position. Cash can be impacted by events preventing patients from getting to their scheduled appointments and impacting the practice’s monthly productivity. Extreme high-volume events may require immediate cash outlays for supplies and staff for services which will not be reimbursed for 30-60 days. Whether the crisis increases or decreases volume, the financial footing of the practice needs to be strong.

Key Cash metrics executives and management need to be aware of to maximize their financial position:

  • Fixed expenses and the volumes required to meet those levels
  • Variable expenses and the impact of spikes or dips in demand
  • Available cash and current assets in hand available to meet these needs.
  • Accurate AR valuation
  • Current cashflow trends and timelines:
    • Charge lag
    • Claim drop lag
    • 1st Insurance payment lags
    • Zero balance lag

Expected Reimbursement:

It can be difficult to predict the full financial impact of these critical events, but with a strong set of analytical tools, it is possible to model what a practice can expect to be paid for any spikes in services rendered, forecast lost revenue from services cancelled or delayed, and even predict the impact of anticipated denials from the payers. Moreover, good analytics will highlight if more will be required from the standpoint of patient collections from deductibles and coinsurance, higher true Self-Pay or Medicaid volumes, and overall reimbursement trends by individual payer. Being able to model this information with a high level of detail will assist the finance team in dynamic budgeting and forecasting the overall financial position of the practice once things return to normal.

Key metrics for the reimbursement team to focus on include:

  • Payer mix by provider
  • Expected reimbursement by procedure or payer
  • Anticipated denials common during times of crisis:
    • Registration denials due to inability of patients to provide current insurance
    • Authorization denials
    • Additional information denials due to lack of documentation time by providers
    • Recovery rates for stated denials
    • Self-pay collection rates at time of service and through the billing office
    • Probability of collection by balance, age, and payer

What is predictable about the business of healthcare is its unpredictability. When a significant crisis occurs, leadership cannot rely on the same monthly management dashboards and reports to drive them successfully through a rapidly changing world. Using strong analytical tools, an organization can use their data in a new way in order to plan for challenges and implement a strategic plan of action. Strong, thoughtful leadership in difficult times is what will keep an organization on solid financial footing, allow physicians and staff to provide excellent care, and inspire the confidence in your patients that you will be there for them when they need you the most.

These are just a few things to consider. To learn more or to see Analytics In Action, come to our Webcast April 29, at 1 PM (Eastern-NYC) “Healthcare Practices: Navigating Through Turbulent Times”.

Click here to register for the Webcast on April 29

Written by: Scott Everitt, MBA, VP of Healthcare Solutions at Practical Data Solutions

PDS is Presenting at the Virtual MGMA The Operations Conference on 4/17/20

MGMA’s The Operations Conference has been moved to an online event in order to support global efforts to prevent the spread of COVID-19.

For those attending the MGMA virtual conference, please look for our session “Visualize Superior Patient Access in Your Practice” on April 17th at 11:00 AM Eastern. 

Practical Data Solutions' CEO Russell Hendrickson and Vice President of Healthcare Solutions Scott Everitt will showcase how combining practice data with visualization tools to build interactive dashboards can illuminate opportunities to expand capacity and increase patient access. They will address how people, processes and technology can come together to improve patient access for higher engagement and better outcomes.

Driving Bottom-line Revenue: Leveraging Visual Analytics

Managing your revenue cycle is critical to the financial health of your organization. The goal is simple—ensure that all entitled revenue has been accurately captured, billed and collected. The revenue cycle creates massive amounts of data transactions which require appropriate staging and modeling to uncover lost revenues, understand denials and identify performance improvement opportunities. Learn how visual analytics can help identify performance gaps and focus leadership to drive and improve your organization’s financial performance. 

Join Scott Everitt, Vice President of Healthcare Solutions and Kelly Constantinetis, Senior Business Intelligence Analyst on April 15, 2020, at 1:00 PM EDT for this free webinar.

Register Today!

MGMA20 | The Financial Conference

MGMA20 | TFC

The Financial Conference is always a great opportunity to connect with healthcare professionals to share the latest in analytics and the challenges organizations are facing today. This conference always sparks great discussions on strategies to run a more profitable and efficient organization. During these great discussions, PDS was able to share how our solutions can help with financial management, payer contracting analysis, business intelligence and revenue cycle management best practices.

MicroStrategy World 2020: Learning, Success, and a PDS Presentation

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MicroStrategy World is always one of our favorite conferences. Michele Perry, PDS VP of Service Delivery & Web Analytics, enjoyed the opportunity to collaborate with Ronald Lettieri, Associate Director of Finance & Analytic at SUNY Stony Brook Medicine. Michele and Ron hope that by sharing how powerful organization-wide self-service analytics can be, they’ll inspire other organizations to embrace the benefits of federated analytics. Beyond their presentation, Michele, Ron, and all attending members of the PDS team greatly enjoyed learning valuable information about what’s happening at the forefront of analytics technology during their attendance.

 

PDS Client Exchange Forum 2019 a Success!

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November 12th-14th, clients joined us at Disney's Coronado Springs Resort | Orlando, FL for 3 days of focused healthcare analytics training, discussions and networking. Our motto is “Your data empowered…” but for 3 days, it was all about our clients empowered. The one-on-one time with customers…invaluable.

Our first day was all about PDS iMPower and PDS Dash – an exchange of best practices and keys to success. Tuesday evening, we enjoyed a networking reception.

We decided to take a more collaborative approach in 2019; after all, “Exchange Forum” was in the name. The second day of the conference focused on round-table discussions; clients learned from each other while PDS staff added their expertise to the conversation. Wednesday night we enjoyed Epcot and the spectacular evening fireworks.
This morning, we continued the round-table discussions and then forum wrapped up after a delicious lunch together.

The 2019 PDS Conference was all about sharing our ideas, our time, and an experience. Our clients and the PDS Team truly made the magic happen, and Disney’s beautiful Coronado Springs Resort was surely a plus.

We hope to see you at a future PDS user conference!

Denials: An Ounce of Prevention

If you missed our October 30, 2019 webinar, visit our YouTube Channel to view it and watch our other webinars on various topics in healthcare, visualization, analytics, dashboarding, business intelligence and data warehousing.

Revenue Integrity Symposium 2019

Revenue Integrity Symposium v2As we return to the Northeast from Orlando, we hope you enjoyed visiting us at the 2019 Revenue Integrity Symposium and that you might have even learned something! If we missed you, we hope to catch you at a future conference.

MGMA19 | The Annual

MGMA2019 v2PDS staff enjoyed their experience at MGMA19 with three days sharing best practices in healthcare management. If you missed us, feel free to navigate to our webinar page to learn more about who we are, what we do, and how we do it. We look forward to seeing you at future conferences.

Improving Patient Access with Visual Analytics

WebinarIconIf you missed our August 14, 2019 webinar, visit our YouTube Channel to view it and watch our other webinars on various topics in healthcare, visualization, analytics, dashboarding, business intelligence and data warehousing.

 

Call PDS 203.262.9224