HEALTHCARE ANALYTICS: DATA THAT DELIVERS.
At the same time hospitals and other healthcare providers prepare to comply with the Affordable Care Act, they have to deal with yet another sweeping new federal healthcare mandate: The American Reinvestment and Recovery Act of 2009 requires all physicians and hospitals to convert to electronic medical records (EMR) by 2014 or face penalties.
Converting millions of paper records into electronic form is a daunting task, but smart providers will learn to use the increased data requirements to their organizations’ advantage. Healthcare organizations that get ahead of the curve now and see a business opportunity in leveraging electronic data are sure to benefit from the heightened role healthcare analytics will play in the healthcare arena for years to come.
The practice of healthcare analytics – defined as the application of statistical and other tools and techniques to examine health data in order to study past performance and produce better clinical and business outcomes – is catching fire, driven by the new federal mandates. Other factors include the increasing financial pressure on providers and demand for better patient outcomes.
The rapid expansion in the healthcare industry, along with the aging of the baby boomers, has placed enormous stress on the nation’s healthcare system, requiring greater information exchange in order to enhance patient care. Hospitals, doctors’ practices and nursing homes are all looking for ways to manage care more cost-effectively. And in today’s tough business environment of budget cuts, closures and consolidation, data analytics provides a powerful financial, as well as clinical, tool.
With a wealth of electronic medical information at their disposal, hospitals and other providers can use healthcare analytics to spot important patterns and trends, improve patient outcomes, reduce redundancies, detect fraud, cut costs, better manage the budget and increase revenues. And medical records present a valuable patient history, helping providers better market their services.
But in order to benefit from the data burst, health administrators must have the right vision, direction and guidance to turn data findings into concrete action plans. By following these five rules, managers can start to master healthcare analytics:
Be strategic.
To leverage the influx of complex and diverse information, providers need to convey within their organizations the value and methodologies of various analytical projects. Healthcare leaders must plan, manage, measure and learn from past situations, such as operational performance and clinical outcomes, in order to improve the quality and efficiencies of business performance. At the same time, they need to look ahead and plan for the inevitable project offshoots and action plans that will follow from analytical research, while remaining focused on business goals. LegalHealth provides guidance on regulatory compliance and billing management issues, helping position clients for success.
Communicate and coordinate across the organization.
Organizational buy-in is critical to success. It is important for health managers not to operate in a vacuum but to coordinate with various departments, including operations and corporate accounting/finance, recognizing all implications throughout the organization. Administrators must have buy-in on the methodologies and explain how progress will be measured, as well as how results may impact existing business practices. LegalHealth has deep knowledge of healthcare organizations based on decades of positive collaboration and excellent working relationships across the industry.
Know the best approaches.
Visual and predictive analytical projects deal with such data-related issues as disbursement, insurance claims, benchmarking third-party payer rates, cost-of-living adjustments and contract negotiations. Taking data sets from billing, accounting and revenue allows managers to find common themes across multiple patient touch points. By identifying redundancies and other systemic problems, managers can develop additional action plans for achieving business goals. LegalHealth has a proven track record of solving complex patient-accounting-strategic-management issues to improve revenues.
Avoid costly contracts.
Evergreen provider contracts with third-party payers renew automatically, extending the financial damage caused by bad contracts. Providers can use healthcare analytics to benchmark rates against other insurers and get the best deals from third-party payers. Spotting trends from recurring problems helps providers avoid costly contracts and better negotiate when renewing contracts. LegalHealth helps clients pinpoint systemic problems and make lasting management changes that ensure their long-term financial health.
Use outside counsel.
Healthcare providers need experienced strategic partners to help them see the big picture and keep focused on meeting their goals. These processes involve thousands of complex laws and regulations. Collaboration with outside counsel is key to understanding the broader regulatory, legal and management ramifications. Providers that put a strong team in place from the start of the process will achieve the best business results.
Anderson & Quinn, LLC is a renowned law firm based in Rockville, Maryland, providing individuals, businesses, corporations, and healthcare institutions with the legal and litigation support they need.
