Healthcare Industry Issues

Profile

Healthcare Transition

The Healthcare Environment swings with every fiscal year. The variabilities are numerous and add complexity to the choices to be made: new and updated electronic devices inside the hospital walls, reimbursement contrivances linked to clinical outcomes and patient satisfaction and alternative delivery organizations. Informed decision makers; Trustee, Donor or Executive will face hard-hitting decisions about alternate choices and long term significances and their import on the community served.

Healthcare Considerations When Planning Post ACA

• Patients migrate to quality. Patients do indeed recognize quality organizations; over time a Harvard Kennedy School study indicates patients will change providers for high quality institutions and the reputations they have garnered. This portent masks the service and financial revenues that may typically be assumed when planning a new project.
• Merger validity is suspect. Hospital mergers have not resulted in price decreases for provider services. The net result of this occurrence is that employers are asking insurers to explore and implement narrow provider networks. The costs to consumers/patients is less and the continued price increases endured by consumers cannot continue.
• Intricate reimbursement schemes will continue. Payers will continue to seek evidence of Value Based Delivery to its members. Concomitant to that end will be greater complexity on the submitted claim form. And insurers will continue to mend provider networks at the bidding of employer healthcare advocacy groups.
• Innovative clinical technology is in the pipeline now. But lessened availability of capital will cause providers to choose assiduously amid competing priorities that may improve existing services or strategically expand to other clinical services. As pricing rivalry continues the rate of utilization will be an important cog in reducing the cost of the service. The debt capability of provider organizations will be tested.
• Consolidation is only one strategy

Via data mining exercises of patient episodes and statistical analysis of those experiences, assignments are framed in a top-down analytical paradigm. Quantitative analysis of discharge records and sophisticated insight gleaned from analysis of encounter data provide the client hidden or overlooked perspectives. Brian Rucco investigates and with result in hand promotes transformational thinking with healthcare providers, policy analysts and industry watchdog organizations. He yields evidence and statistically based reports that lessen ambiguity. Business Intelligence actions have assisted clients delineate business problems and better manage risk, size-up disruptive innovation, and discover root cause issues through data driven decision making.

Fact based industry specific paradigms enables management to minimize personal intuition, and better assess program performances within the organization -- by attuning performance with effective benchmarks and assessing collateral risk inherent in contending strategies. This integrated analytics methodology permits the client to engage with all the constituencies across the organizational spectrum and steer the decision making process. Organizations can stretch administrative resources, actualize service benefits and better grasp the sometimes unintended consequences of change initiatives attributed to shifting public policy and regulatory environments.