Costs of Quality Data

The transition from volume to value continues to pick up speed and transform the healthcare industry.  Quality measures are increasingly more significant for improved financial outcomes.  But does tracking quality metrics directly improve quality of care?  Due North Analytics believes in data based decisions, including quality based data.  In order to achieve data based decisions, reporting tools and infrastructure are a necessity.  Providers now face the dual challenge of creating quality data framework as well as reporting capabilities for transparency and reimbursement.  A recent Health Affairs article, titled “US Physician Practices Spend More Than $15.4 Billion Annually To Report Quality Measures” acknowledged these associated costs. The time required to monitor quality metrics not only increases costs but can also steal potential time from patients.  Due North Analytics can assist providers to standardize the necessary quality reporting proficiencies in order to optimize operational and financial efficiency.

Evolution of KPIs and Dashboards

Analytics, big data and interoperability have become common talking points for healthcare providers.  As an HLM Intelligence Report stated, “Healthcare leaders now realize that expertise in analytics is a required core competency, vital to an organization’s future survival and success.”

Whether it’s cost control, care coordination, price transparency or patient engagement, the need for data analytics with complex metrics is as important as ever.  The essential tool for monitoring multiple metrics is the dashboard.

Dashboards have evolved to cover all healthcare domains.  They have become much more than a tracking tool for Days in AR (although still a critical KPI with high deductible plans and increased patient responsibility dollars becoming the norm).  Dashboards now go further than the typical operational metrics, like block utilization and ER wait times.  At Due North Analytics, we believe a well-designed dashboard should include KPIs that combine the finances and the operations with the indispensable clinical quality metrics.  As the industry transitions from volume to value, quality metrics ensure the best proven care accompanied by improved reimbursement.  It is imperative organizations gather multifaceted data and accurately monitor all aspects of the business with dashboards.

Managed Care Contracts and the Affordable Care Act

Regardless of your feelings about the ACA (Obamacare), the insurance exchanges have allowed healthcare access for millions of people.  Increased enrollment necessitates comprehending the impact of these new patients while encouraging strategic service line development.  As service lines and payor mix are impacted, the associated managed care contracts should also be adjusted.

Due North Analytics was created with the provider in mind.  Our Reimbursement Simulation Models can assist providers to recognize the changing demographics, the revenue consequences, and deliver invaluable information for contract negotiations.

Address Declining Inpatient Volumes with Managed Care Contracts

A September 24, 2014 article spotlights hospital closings due to declining inpatient volumes. The most recent example being a 162 licensed bed HCA hospital in St. Petersburg, Florida.  The article highlights a recent survey where 68% of non-profit hospitals realized flat or declining Inpatient volume for the first half of 2014.  Conversely, lower revenue-producing Outpatient visits for the hospitals surveyed increased 72%.  This is but one of multiple forces converging on the health care industry.  Smaller rural hospitals are especially susceptible to current industry stresses.

Planning, modeling, and better managed care contracts are more critical than ever.  But while large organizations like HCA have extensive analytics tools at their disposal, many rural hospitals simply cannot afford to house such resources.

Due North Analytics can help with advanced analytics necessary in today’s healthcare environment.  Our high-value/low-cost model is especially suited for organizations who don’t have the resources to address all the converging forces on their own.