How Are We Going to Pay For All This? - Cover

How Are We Going to Pay For All This?

Earlier this year, I talked about a day in the life of a pharmacy director—a very stressful day. Though she was a hypothetical person, her challenges are very real and faced by real providers that I talk to each day. And of all the challenges my provider friends faced in 2018, financial challenges were mentioned the most often.

My KLAS colleagues and I are eager to help providers succeed. With that goal in mind, I compiled a few of the specific questions I hear providers ask about their financial worries, some links to KLAS research that may help answer those questions, and information about a couple of the vendors and firms helping the most in this space.

Common Questions 

The types of things that providers brought up as their biggest challenges vary significantly and never seem to end— shifting reimbursement models, rising costs, and resource shortages are just a few. Blanketing them all are the general expectations to do more with less. Perhaps some of the questions below will sound familiar to you:

  • How do we keep this rural hospital open and physicians working in it?
  • What healthcare organization can we join to get economies of scale?
  • How much more do we have to invest in revenue cycle products and services to decrease rejections and improve our CMI?
  • How much do we have to pour into security before we can get back to caring for patients instead of just securing their data?
  • Can we continue without replacing the employees who just left our facility?
  • Can anyone tell us what the government is going to do with reimbursement and what we should do about it?
  • Where do we start with population health? 

Helpful KLAS Research

It’s worth noting that providers mentioned financial challenges more frequently than other key healthcare topics, including physician burnout or advancing patient care. KLAS hopes to save providers time by doing some digging and sharing the data we find. The following KLAS reports may be relevant:

  • KLAS’ Healthcare Consulting and Services 2018 report may help provider organizations decide which firms they can trust to partner with them in their financial endeavors and meet their specific needs.
  • Providers wondering which vendors can best help with population health goals—all while focusing on improving patient care—can turn to the Population Health Management 2018, Part 2 report.
  • Healthcare professionals can go to the Managing the Cost of Care 2017 report to read a list of strategies for lowering the cost of care and learn which ones are used most.
  • Stay tuned for the upcoming Revenue Cycle Services 2019 report to be published in the coming months!
  • In 2019, KLAS is putting together a unique summit that will bring the biggest payers and the largest providers together to tackle how to cut waste out of healthcare. Because payer relationships affect many of the challenges providers face, I’m excited to see the insights and outcomes from this summit. More details to come soon!

Notable Vendors and Firms

While many vendors in the market are working to ease the financial burdens of healthcare providers, the following stand out in KLAS research as being particularly effective:

  • PwC offers consulting in several areas—including financial improvement, revenue cycle optimization, strategy and growth, and value-based care—and has received high ratings for being a customer-centric partner.
  • HealthEC was rated in the Population Health Management 2018, Part 2 report as being the highest contributor to financial success and scored well in most other areas.
  • Chartis Group won Best in KLAS in Financial Improvement Consulting in 2018 and offers one of the broadest ranges of services on the market.

There Is Hope

The struggles are real, but so are the solutions. Many avenues and opportunities are available for financial success in its many forms. Please watch for upcoming posts in this series for more information on provider challenges.  

Photo Cred: Shutterstock, ThanomphongJantharotjana