When Data Becomes Strategic

We have been told that data leads to information, and information leads to knowledge. It is this knowledge, then, that drives innovation – the engine powering transformation in healthcare. While the luster of innovation is what grabs our attention, data and analytics are what make it possible in the first place. Continue reading

Payor Contract Negotiations: What Went Wrong?

After several long months, the contracting team at Community Hospital completed negotiations with its largest commercial payor and came out of the discussions feeling optimistic about the rate increases obtained.  Not only did they anticipate significant revenue increases but they also felt satisfied in being able to use this opportunity to transition from a percent-of-charge to Medicare base rate methodology – affirming their commitment to gradually evolving to value-based payments.  An excellent steward in its community, Community Hospital also took pride in avoiding the runaway charge increases prevalent in the market.  Things were looking up…until the payments came in.  Continue reading

Hospital/Medical School Affiliations – Why Governance Matters

As the healthcare industry consolidates, realigns, and struggles to better steward limited resources, hospital and medical school leaders across the country are striving to optimize existing strategic partnerships and develop new ones. The potential benefits of such relationships are tremendously attractive – a productive strategic affiliation creates opportunities for hospitals/health systems and their medical school/university partners to gain access to competencies and resources that enable them to expand their individual and collective enterprises in ways that would not be possible independently. Continue reading

To Warehouse or to Mart

I was recently asked about the influence of business intelligence (BI) in schools of medicine (SOMs), what the difference is between a data warehouse and a data mart, and which one of the two is better suited for an SOM.

SOMs have two choices to make in determining the overarching scope of the BI effort:  a full-scale data warehouse or an academic mission- or department-specific data mart (or series of marts). A data warehouse integrates information from multiple information systems. Data marts, however, are specific to one subject area or system – for example, finance, research, or grants management – and are often smaller in size and scope than a warehouse.

Business Intelligence Overview

Continue reading

Business Intelligence – the Next Implementation Priority

As with many other business and market drivers inspiring changes in healthcare, the need for improved business intelligence (BI) tools and capabilities is multifaceted.

Policy Drivers: 

  • HITECH Legislation – Meaningful use requirements, and the revenue associated with early attestation, have inspired many physicians and hospitals to implement EHRs to meet Phase 1 requirements.
  • ACA Legislation – Many of CMMI’s new models for ACOs, bundled payments, etc., include specific quality measures.  However, some new models from CMMI propose that institutions develop their own quality and other performance measures.

Financial Performance:

  • Cost Reductions – Federal and state healthcare funding continues to be reduced in current and projected budget cycles.
  • Payor Agreements – New payor agreements include both cost reductions and financial and performance measure improvements.

Continue reading