The Journey to Value-Based Reimbursement

Amid MACRA, value-based care, bundled payments and alternative payment models, healthcare CFOs are receiving a consistent, powerful message. Your iceberg is melting!

The quantity to quality transformation is forcing dramatic change for traditional revenue cycle processes, cost accounting approaches and payer contracting strategies. All must evolve to meet new value-based demands. Simply improving financial operations is no longer enough. A complete overhaul of each organization’s reimbursement model is required.

I was recently interviewed by Consulting Magazine regarding views on Value Based Care.  I suggest four key strategies to meet challenges facing healthcare finance leaders today as they prepare their organizations to thrive under value-based care:

  • Identify and then reduce costs
  • Evaluate, chart and execute growth and consolidation organization and service opportunities
  • Personalize the patient experience
  • Address new regulatory requirements now so you don’t get caught out

Underlying all this monumental change is stronger IT interoperability. Upgrades, new data analytics capabilities and the optimization of EHRs all lie ahead for healthcare provider organizations.

Navigating the Complexities

The article, entitled “The Road to Recovery: Healthcare’s Long Journey to Value” , brings together thirteen healthcare experts to discuss how consulting partnerships are also evolving to support the shift from fee-for-service to fee-for-value. Here are four key takeaways from the industry’s leading healthcare consultants, including Pivot Point Consulting:

  • Traditional project consulting moves to deeper, long-term relationships.
  • The greatest needs are related to strategy, consolidation, data analytics and process improvement.
  • Multiple consulting teams must come together versus operating in silos.
  • Consultants who have served as CEOs, CFOs, COOs, etc. offer the most value.

Jon Melling is a management consultant with over 30 years’ experience working in health informatics in the United States and internationally. He is a leading authority in revenue cycle, health information exchange and interoperability strategy. He is the past chair of the Health Business Solutions Committee, and serves as a member of both the ICD-10 Task Force, the Revenue Cycle Improvement Task Force and the Alternative Payment Methods Task Force.

To view the full article featuring Jon Melling, click here>>

To learn more about strategic consulting services to move your organization to value-based reimbursement, contact us at info@pivotpointconsulting or 800.381.9681.

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