In part one of our value cycle series, we looked at the factors driving the growth of healthcare spending as it approaches 20% of our gross domestic product. The next question is: who’s spending this money? Businesses are hit by increased expense, but increasingly it’s the healthcare consumer bearing the heaviest load.
Both CMS and private payors realize that costs can’t rise forever. Thus the rise of new reimbursement models rewarding value over volume. In these models, providers failing to meet quality and cost outcomes will be penalized while those delivering to defined measurements of value rewarded.
Revenue is of course still vital to success, and a well-managed revenue cycle will always be a critical part of a provider’s ability to care for their community. But the relationship between revenue, cost and quality – always important in the past – must now be coordinated even more closely. They cannot be addressed as separate concerns but instead managed as components of a single larger process.
Managing this process means first identifying risks all across the value cycle. Without visibility into – and understanding of – cost, revenue and quality, a provider system risks their patients’ satisfaction, their own profitability, and their regulatory compliance. Once risks are discovered, a value cycle approach means converting those risks into opportunities for improvement in cost, revenue and quality. Finally, the value cycle means optimizing these improvements, turning them into sustainable processes.
Discover, convert and optimize. The value cycle connects cost, reimbursement and outcomes, helping providers meet their mission and margin in a world linking reimbursement to value.
How are you aligning your clinical, operational and financial data? How is the drive to deliver value affecting different departments in your system? We’d love to hear from you at email@example.com.