Mercator Health AdvisorsFocus Services – Thoughts and Philosophy for 2023
Interim Management / Coaching and Oversight
Interim Management may serve not only as an inhouse assessment of strengths and weaknesses, but can also offer insight into organizational culture, inherent conflicts, and appropriate breakthroughs to the status quo. It is a sound transitional option towards building common objectives among key players geared to permanent leadership. Further, we see coaching and oversight as acceptable standards in the same light as accounting and legal.
Market and Hospital Assessment to Strategic Planning
Strategic solutions start with an understanding of market (population) characteristics and how they drive the key factors of payor eligibles/expenditures, chronic disease projections, risk segmentation, etc. These matters form the base for full hospital assessments. As these are defined, a clear message may be offered to “key players” and lay the way towards sustainable strategic plans.
Practical Value Based Healthcare
Value Base Healthcare is not a “catchphrase.” It is a commitment towards evidence based protocols that shifts to fully advantage prevention and chronic disease management at the local primary care level, with resulting positive impact on local patient volumes and revenues. Technology and telemedicine will only accelerate this predictable transformation for all payors.
“Everywhere markets” are certain local services available with minimal capital outlay that can offer immediate clinical and financial impact in any hospital location. Foremost in these strategies are: behavioral health for all ages; niched based services (IV therapy, sleep studies, wound care, etc.); and chronic disease management (downstream) protocols.
Principles of Cost Based Reimbursement
The true advantages of (compliant) cost based reimbursement is rarely optimized and often misunderstood. “Follow the Money” is the founding principle for common standards of care/common outcomes, two way referral systems, and (yes) two way revenue streams in any regional affiliation.
Adjunct Revenue Streams
“Below the bottom line” of a hospital income statement lies certain revenues that can assure financial viability. Particular attention must be paid to the regulatory requirements and accountable reporting. Among these programs are: 340B; ACO shared savings; chronic care management; and DSH-UPL calculations.
Integrated Rural Health Networks
Rural Health Networks must be driven by mutual understanding and complementary advantages to all parties. Two way referrals, two way revenue streams, common standards of care, and interdependent “outcome strategies” are all part of such affiliation relationships. A formal due diligence process is a productive exercise to facilitate the roles of each hospital.