Hospices adopt business intelligence tactics to analyze potential risks and opportunities and guide strategic decisions. Some are finding that these methods, often technology-based, can help them maximize revenue and lower costs, according to health care consultants at New York accounting firm Freed Maxick.
“Business intelligence” is defined as the processes and technology that a company uses to collect and analyze the data produced from its activities. To implement this effectively, hospices need insight into all of the processes within their organizations that impact their revenue cycle, so that they can “put sight lines from front-end to process principals,” according to Maureen Lehsten, director of healthcare consulting at Freed Maxick, speaking at the National Hospice and Palliative Care Organization’s leadership and advocacy conference.
“One of the highest priorities is managing revenue cycles to care for patients,” Lehsten said. “They need to clear the pebbles in the flow and make sure they don’t have a rock in the cash flow, which reduces the time between patient arrival and cash arrival.”
From a cost and revenue cycle perspective, leveraging data already captured by the organization can improve cash flow, according to Dan Gerena, business intelligence practice manager at Freed Maxick.
Payroll and electronic medical records systems, for example, can paint a picture of where money is going. From the cost of providing patient care to receiving payment, the data collected can tell a broader story of a hospice’s value proposition, Gerena said.
This level of attention to the back office and clinical operations will be necessary to succeed in a value-based payment landscape, according to Lehsten.
Value-based care should feature more prominently in long-term palliative care reimbursement. Among the first steps is the hospice component of the Value-Based Insurance Design Demonstration (VBID), known as the Medicare Advantage (MA) hospice carve-in. The program has entered its second year.
Some hospices are also looking to participate in ACO Realizing Equity, Access, and Community Health (REACH), which replaced the Global and Professional Direct Contracting (GPDC) models.
Other upcoming models from the Center for Medicare & Medicaid Innovation (CMMI) have yet to be announced.
Suppliers should prepare for these changes by reviewing cash flow data to understand their costs and optimize the revenue cycle process, Lehsten said. This is of particular concern when working in Medicare Advantage where payment terms are often more complex than the traditional fee-for-service model.
“Cutting is a major disruptor for all palliative care providers,” Lehsten said. “Are there areas where you need to dig a little deeper to respond very proactively to what you see in real time? The revenue cycle process enables visualization to change behaviors across the organization, improve cash flow acceleration, reduce denials, and identify where those claims get stuck early in the cycle . »
Careful data analysis can inform hospice efforts to boost efficiency and reduce costs in anticipation of the payment reductions that typically occur in Medicare Advantage.
“The way to become more agile as an organization is really to have visibility into those metrics that drive quality and cost,” Gerena said. “[It’s] change the paradigm of a static analysis and work with real-time data to understand where the opportunities lie. This is [telling] a story about real data alignment on how you are a low cost provider. »
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