Hayes' Healthcare Blog

Leveraging Peer Collaboration and Information Sharing: 3 Things to Think About

Posted by Robert Freedman on May 24, 2017 at 9:00 AM

An article in Inc. Magazine outlined five reasons why collaboration is crucial. While the article was focused mainly on business organizations, the concept is just as important for those in healthcare generally and for compliance and auditing professionals specifically.

The key reasons for working with peers in your industry are:

  • Self-awareness – Collaboration forces you to clearly describe areas of strength and weakness
  • Scale – “Two heads are better than one”
  • Creative Abrasion – Converting energy from people who are different into positive action
  • Take the long view – Ideas may not have an immediate impact but could be beneficial down the road
  • Learn, learn, and learn some more – Collaboration sets an expectation of continuous learning to expand the knowledge base of the organization.[1]

No person – or organization – has all the answers. The more you can work with peers at similar institutions facing similar challenges, the better the chances you can effectively address and successfully solve them. There are three things to consider that can help energize peer collaboration in your organization.

Read More

Topics: mdaudit, Data analytics, Risk-based audits

Why Healthcare Technology Innovation Must Consider the Patient Story

Posted by Jeff Liddell on May 17, 2017 at 9:00 AM

By Jeff Liddell, Harmony Healthcare IT Consultant, Licensed Social Worker, Emergency Psychiatric Services High Reliability Organization Coach

The buzz and excitement surrounding last month’s NCAA Basketball Tournament provided another example of how the Road to the Final Four has become an annual community ritual encompassing people of all ages and backgrounds. Everyone, it seems, follows the action with brackets in hand as the field is whittled down from 68 to one National Champion – this year North Carolina.

The enormity of the event can be overwhelming, but as I followed the action I was most inspired by the individual stories of these college players - some of them beginning in faraway places like Poland, Africa, and Germany. While the victorious Tarheels cut down the nets amid a shower of blue and white confetti, many of the player stories had already begun to fade away.

Something similar is happening in the healthcare industry. The exhilaration surrounding the innovations in healthcare technology has taken center stage – sometimes at the expense of the stories of the patients the technology is meant to help. As industry leaders, we can’t be dazzled to the point where the patient story is lost beneath the waves of technology sweeping healthcare today. In an environment of mergers and acquisitions, consolidations and the tsunami of new technology and challenges to deliver care, we must be vigilant in ensuring that the patient remains the focus.

Read More

Topics: healthcare IT, patient experience, Hayes Thought Leadership Blog Series

Non-Medicare Payer Contracts and High Deductible Health Plans: 5 Things to Consider

Posted by Paul Fox on May 10, 2017 at 9:00 AM

Many non-Medicare provider contracts have unwritten ramifications of which you should be aware.  In today’s world of High Deductible Health Plans (HDHP) what you are really negotiating is your future self-pay liability until your patient’s deductible has been satisfied.  Do you have a viable strategy in place to understand what your organization’s options are and what you can/cannot do under your payer contract terms?  Additionally, should you insist certain clauses be present in the contract which will empower your facility to accurately collect at the time of service?

Here are five things to consider before entering into an agreement with a payer.

Read More

Topics: high deductible health plans, Healthcare insurance

What’s the Key to an Effective IT Transition? Governance and Strategy

Posted by Sondra Akrin on May 3, 2017 at 9:00 AM

As of 2015, one out of every five providers was looking at replacing its EHR system.[1] That is less than prior years when there was widespread dissatisfaction with healthcare IT systems but dissatisfaction isn’t the only reason organizations transition to a different IT system. Growth and the need for a more comprehensive solution is another reason, but even more common is a forced change because of an acquisition or merger.

Consolidation in the healthcare industry continues at a rapid rate, and one of the most difficult tasks with every merger is reconciling the IT infrastructure. In most cases that means the acquired group will be transitioning to the IT system of the acquiring organization. Chances are you will face an IT transition as some point in the future so you need to be prepared.

Going through the transition of a Practice Management (PM) or clinical (EHR/EMR) IT system can be a challenging and difficult experience. The best way to avoid the many pitfalls is to develop a detailed plan before the project even begins.

At the top of your list should be the two most critical elements of the planning process: establishing your governance structure and outlining your strategy.

Read More

Topics: healthcare IT project management

Implementing A New Compensation Plan: 5 Ways to Get Physician Buy-In

Posted by Don Michaels, Ph.D. on April 26, 2017 at 9:00 AM

By Dr. T. Christopher Windham, MD, FACS, Chief of Oncology, Cone Health Cancer Care and Don Michaels, Ph. D, Hayes Management Consulting

The move from fee-for-service to value-based care in the healthcare industry has been gaining momentum and its ultimate adoption is now a foregone conclusion. The question is no longer if the switch will be made, but when it will finally be a reality. The implementation of MACRA is a huge step down the value-based road and organizations are scrambling to meet the requirements of the new law.

Hospitals and physician practices are making major strategic and tactical changes to ensure they can survive in the new environment and increasingly that means determining physician compensation by means other than strict productivity. Healthcare IT vendors are trying to adapt their systems to meet the data collection and reporting needs of the new compensation plans. For both vendors and organizations, meeting these needs remains a challenge.

Read More

Topics: physician compensation, value-based care

From Boardrooms to Exam Rooms: 4 Strategies to Enhance Frontline Engagement in Continuous Improvement

Posted by Henry Bernstein on April 19, 2017 at 9:00 AM

By Henry (Hank) Bernstein, DO, MHCM, FAAP, Professor of Pediatrics, Hofstra Northwell School of Medicine and Shannon Cleary, BA, Research Assistant, Cohen Children’s Medical Center of NY

It is well known that a key objective in the evolving healthcare landscape is improving outcomes. To meet that goal, many organizations are embracing the tenets of the Institute for Healthcare Improvement (IHI) Triple Aim – improving the health of populations, enhancing the patient experience, and reducing the cost of care.

Achieving success in these tenets requires implementing practice improvement. Traditionally, individual members of clinical teams haven’t been eager to participate in practice improvement programs, largely due to heavy clinical and administrative workloads. However, to accomplish meaningful, productive change, providers on the frontline must be involved in the development and implementation of any practice improvement initiative.

Read More

Topics: physician training, improve patient satisfaction, Hayes Thought Leadership Blog Series

5 Reasons You Should Use an Independent Healthcare Expert for Clinical Optimization

Posted by Rena Hrivnak on April 12, 2017 at 9:00 AM

EHR technology has reached near universal adoption as organizations continue to invest in their IT environment. The clinical and business side of most healthcare organizations have adapted to the use of EHR’s and as resistance has melted away, there is a clamor to get even more utility from their systems. The general upheaval in the industry has also continued to shrink revenue and squeeze margins, leading organizations to launch cost savings initiatives across the board. Many look to their clinical systems to help them improve productivity, efficiency, and patient satisfaction to help drive revenue increases and trim costs.

Attaining those goals often leads to a clinical optimization program. Though worthwhile, these initiatives can often fall by the wayside or fail to get enough mind share because existing staff is tied up with day-to-day tasks that consume their time. Some organizations look to their EHR vendor to help but this can lead to a narrow, single solution view of potential improvements.

Often the best solution is bringing in an independent expert consultant who can help drive the optimization program and achieve tangible results. Here are five reasons you should consider an independent healthcare expert to help with your clinical optimization program.

Read More

Topics: IT staff management, clinical optimization

Looking to Optimize Your Epic Revenue Cycle? Concentrate on These 4 Things

Posted by Karen Lilly Castle on April 5, 2017 at 9:00 AM

The healthcare industry continues to be in flux. The defeat of the Republican’s plan to repeal and replace the Affordable Care Act ensures that the status quo will continue. However, that status quo means a continuation of revenue reduction and pressure on margins. Meanwhile, the implementation of MACRA, the march to value-based care and a shift to alternative payment methods goes on.

All these factors ensure that revenue cycle optimization is more important than ever and organizations will continue to focus on plugging leaks, streamlining processes and implementing automations. Some of the biggest challenges include billing and collections errors, lack of claims process monitoring and insufficient staff training.

Epic’s end-to-end solution continues to attract new clients and is one of the fastest growing EHR applications in the industry. The comprehensive nature of the Epic solution makes it an attractive option, but the breadth of the platform makes it more critical that you ensure it is integrated properly in your organization. There are dozens of modules in the Epic offering, and they can sometimes be isolated in separate siloes. Without an effective integration plan, you may not see the results you need.

Focusing on these four key areas will help ensure you get the full benefits of your Epic solution.

Read More

Topics: revenue cycle management, epic

4 Opportunities Analytics Can Provide

Posted by Robert Freedman on March 29, 2017 at 9:00 AM

The risks of non-compliance in the healthcare industry have never been greater. In fy2016, the HHS Fraud and Abuse Control Program returned $3.3 billion to the Federal government and private parties. The Department of Justice (DOJ) opened 975 new criminal health care fraud investigations.[1]

In fy2015, Medicare Recovery Audit Contractors (RAC’s) identified and corrected 619,000 claims resulting in $441 million in improper payments - $360 million in recovered overpayments and $81 million in underpayments repaid to providers.[2]

With both top and bottom lines continuing to shrink, you can’t afford to be hit with a massive overpayment penalty or to undercharge for patient activity by hundreds of thousands of dollars.

The key to managing both risk and opportunity is getting into your billing and collections data, and for that you need a robust analytics solution. Here are four opportunities you can take advantage of with a comprehensive analytics program.

Read More

Topics: mdaudit, Healthcare Analytics, Risk-based audits

7 Tips to Cultivate Your Trainer, Part 2 of 2

Posted by Angela Hunsberger on March 22, 2017 at 9:00 AM

This is the second installment of a two-part blog mini-series where I share the tricks of the trade with detailed tips surrounding 7 essential “train the trainer” categories.  Missed the first half? No worries, you can check it out here: 7 Tips to Cultivate Your Trainer, Part 1 of 2.

Read More

Topics: training, clinical optimization

Want more from Hayes?

5 Cool Things in Healthcare

Sign up for our weekly 5 Cool Things in Healthcare newsletter.  Every Friday we give you five stories of innovation, disruption, and - you guessed it - coolness. 

Here's how:

Subscribe to Email Updates

Posts by Topic

see all