Use Data to Combat Declining Reimbursements

August 8, 2014 Streamline Health

There are many factors that hospital CFOs must deal with, including the financial impact of such regulatory initiatives as Meaningful Use and ICD-10. But another common challenge that can make or break an organization is significantly declining reimbursements. CFOs that are unable identify root causes and head off declines at the pass may soon be searching for another job.

In a recent article for Healthcare Finance News, Rick Shrader, Streamline’s VP of Sales and a former hospital CFO, takes an in-depth look at hospital reimbursement declines. Shrader addresses several of the challenges hospitals face when it comes to keeping reimbursements high and highlights the importance of data and analytics to stay one step ahead and ensure a strong bottom line.

There are several factors that are currently playing a role in reimbursement declines for hospitals. Fee schedule reductions for Medicare and Medicaid as well as lower rates for commercial plans are key causes, in addition to initiatives found in the Affordable Care Act (ACA) such as readmission penalties.

Financial leaders able to remain out in front of any potential decline are most poised to lead their organizations to success. Learning of claims denials and reimbursement declines after the fact is a recipe for disaster, and advanced analytics that allow CFOs to remain proactive are essential. Hospitals need not only have access to the “right” data, but that information must be clean, accurate and up to date to allow leaders to glean actionable insights in real time.

The ability to make use of financial, operational and clinical data to gain a better understanding of where a hospital is succeeding and where improvements may be required is an important first step. As Shrader explains, predictive analysis of this information to understand the root causes of current challenges and how the organization will continue to be affected is equally crucial.

For more information, we invite you to read Rick Shrader’s full article, published by Healthcare Finance News.

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