Mercy is one of a growing number of hospitals that have turned to healthcare consulting firms for help to streamline and improve their clinical operations. Increased financial pressures associated with declining inpatient volume, rate pressure from insurers, and Medicare performance-based rewards and penalties have forced many health systems to search for ways to improve quality and reduce costs.
Meanwhile, other systems, such as Cook County Health and Hospitals System in Chicago, have chosen to address patient-flow issues on their own.
“We're starting to see hospitals embrace the use of data and efficient processes much the same way other industries have done for years,” said Brian Sanderson, managing principal for the healthcare service group at Crowe Horwath, one of the nation's largest healthcare consultants.
Dr. John Flynn, co-director of the Osler Center for Clinical Excellence at Johns Hopkins University in Baltimore, said hospitals have hired consultants to improve the efficiency of their clinical services, including emergency and surgery departments and specialty clinics. “There's a tremendous push for delivering services, delivering them more efficiently and driving waste out of the process,” he said.
Costs for such services can range from tens of thousands of dollars for interventions that last a few weeks, to several hundred thousand or millions of dollars for more in-depth processes that can take as long as a couple of years. Tom Brunelle, a regional vice president for Care Logistics, said his firm's consultants may continue to work with a hospital for several years after the initial process changes are implemented. The cost of these consulting services may be a deterrent for some health systems, Flynn said.
The total number of healthcare consulting firms has increased at a rate of about 1.2% annually over the past five years for a current total of more than 40,000 firms with about 80,000 employees, according to a March report conducted by market research firm IBISWorld. It is unclear how many of those 40,000 healthcare consulting firms engage in process and patient flow consulting.
Independent specialty consulting firms are being acquired by larger, general consulting companies to gain entry into a market with profits expected to grow at an average rate of 4.3% in 2015. Total revenue is projected to grow by 5% a year to more than $14 billion by 2020, according to IBISWorld.
Despite the trend toward consolidation, the consulting industry remains fragmented. In 2015, the three largest firms accounted for a quarter of total market share, with more than 90% of companies composed of fewer than 10 workers.
In addition to Crowe Horwath, other big players in healthcare consulting include Deloitte Consulting, which holds the largest share of the market at 10.5%, and IMS Health, which is second with an 8.5% share.
Not surprisingly, hospitals and health systems are key clients for those consultants, accounting for more than 38% of their business, with pharmaceutical companies second at 19%. One of healthcare consultants' major services is “strategic management,” which makes up more than 36% of their business.