Lack of actionable data to inform restart planning – Without clear, transparent, interconnected data, hospitals will find it difficult to identify actual surgical needs and available capacity quickly and accurately. Forecasting, clinical and operational data can help guide the tactics necessary to optimize capacity.
- Hospitals must prioritize case backlog, improve patient readiness and throughput, and maximize surgery and procedure utilization.
- Robust spend analysis can drive effective supply conservation and optimization.
Care coordination challenges – Inconsistencies with scheduling, equipment availability, patient preparedness and other departments hinder rapid, efficient use of perioperative resources. Health systems need data-enabled agility to redesign care delivery.
- Optimize high-margin growth to focus on areas that drive revenue and align with market needs for managing community wellness – including surgery, ambulatory, virtual health and others.
- Build flexible capacity to scale up and down to adapt to different surges quickly, efficiently and cost-effectively.
Payer mix – Soaring unemployment claims are associated with widespread loss of health insurance coverage. Stabilizing from the ripple effect as the job market and debt begin to stabilize and unwind will take time.
- A payer mix analysis can help prioritize elective cases and determine the financial viability of specific procedures.
- Hospitals that manage payer relationships and develop a sound payer strategy are taking a big step toward recapturing lost revenue.
- Optimizing documentation and coding can maximize compliant reimbursement from all inpatient discharges and ED visits (including COVID-19 cases) and physician fees.
Shifting landscape and resource impact – The ongoing pandemic environment has changed the US health care landscape, with consumers, providers, payers, suppliers, the government and others all shifting their expectations. Financial and organizational uncertainty may create extreme stress on physicians, nurses and staff and will pressure-test your core culture.
- Take a strategic approach to assessing physician alignment to evaluate landscape, identify risks and deploy strategy.
- Efficient scheduling and use of staff and labor resources means freeing up time, resources and bandwidth to minimize disruptions and maximize surgeon efficiency.
- Identify adaptive workforce strategies to build resiliency.
Taking these and other immediate and subsequent actions will enable organizations to reignite the revenue engine by salvaging as much elective surgery as possible in 2020 and beyond. Engaging a centralized planning team that includes strong data and expertise will empower your organization to model demand and capacity, anticipate and address operational hurdles, and accelerate the rollout of a successful plan.