The New NCQA Standard that Health Plans Can’t Afford to Ignore
As a health plan, you are likely familiar with the National Committee for Quality Assurance (NCQA). A government agency whose mission is to “work for...
For a hospital CFO, the COVID-19 pandemic shifted priorities and emphasized cost containment and innovation in reimbursement models. It has forced leaders to take a hard look at their revenue management processes. In fact, per a recent FinThrive-sponsored survey, more than 25% of health system CFOs expect to invest in an end-to-end revenue management platform to improve their revenue cycle efficiencies.
To learn how CFOs are responding to current financial pressures, we hosted an executive listening session focused on uncovering tactical steps leaders are taking to accelerate financial recovery.
Here’s what we heard:
- Growing, developing and educating staff is imperative despite intense cost containment and reduction efforts. Without a strong network of providers, long-term viability may be sacrificed.
- Maintaining a rock-solid balance sheet is key to moving forward. Immediate efforts should be focused on cost reductions and moving high-utilization and high-cost populations into risk-based payment models.
- Value-based care is necessary for cost containment. Without innovation in this model, health systems become over reliant on fee-for-service reimbursement from the volatile shifts in patient volume due to COVID-19.
- Adapting to changes in technology and the rise of telehealth services will carry forward in the long term. Patients enjoy the convenience, safety and continuity of care offered by digital healthcare. Healthcare leaders need to stay on top of payments for these services—and the impact it can have on reimbursements.
- Watching for delayed merger and acquisition activity and assessing its potential impact on overall yield should continue. You’re likely to see physician groups merging with hospitals or other large physician groups, as well as vertical integration of insurers and physicians.
- Providing accurate payment estimation and price transparency tools, which enable patients to understand and finance their bills, are critical. Overall yield can be improved via self-service care transactions that provide patients a more convenient way to pay.
- Understanding “pandemic learnings,” as we transition into more normalcy, will be essential. This may include curbside pharmacy pickup, work-from-home opportunities, updated appointment scheduling and drive-through testing areas.
- Identifying opportunities to consolidate vendors can reduce costs. Vendor management is a time consuming and labor-intensive process for procurement teams. During the height of the pandemic, many health systems introduced new solutions that may have created fractured workflows and data silos. Innovative financial leaders are now working to consolidate vendors to reduce subscription fees and improve operations.
Learn more about end-to-end revenue management at FinThrive—where finance can flow freely, without complication.
