Post on 20-Aug-2020
November 21, 2017 1© 2017 DXC Technology Company. All rights reserved.
Technology and Ensuring You Are Investing in The Right Thing…
Mary Mirabelli, FHFMA, 2016-2017 National Chair
Vice President- Strategic Healthcare Advisory Services
DXC Technology
November 21, 2017 2© 2017 DXC Technology Company. All rights reserved.
For Today…
• Setting the Stage- US Affordable Care Act and Meaningful Use
• United States HFMA Focus
• Innovation That Matters- Meeting Triple Aim
• Return on Information
• Using A Business Value Framework
• Disruption in the Market and Value Gained
• Business Case Lessons Learned
• Summary and Close
November 21, 2017 3© 2017 DXC Technology Company. All rights reserved.
November 21, 2017 4© 2017 DXC Technology Company. All rights reserved.
Innovations That Matter- Meeting the Triple Aim
November 21, 2017 5© 2017 DXC Technology Company. All rights reserved.
HFMA in the United States
OUR MISSION
Lead the financial management of health care
OUR VISION
HFMA will bring value to the industry
as the leading organization for healthcare finance
HFMA believes we must lead
healthcare stakeholders to meet the
challenges of today while creating a
sustainable healthcare industry.
November 21, 2017 6© 2017 DXC Technology Company. All rights reserved.
How Technology Investments Can Look to a CFO…
November 21, 2017 7© 2017 DXC Technology Company. All rights reserved.
So where do we as finance professionals fit in this innovative“digitally transformed” world?
November 21, 2017 8© 2017 DXC Technology Company. All rights reserved.
And Yet, We Need to Build on Finance Professionals’ Change Leadership Strengths and Skills as We Assess Innovation Investments
“CFOs are often better
leaders than they think
they are. They are good
at setting goals,
measuring results, and
looking at variances.”
-Quint Studer, CEO
& Founder, Studer Group
“The CFO is really in a role
to help the various
stakeholders understand
how the pieces fit together.” -Noblis Health Innovation
Senior Principal, Paul Breslin
“When asked what role finance
officers can play in transforming our
healthcare system, David Walker
said to remember what the ‘P’ in CPA
stands for.” -HFMA Board member Edward Giniat,
quoting the former U.S. Controller General
& CEO of the Peter G. Peterson Foundation
© 2017 DXC Technology Company. All rights reserved.
November 21, 2017
Return on InformationThe Newly Defined ROI
November 21, 2017 10© 2017 DXC Technology Company. All rights reserved.
https://nam.edu/perspectives-2014-return-on-information-a-standard-model-for-assessing-
institutional-return-on-electronic-health-records/
November 21, 2017 11© 2017 DXC Technology Company. All rights reserved.
Key Components on Return on Information Discussion Paper
Benefits
• Reduction in Operating Costs
• Reduction in Capital Expense
Costs
• One time costs
• Ongoing costs
Overall Value
Benefits
Expenses
Revenue Impacts
© 2017 DXC Technology Company. All rights reserved.
November 21, 2017
A Business Value Framework To Assess Impact of Technology Solutions
November 21, 2017 13© 2017 DXC Technology Company. All rights reserved.
Use a One Page Business Value Framework (BVF) to Connect the Dots
Executive KPIs
Financial and Operational KPIs
Industry Strategies and Initiatives
Business and Clinical Processes and Functions
Operating KPIs
November 21, 2017 14© 2017 DXC Technology Company. All rights reserved.
September 8, 2017DXC Proprietary and Confidential
Sample Business Value Framework for the Healthcare
Provider
Industry
Strategies
Industry
Initiatives
Going ‘Digital’ Improve Clinical & Operational Efficiency
Adapting to outcomes-focused financial models
Move towards consolidated healthcare delivery model
Preventing cyber attacks on networked devices
• Customer engagement• Patient apps & portals• Data infrastructure & Analytics
• Internet of Things (IoT) & real-time health system (RTHS)
• Intelligent EHR systems
• Digital Provider Solutions
• Revenue Cycle Management• Quality & Performance Measures• New diagnostic technologies• Clinical & Operational Analytics
• Outcome-focused & data-driven governance structure
• Wellness programs
• Establish evidence-based clinical pathways
• Redefine quality & performance measurement systems
• Outcome-focused & data-driven
governance structure
• Integrated health & social caresystems
• Measure Outcomes• Develop a partner ecosystem
• Implement ecosystem-wide system integration
• Achieve higher bargaining power/ economies of scale
• Data security & privacy• Regulatory compliance
• Network & Infrastructure security
Executive
KPIs
Financial/
Operational
KPIs
Patient Access Outcomes & Cost of Care Patient Engagement Population Health
Quality of Care
Regulatory
Compliance
Capacity &
UtilizationRevenue Cycle
ManagementPatient Mix
Reimbursement
Modalities
Capital
Management
Productivity &
EfficiencyOutcomes/Cost
Consolidation
Clinical Operations and logistics Payments and finance HR IT Business development and customer service
Population Health
• Clinical errors & adverse
events
• In-patient mortality rates
• Re-admission rates
• Length of stay
• Frequency/Type of
communication between
provider/patient
• Patient follow-up
• Hospital acquired Infections
• Referrals
• Patient Wait times• Bed Turnover rate• Occupancy rate• Asset utilization rates• Capacity gaps
• In-patient vs out-patient
• Cost per discharge
• Revenue days due to coding
• Payment denial rates• Claims processing time• Total Operating Margin
• DSO / Days of Payables outstanding
• Cash on hand
• Revenue per patient/physician
• Staff-to-patient ratio• Staffing costs
• Trainingsper department
• Staff turnover rates
• Staff productivity metrics
• # of IT employees
• TCO / realized ROI on IT projects
• # process of digitized
• IT budget as a percentage of total revenue
• # of standalone systems• System downtime• # of IT security events• Cost per security event
• Capex vs. Opex
• Market Share• Payer Mix• Service-line mix• # of media mentions• Public health initiatives
• Patient awareness programs
• Patient Satisfaction• # of Complaints
• Patient confidentiality
• Healthcare spending per capita
• Premature mortality rates
• Quality of life for patients with LTCs
• Deaths attributable to healthcare system
• Mortality due to lifestyle
& other risk factors
Business
Processes
&
Functions
Operating
KPIs
© 2017 DXC Technology Company. All rights reserved.
November 21, 2017
Disruption and ROI
November 21, 2017 16© 2017 DXC Technology Company. All rights reserved.
Today’s digital disruption in healthcare is happening at the edges, but it will accelerate and change tomorrow’s clinical business operations.
Healthy
living
& preventDiagnose Treat and
intervene
Recover
and
rehab
Home care
monitor
& manage
Research and development
Aging in place Sharable and
interoperable
Digitization 3-D printing Population
health
Data is owned by
the consumer
Analysis of
data
Metabolic
analysis
November 21, 2017 18© 2017 DXC Technology Company. All rights reserved.
Level / complexity of care
Co
st
Self
service
(there is an
app for
that)
Assisted/
monitored
(Tele-…)
Coached
(Help me get
well - Physical
or virtually)
Expert /
specialists
(Fix me –
acute, dental,
…)
Consumers are pushing “Self Service” capabilities enabled by digital technology for patients,clinicians and support functions.
Preventive wellbeing
• Apps supporting the
whole care continuum
• Digital Healthcare
transactions anytime,
anywhere
• Consumers will drive
the use of technology
for simple diagnostics
and self-monitoring
• Less in person, more
virtual interactions
• “Acute” care will change
November 21, 2017 19© 2017 DXC Technology Company. All rights reserved.
Given this Framework- Let’s Look at a Few Examples Healthcare “Disruptors”…Where do they fit in the BVF?
November 21, 2017 20© 2017 DXC Technology Company. All rights reserved.
Know also that there are tools to let you know what actually works and is mature enough to generate benefit.
Telemedicine Hype Cycle- Gartner 2015
November 21, 2017 21© 2017 DXC Technology Company. All rights reserved.
Evaluating How to Assure a Solid Return on Digital Investments
21
November 21, 2017 22© 2017 DXC Technology Company. All rights reserved.
Assure a business case that includes a solid rationale, clear clinical, financial and operational measures and outcomes, and all costs- and links to the business value framework.
•Clinical Outcomes
•Population Outcomes
•Patient Engagement
•Patient Satisfaction
•Revenue Stream
•Investment Required
•Cost Avoidance and Cost Savings
•Added Value
•Shared Savings
22
November 21, 2017 23© 2017 DXC Technology Company. All rights reserved.
A Few Business Case Lessons Learned from Technology Implementation
• Be specific on costs- incremental new vs. current resources
• Estimate the contingency and build a process for overage
• Tie benefits to the chart of accounts and general ledger
• Measure regularly to assure costs don’t creep back in
• Be transparent on the way in which opportunity costs will be handled
• Require a feedback loop post implementation on benefit
• Unexpected benefits- order sets, blood product usage, antiobioticstewardship
November 21, 2017 24© 2017 DXC Technology Company. All rights reserved.
This is really where we as finance professionals shine- it’s our role.althcare Industry
24
I Think this is
PEE-PEE!
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Thank you.