Why Actionable Insights and Reporting Frameworks are Urgently Needed: Part I

Quick Summary

The healthcare industry is facing various challenges such as rising costs, shifting regulatory requirements, and growing patient expectations. To address these challenges, healthcare executives and administrators require timely, accurate, and relevant data to make data-driven decisions.

Uppercentile, a reporting framework and smart baselining solution, provides healthcare executives with better data collection, analysis, and action. The importance of big-picture thinking is highlighted, particularly as healthcare executives face challenges such as workforce shortages, increasing expenses, inflation, capacity constraints, and unpredictable spikes in demand. Urgent action is required, including the development of a sense of urgency, creating a vision for the future, conducting a comprehensive assessment, and prioritizing actions. One case study is the University of Mississippi Medical Center, which faced financial challenges due to the pandemic but generated savings of over $30 million and increased revenue by $50 million by implementing a financial turnaround plan.

Overview

As the healthcare landscape continues to evolve and become increasingly complex, healthcare organizations are facing a host of challenges, including rising costs, shifting regulatory requirements, and growing patient expectations. To stay competitive and improve outcomes, healthcare executives and administrators need access to timely, accurate, and relevant data that can inform their decision-making.

While traditional market research solutions have been relied upon by many healthcare organizations, they often provide siloed data that makes it difficult for healthcare workers to identify which insights belong to which functional department.

Furthermore, these solutions often fall short in providing actionable insights that drive meaningful change.

Enter Uppercentile, a reporting framework and smart baselining solution that provides healthcare executives with a better way to collect, analyze, and act on data. Uppercentile's intuitive design is tailored to healthcare priorities and written by people who understand every third-party service that touches care delivery. Its linked reporting allows for better sequenced actions, taking the guesswork out of what to do next. With Uppercentile, healthcare leaders can make data-driven decisions with confidence and clarity.

However, with emerging trends such as value-based care and the shift towards patient-centered models, combined with the recent CMS Interoperability and Patient Access Rule, it is more important than ever for healthcare systems to have robust reporting frameworks and actionable insights in order to comply. This rule, which went into effect in May 2021, requires healthcare organizations to share patient data in a standardized way and is part of a broader effort to improve care coordination, reduce costs, and improve outcomes.

In this blog post, we will explore these trends and regulatory requirements in more detail, as well as the key benefits of implementing a reporting framework like Uppercentile. We will also highlight case studies and best practices from healthcare organizations that have successfully leveraged actionable insights to achieve better outcomes and improve their bottom line. By the end of this paper, readers will have a better understanding of why actionable insights and reporting frameworks are crucial for success in a rapidly changing healthcare landscape.

The Urgency of the Big Picture

The COVID-19 pandemic has shaken the healthcare industry to its core, and hospitals have been particularly impacted. In addition to the pandemic, changes in US demographics have further compounded the challenges facing hospital leaders in 2023. As a result, executives are confronted with a myriad of challenges including workforce shortages, increasing expenses, inflation, capacity constraints, and unpredictable spikes in demand. While financial challenges are forcing hospitals to focus on addressing their immediate issues, executives must urgently act and plan for the future to ensure the sustainability of their organizations.

Why It Matters

In healthcare, hospital leaders must have a holistic view of the healthcare system and how their organization fits into it. The big picture provides a macro-level understanding of the factors that are shaping the healthcare landscape, such as changes in the US demographics, technological advancements, and shifts in payer models. Hospital leaders must understand these factors to plan for their organization's future.

Focusing only on immediate challenges can cause executives to lose sight of the larger picture. While addressing immediate challenges is important, hospital leaders must also keep an eye on the long-term threats to their organizations. These may include issues such as workforce shortages, increasing expenses, inflation, capacity constraints, and unpredictable spikes in demand. If left unchecked, these issues can cause significant financial and operational strain on healthcare organizations.

Case Study: One example is the University of Mississippi Medical Center (UMMC), an academic medical center in Jackson, Mississippi. UMMC faced significant financial challenges due to the pandemic, including a decline in patient volume and an increase in the cost of supplies and equipment. To address these challenges, UMMC took a big-picture approach to its financial management. The health system implemented a financial turnaround plan, which included cost-cutting measures, revenue enhancements, and process improvements. These measures helped UMMC generate more than $30 million in savings and increase its revenue by $50 million.

Hospital leaders must take a proactive approach to addressing these challenges. They must be able to anticipate and prepare for the changes in the healthcare landscape that may impact their organization. By having a deep understanding of the macro-level trends, executives can make strategic decisions that will allow their organizations to thrive in the long term.

One way to ensure that hospital leaders are focusing on the big picture is to establish a strategic planning process that involves regular reviews of the organization's long-term goals and progress towards achieving them. This process should also include regular assessments of the external environment to identify potential threats and opportunities. By having a systematic approach to strategic planning, hospital leaders can ensure that they are keeping the big picture in mind and are taking actions to prepare for future challenges.

Urgent Action is Required

Hospital executives must take urgent action to address the challenges they face. The longer they delay, the more difficult it will be to implement the changes needed to sustain their organizations. Inaction will lead to a further deterioration of financial performance, which will exacerbate existing challenges.

Some best practices when circumstances force a care provider to take action:

1. Develop a sense of urgency: Hospital executives must recognize the urgency of the situation and communicate the need for action to all stakeholders. This will help to mobilize the organization and motivate staff to work towards a common goal.
2. Create a vision for the future: Hospital executives should create a clear and compelling vision for the future of the organization. This will help to align staff with the strategic direction of the organization and provide a roadmap for future decision making.
3. Conduct a comprehensive assessment: Hospital executives should conduct a comprehensive assessment of the organization to identify the root causes of the challenges faced. This will help to identify areas for improvement and prioritize actions that will have the most impact.
4. Prioritize actions: Once the assessment is complete, hospital executives should prioritize actions based on their impact and feasibility. This will help to ensure that the organization focuses on the most critical actions that will have the greatest impact on the bottom line.
5. Develop a roadmap: Hospital executives should develop a clear roadmap for implementing the identified actions. This roadmap should include timelines, responsible parties, and key milestones to help ensure accountability and track progress.
6. Engage all stakeholders: Hospital executives should engage all stakeholders, including staff, patients, and the community, in the implementation of the roadmap. This will help to build support for the changes and ensure that everyone is aligned with the vision for the future.
7. Monitor and adjust: Hospital executives should monitor progress against the roadmap and adjust actions as needed. This will help to ensure that the organization stays on track and is able to adapt to changing circumstances.

By following these best practices and recommendations, hospital executives can take urgent action to address the challenges they face, sustain their organizations, and improve financial performance.

Quick Wins and Big Picture Priorities

While hospital executives must take a long-term view of the challenges facing their organizations, they can also achieve quick financial gains by focusing on fundamental cost management issues that preceded the pandemic. One area where hospitals can achieve quick wins is by cracking down on premium pay utilization. By limiting the use of premium pay, hospitals can reduce expenses and increase their bottom line.

Another area where hospital executives can take action is by strengthening decision control processes for resource requests. By tightening the screws on request reviews and limiting approvals to "mission-critical" resources, executives can ensure that resources are allocated efficiently and effectively.

A breakaway consideration: Uppercentile's Pathways offering is designed to provide hospital executives with a comprehensive approach to addressing the challenges they face. As part of this approach, Uppercentile may recommend staffing companies that provide alternatives for lower-cost nonclinical and clinical staff, as an alternative to high-cost traveling nurse temps.

By implementing these types of cost-saving measures, hospital executives can achieve quick wins and reduce expenses, which can help improve their bottom line in the short term. Additionally, by working with Uppercentile, hospital executives can develop a long-term strategy that addresses the challenges their organizations face in a holistic and comprehensive way.

Uppercentile's market research and Pathways offering may take time to put into practice, but the benefits of taking a long-term approach can be significant. By having a clear understanding of the challenges facing their organizations and a plan for addressing them, hospital executives can position their organizations for success in the years to come.

Finally, executives must start preparing for the redetermination of Medicaid enrollee eligibility. This process could eventually affect up to 18 million people, which would impact hospital revenues. By starting to prepare for this process now, executives can ensure that their organizations are in the best position to weather the changes that are coming.

Conclusion

Hospital leaders face numerous challenges in 2023, and the COVID-19 pandemic has further exacerbated these challenges. While financial challenges are forcing hospitals to focus on addressing their immediate issues, executives must also focus on the long-term threats to their organizations. By taking urgent action, hospital executives can achieve quick financial gains while also positioning their organizations for long-term success. The big picture provides a framework for hospital leaders to understand the challenges they face and the actions they must take to overcome them. Ultimately, hospital executives must act now to ensure the sustainability of their organizations in the face of all the hurdles and challenges.