Health system execs add revenue with clinical innovation

Hospital and health system executives are looking for ways to add revenue as costs continue to increase and margins stay tight. Many see boosting clinical care services, outcomes and value-based care initiatives as the path to a stronger financial situation.

David Reich, president of The Mount Sinai Hospital and Mount Sinai Queens in New York said the system is focused this year on patient care innovations linked to revenue opportunities, including 340B program optimization and other pharmacy initiatives, cell-based therapies and novel antibody therapies for oncology care, and complex procedural services growth. Digital transformation enhancements coupled with a renewed focus on clinical services is making a difference.

"AI-powered clinical decision support improves revenues through better outcomes and coding opportunities," Mr. Reich said. "Expansion of our hospital-at-home program is expected to create opportunities for a higher case mix index of those patients remaining in hospital beds."

Charlotte, N.C.-based Advocate Health is also focused on digital enhancements for clinical care as a mechanism to increase revenue in the next few years, according to Katie Barr, RN, MSN, system vice president and chief nursing informatics officer. She told Becker's the system is building on the momentum of telehealth adoption over the last few years to focus on digital first care options for routine and chronic care management.

"Tech-enabled patient care certainly has the potential to not only improve patient care and boost efficiency, but also increase revenue and boost patient satisfaction," she said. "We are also evaluating care models across the continuum to determine where automation and technology can boost efficiency, and in turn maximize staffing and contribute to a quality of care. Automation is also being considered as a way to optimize revenue cycle processes and efficiency, thus increasing revenue."

Alternative revenue streams for health systems include adding urgent care facilities, pharmacy services, virtual care, hospital at home, and value-based care capabilities. Healthcare is moving more outpatient, and focused on convenience for patients and their families. While virtual and outpatient services may have a lower reimbursement rate than inpatient acute care, there is a great opportunity to expand access to care and better serve patients overall.

Randolph Siwabessy, CFO of UCI Health in Orange, Calif., told Becker's earlier this year the system is focused on improving operational efficiency by leveraging technology and adopting a "healthcare-of-the-future" framework, and partnering with payers to further innovative pay models.

"Population health management and value-based care, coupled with our efforts to advance care at home, are foundational to our health system's sustainability in the realms of quality and financial performance," said Mr. Siwabessy. "By focusing on these pillars, we expect to serve more patients in our community through expanding our care model. These efforts will allow us to diversify our top-line growth and ensure that we have the capacity to invest in our tripartite mission of discovery, teaching and healing."

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