How can health systems pinpoint key areas for expansion? 4 experts share insights

With larger players like Amazon and JP Morgan disrupting the healthcare continuum, health systems are looking for ways to balance growth and access to care with financial stability and viability. It's not just expansion but also, it's having the tools in place to understand when expansion is most valuable.

The discussion of financial stability mixed with expansion plans was at the forefront of a discussion during an April 12 panel at the Becker's Hospital Review 9th Annual Meeting, which took place from April 11 to April 14 in Chicago. Panelist involved in the discussion included Pamela Hess, CFO of Jacksonville, Fla.-based St. Vincent HealthCare; Ellen Feinstein, vice president of cancer services at The University of Chicago Medicine; Mickey Lemon, vice president of business development at VisitPay; and Tarese Dubiel, senior financial analyst at Marshfield (Wis.) Clinic Health System.

Here are four thoughts panelist discussed on the issues of finance and expansion.

1. "Everyone is looking for something and there is a limited pool of dollars. This makes return on investment important," said Ms. Hess. "Our hospital is more than 100 years old and many of the appliances have not been updated. So, while these updates may not provide a return on investment, you need to make the investments to upgrade. Then on the investments that do provide a return, you need to have more of to offset the costs."

2. "Since [Marshfield Clinic Health System] is a nonprofit, we don't always look at the return on investment," said Ms. Dubiel. "We look at the needs of our patients first. For example, we have 15 locations across the state and if we believe there is a need or a service for patients, we will test the waters at a certain clinic. This helps us, as the outreach partners can determine if the programs fill up or services are utilized."

3. "There are a lot pieces that go into decision making," said Ms. Feinstein. "But in a very simple way, [The University of Chicago Medicine] looks at all our products and services ... and looks at metrics and volumes. Oftentimes to reflect, we look at the opportunities that present themselves. Some of these are reactions and even defensive moves of things that arise. Also, there are times for a direct need for a community benefit."

4. "[VisitPay] takes a digital and analog approach in decision making," said Mr. Lemon. "Last year we did a cohort study and listened, taking a human-centered design approach to problem solving. We asked ourselves 'what is it consumers are asking for?' and juxtaposed that to what the provider needs. From there, we made the results our drivers in investment decisions."

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