Whitepapers & E-Books

Healthcare's cost crisis is putting the squeeze on patients and providers alike. In recent years, as the cost of care delivery has risen, reimbursements for health systems have declined and patients' out-of-pocket obligations have increased.

The COVID-19 crisis has exacerbated these challenges. Hospital financial leaders will have to find new ways to help their organizations weather this storm, and the patient financial experience will remain among their primary concerns.

This ebook provides an overview of some of healthcare's most enduring challenges and offers insights for healthcare leaders working to transform the patient financial experience.

When it comes to determining emergency department (ED) facility visit levels, providers and payers have different perspectives on ED care and supporting resources. This difference in perspective creates friction. As a result, payers push back on ED facility visit levels and issue downgrades, denials and delays in payment.

In order to counter payer pushback on ED facility visit levels, hospitals must follow precise protocols for maintaining claims accuracy and consistency. In this paper, we present three key elements that hospitals can use to support defensible ED visit-level determinations and a three-step process for diagnosing areas for improvement.

When it comes to managing risk for today’s healthcare organizations, billing compliance and revenue cycle professionals face a common set of challenges: missed charges, over- or under-reported units, duplicate claims, over- or under-coding, and other issues. Combining forces to address these challenges not only ensures better outcomes, it also reduces the cost of auditing and risk management.

This white paper explains how combining the efforts of both groups under a “revenue integrity” umbrella enables organizations to align resources to pursue common goals such as a more robust revenue stream, decreased compliance risk, and enhanced bottom line performance.

What you’ll learn:

• Today’s landscape: how healthcare organizations are coping with ongoing changes to regulatory and reimbursement requires, and the associated risks
• Billing Compliance and Revenue Cycle oversight: two sides of the risk equation
• How to leverage analytics to manage compliance risk and optimize revenue
• How aligning your billing compliance and revenue cycle resources can strengthen overall revenue integrity

The COVID-19 pandemic is affecting the nation's healthcare system on multiple fronts. In addition to delivering care to those in need among intensifying demand, hospital executives must also focus on their organizations long-term fiscal health as the pandemic has pushed the overall health of the economy into precarity.

It's estimated that indirect spend can account for 15 to 27 percent of total operating expenses. Meanwhile, U.S. hospitals overspend an average of $39 billion annually on clinical and nonclinical purchased services.

Purchased services, while commonplace in supply chain sourcing strategies, remain a final frontier for exploring spend optimization. With the possibility of quick time to savings and long-term strategic potential, we've identified six common themes among organizations with successful purchased services programs in place.

Many leaders of America's health systems are walking a fiscal tightrope with their organization's long-term viability balanced on their shoulders. Margins are thin and the stakes are high. Enter value-based care.

While many experts argue healthcare's traditional fee-for-service payment models have contributed to the nation's ballooning healthcare cost crisis, transitioning to value-based models brings its own challenges — challenges that can only be met with innovation. However, with limited resources, hospital leaders have to be savvy investors when it comes to innovation. Each piece of technology or new process must be integrated with a tangible ROI in mind.

During an executive event sponsored by Philips at Becker's 8th Annual CEO & CFO Roundtable in Chicago, hospital leaders gathered and engaged in a discussion about current barriers to innovation and how providers might overcome them. This white paper is based on their conversation.

The COVID-19 pandemic has put the spotlight on telemedicine. With healthcare organizations moving to expedite the launch and expansion of telehealth and virtual services, quick fixes to process hiccups can be especially attractive. However, these quick solutions will not help organizations achieve long-term success. Hospital leaders have to act swiftly, but they should do so with foresight and care.

Download this guide for a complete list of the things you need to do to make telemedicine work.

Leading chief financial officers recognize there are limits to brick and mortar assets and virtual care offers opportunities to address challenges in ways that are cost effective and responsive to the quadruple aim.

This e-book provides an in depth look at how telehealth is an enabler of improved care delivery, offering the ability to address clinician burnout and enhance patient access and convenience, all at a lower cost.

Read the e-book to learn:
- The new economics and value equations of virtual care
- Virtual care’s role in improving care, access and physician burnout
- A data-drive approach to consumer adoption to maximize ROI

Data analytics are increasingly used by hospitals and health systems to bring healthcare's enormous datasets into focus. While the technology has broad applications in healthcare — from tracking patient outcomes to monitoring pharmacy performance — many hospitals and health systems have been slow to integrate data analytics solutions. Barriers include the input of flawed data, a lack of executive buy-in, growing concerns over patient data privacy and ownership, and ineffective solutions that fail to serve the end user.

This E-book contains 10 articles that describe not only the many potential advantages of data analytics in healthcare, but also best practices for selecting and deploying an analytics solution. As several health IT experts agreed in one article, "The potential of using analytics to improve efficiency and outcomes is limited only by physician creativity."

Technology innovations have long held the promise of solving some of healthcare's most intractable problems. However, in previous iterations, some technology advancements weren't entirely user friendly. Today, emerging health IT solutions put the human experience front and center to improve healthcare for both providers and patients.

From key priorities for healthcare CIOs to insights on digital integration, this ebook features must-read articles for healthcare leaders focused on innovation.

The value of virtual care has never been clearer. Hospitals across the country and globally have expanded the use of telehealth to address capacity issues system-wide.

Even before the COVID-19 outbreak, telehealth was gaining favor among health care providers. This e-book details the successes of two leading health systems' efforts to expand virtual care programs into non-acute service lines. At this moment, we don't know what healthcare's "new normal" will be once the pandemic subsides. But it is safe to say telehealth will continue to play an important role in the future of care delivery.

Reliable data can be hard to come by, but it’s imperative to driving healthcare forward — especially in these trying times. Being able to quickly determine quality data can lead to actionable insights and optimized recoveries.

Download our quick guide to better understand the importance of:

• Identifying accurate data sources
• Gathering information in a meaningful way
• Prioritizing internal and external collaboration efforts
• Using insights to enhance patient outcomes and influence profitability

Physician burnout can lead to medical errors and affect patient safety, provider attrition, health system economics and more.

But Suki, an AI-powered clinical digital assistant, can help physicians save time on documentation and other administrative tasks, which are major contributors to burnout.

Organizations that use Suki have:

• Increased revenue through higher encounter volumes
• Reduced claims denial rates due to high quality documentation
• An analysis quantifying physician satisfaction and impact on organizational economics as a result of using Suki is available in a short report.

Healthcare organizations collect massive amounts of clinical, financial and operational data. But they’re often challenged by the “last mile” – transforming that data into meaningful insights for front-line clinicians that strengthen their bottom line.

This whitepaper examines the challenge of connecting clinicians to insights that improve revenues. Several healthcare leaders share their perspectives on the tools and strategies needed to empower clinicians with insights that help improve clinical and operational performance:

• The importance of point-of-care analytics
• Improving data quality, transparency and accessibility
• Standardizing care for higher quality and revenues
• The benefits of tracking and sharing performance insights

The whitepaper features expert views from:

• Doug Mitchell, MD – Co-founder and CEO, Adfinitas Health
• Dennis Deruelle, MD – Executive Director of Hospital Medicine, American Physician Partners
• Steve Liu, MD – Founder and Chief Medical Officer, Ingenious Med
• Chris Hegge – Head of Product Development, Ingenious Med

Today’s EHR was not designed to handle collaborative patient care or to position hospitals and health systems for value-based care success.

EHRs do not capture enough information to tell the whole story of individual patients or populations, do not deliver the level of context needed to develop and extract necessary insights and do not easily share data with everyone who needs it.

Download Geneia’s whitepaper, "Hospital Success in Data-Driven, Value-Based Care" to learn:

• Steps hospitals can take to capture crucial social determinant of health data
• Key considerations for choosing a population health management solution that seamlessly integrates with the existing EHR

In the decade since the HITECH Act was passed, first-generation electronic health record systems provided a foundation for innovations such as electronic prescribing, clinical decision support and predictive analytics.

While usability and productivity issues with EHRs have been well documented, there are significant untapped opportunities to optimize the EHR and health IT to benefit everyone from provider to patient.

In this whitepaper, PatientKeeper outlines a vision for the future of health IT through the next decade, which includes:

• New data-driven approaches that leverage the clinical information being captured by the EHR to improve patient outcomes and reduce physician burnout
• Optimized communication between physicians, nurses and ancillary staff to produce better patient outcomes as efficiencies improve
• Better interoperability to improve care coordination and inspire opportunities for ideas like telemedicine to alleviate physician shortages

As Medicare Advantage plans improve their performance, enrollment rises. With increased enrollment comes a greater need for quality data to help health plan leaders understand their member population. Initiatives meant to maximize reimbursement, manage risk and implement quality improvements all rely on health plans having accurate patient data.

The problem is that the most critical, valuable data such as medical history and clinician notes are locked away in unstructured text and likely not being used.

Read this whitepaper to learn how innovative technology solutions can be leveraged by health plans to extract clinical meaning from unstructured data.

When surgical care is delivered in the ASC, both payers and patients win. Surgery patients tend to have better experiences when treated in an ASC, and the price tag on these procedures is generally lower than it would be if performed in a hospital. The bottom line: payers reimburse less for procedures in the ASC, and patients have higher satisfaction with the care experience.

However, as ASCs deliver care at a lower cost, it's important for these organizations to ensure bills are accurate and that claims go out clean and garner fair, timely reimbursement. Payer reimbursement for medical procedures is highly dependent on detailed clinical documentation. The list of possible Current Procedural Technology (CPT) variations can appear endless, even for a single type of operation.

During an executive roundtable at Becker's ASC Review 26th Annual Meeting: The Business and Operations of ASCs in Chicago in October, two Nuance CMIOs and the CEO of Greensboro (N.C.) Specialty Surgical Center, discussed how ASCs can enhance documentation workflow, increase the specificity of clinical documentation and optimize the billing cycle. This whitepaper is based on that conversation.

The drive towards greater penetration of machine learning in healthcare is being accompanied by increased calls for machine learning and AI based systems to be regulated and held accountable in healthcare. Explainable machine learning models can be instrumental in holding machine learning systems accountable. Healthcare offers unique challenges for machine learning (ML) where the demands for explainability, model fidelity and performance in general are much higher as compared to most other domains.

While healthcare ML has demonstrated significant value, one pivotal impediment relates to the black box nature, or opacity, of many machine learning algorithms. Explainable models help move away from the black box nature.

In this research paper, KenSci:

• Explores the impact of Explainable or Interpretable Machine Learning Models in Healthcare
• Review the notion of interpretability within the context of healthcare, the various nuances associated with it, challenges related to interpretability which are unique to healthcare and the future of interpretability in healthcare.
• Demonstrates how the user can understand the arrival of predictions by the ML models

While the coronavirus pandemic has presented an opportunity for health systems to more conveniently and affordably implement telehealth, the challenge is differentiating between interim point solutions and sustainable virtual care.

In this whitepaper from Force Therapeutics, you’ll learn how leaders and innovators are using technology to prepare for the reboot of elective surgery by:

• Increasing short-staff efficiency by digitizing preoperative workflows and patient optimization.
• Controlling leakage outside the system by seamlessly integrating services after surgery.
• Intelligently growing new programs and promoting them to the consumers of healthcare.

Exploding administrative costs, growing patient expectations, and increasing clinician burnout have pressured administrators to digitally transform the healthcare experience.

In response, leading healthcare organizations are rapidly investing in the automation of manual administrative processes like patient registration, clinical intake, provider documentation, and medical billing.

This whitepaper reviews 4 key strategies that healthcare administrators must consider to effectively implement intelligent automation in their organization.

Download the whitepaper to learn:

• Common pitfalls to avoid when automating administrative workflows
• The return-on-investment to aim for when automating intake, clinical documentation and other administrative processes
• Best practices for integrating automated digital experiences with the EHR

Critical care is distinguished in U.S. hospitals for a number of reasons, including the complexity of patients, evolution of technology and growing use among older adults. The costs and risks associated with caring for high-acuity patients make critical care settings vulnerable places within any hospital. These units are more susceptible to decisions about staffing, technology and models of care.

This e-book, 10 Must-Reads on Critical Care, contains 10 articles that examine the use of modern technology in ICUs, such as AI and robots, and how distinct models of critical care delivery influence patient outcomes and staff wellbeing. Articles also touch on infection control in critical care settings, medical care that reduces ICU use and ICU rotations.

Amid regulatory uncertainty, nurse and physician shortages, and an epidemic of burnout, today's health system leaders must work to protect their most valuable assets — clinicians. Providers on the frontlines are the lifeblood of a health system, and these individuals should be working in safe environments where innovation and a constant commitment to performance improvement are deeply embedded in the workplace culture.

The following nine articles contain insights for nurse leaders on fostering a culture of innovation, retaining talent and equipping teams to meet the healthcare needs of tomorrow.

Key learning points include:
- Cultivating and supporting a culture of innovation in healthcare
- 3 ways nurse leaders can create a culture of resilience
- Mentorship matters: when nurses succeed, hospitals can, too

As health systems focus on delivering care during the global COVID-19 health crisis, revenue cycle and finance leaders are bracing for seriously challenged cash flows and constrained revenues. Inpatient censuses are at record lows in preparation for surge capacity expectations and profitable elective procedures are postponed. That puts health care providers in a precarious financial position.

Through our client engagements, Optum Advisory Services experts have identified several no-regrets strategies that health systems should consider now. This white paper highlights tactics to stabilize performance and accelerate recovery.

Hospitals are a fast-paced, highly regulated and complex working environment, in which care teams often struggle to communicate effectively. The result can be increased stress on providers, inefficiency, and potentially poor patient outcomes.

While COVID-19 has highlighted the challenges of achieving effective care team collaboration, communication has been a pain point for clinicians for years.

In this whitepaper, PatientKeeper examines how healthcare leaders can analyze and manage the communication challenges facing the care team as a whole, including:

• Identifying common communication challenges that hinder providers’ ability to deliver care and increase the potential for physician burnout
• Navigating the variety of technologies available to improve clinical communication and thinking beyond the needs of today
• How to measure the effectiveness of these communication tools to ensure maximum ROI

The social determinants of health (SDOH) are increasingly recognized as critical drivers of health and well-being. SDOH data can help healthcare organizations better understand and manage a variety of chronic conditions, but the key is to find the right data, understand its relevance, and apply it directly to patient care.

In our latest white paper, ZeOmega co-authored with the Center for Open Data Enterprise (CODE), we present a new approach to improving population health outcomes by applying public and proprietary data sources to the identification and addressing of SDOH needs.

In The Social Determinants of Health: Improving Population Health With Data-Driven Insights, you’ll read about:

• Why SDOH are important to population health management
• What public data sources are available to address SDOH
• What conditions are commonly affected by SDOH
• How ZeOmega can help you apply SDOH data to your population health strategy

The coronavirus pandemic, and resulting economic impact, have created unprecedented clinical and financial challenges for healthcare providers. On the financial side, providers are urgently seeking alternative sources of revenue to counter diminishing traditional reimbursements. The markets should be one area of focus in these efforts. The historic low-rate environment presents an opportunity for many healthcare providers but requires a shift in investment strategy.

Fortunately, there are many strategies healthcare organizations can utilize to fully leverage available cash to maximize returns without undue risks. This article provides insights into:

• Days cash on hand
• Lines of credit
• Money market funds
• Fixed income investments
• Loans and bonds

The ability to optimize investment returns through proactive control of cash is substantial. These seven strategies can help organizations turn today's financial challenges into tomorrow's financial opportunities.

• Learn about the four common cash investing challenges healthcare providers encounter.
• Discover seven strategies that can form the basis of a beneficial approach to optimizing cash investments.
• Learn four critical characteristics healthcare providers should seek in their banking relationships.

A lot of the value of IT comes from the fact that software often can be deployed quickly and scaled efficiently. Particularly in the face of a pandemic, where the needs of the population evolve day to day, reaction time is crucial.

Read this whitepaper to discover just a few of the ways IT has rapidly transformed to meet the challenges and pressures this global pandemic is placing on patients, clinicians, IT, and security:

• Ensuring staff and clinicians are safe and healthy and enabling them to report illnesses
• Onboarding new clinicians, such as recent medical school graduates and traveling nurses, and other staff quickly, efficiently, and with as few touchpoints as possible
• Responding to the influx of potential patient inquiries, orchestrating triage, and facilitating scheduling and more

With the CMS Interoperability and Patient Access final rule, modified Conditions of Participation require hospitals — including psychiatric and critical access hospitals — to send electronic ADT notifications to a primary care provider identified by the patient and post-acute providers.

While the conditions aren’t optional, the benefits that come from them are. Hospitals that learn to leverage the CoP for collaboration will see additional benefits, including reduced care costs and improved patient outcomes.

This downloadable whitepaper will cover:

• What hospitals need to know about the new rules and how they impact technical and clinical interoperability
• How care teams can use CoP interoperability to improve patient outcomes — including a 60 percent reduction in hospital readmissions and a 32 percent reduction in opioid deaths
• How collaboration can help improve cash flow, including saving roughly $1 million in unnecessary care costs and increasing revenue 30 percent

As many of the nation's leading health systems continue to innovate toward value-based models of care, executives are increasingly investing in and implementing new technologies and processes designed to improve care quality, lower costs, and enhance both the patient and provider experience. Imaging services represent a prime target for optimization efforts that can support these aims.

Hospital and health system leaders looking to overcome financial difficulties, improve the patient experience and ensure providers are operating under optimal conditions should prioritize efforts to streamline imaging services.

This white paper details five best practices for optimized imaging services. Key learnings include:

• How to create a culture of collaboration
• How to identify appropriate key performance indicators (KPIs) and improvement benchmarks
• How optimized imaging services can support the pursuit of the Quadruple Aim

Asking for a pay cut, or trying to get less than what we're owed, is the opposite of what most of us are wired to do – and with good reason. It's natural to want our fair share, not to leave it behind.

Still, health systems around the country frequently experience inadequate payment. The complexity of the current reimbursement environment demands hospitals take a proactive approach to billing. Without a sound billing strategy for Hierarchical Condition Categories (HCC), for example, large organizations can wind up leaving millions of dollars on the table every year. Most of us aren't surprised to learn this, since we know that HCCs and clinical documentation can be a headache. This whitepaper dives deep into HCC reimbursement issues and offers insights into how a 100-plus physician group in northern Illinois increased its monthly reimbursements by $160,000 with a smart HCC strategy.

Download the whitepaper to learn:

• Why your organization needs an HCC strategy
• How to correctly capture HCCs in the EHR
• What to do to ensure Medicare Advantage is a profitable part of your institution

Considering an enterprise-wide solution for lab operations? To further extend the value of the laboratory and support the organization’s strategic initiatives, consider these five factors when assessing enterprise-wide technology for lab operations:

• Costs for lab components will be higher than expected.
• Best-of-breed lab systems support strategic imperatives.
• Limited lab functionality creates new gaps in care.
• Best-of-breed technology supports consolidation and growth.
• The downstream effects of disruption are far-reaching.

The continued growth of specialty pharmaceuticals requires hospital pharmacies to think differently about traditional inventory models. A consignment inventory model ensures critical medications are available when you need them, allowing you to focus on patient care instead of time-consuming manual processes, excessive carrying costs, or waste due to obsolescence.

In this article you'll learn:

• Key factors to consider when evaluating a consignment model
• How consigning emergency drugs with variable demand can help to reduce costs
• How an RFID-enabled consignment program automates manual tasks

Optimal care delivery is a necessity in today’s healthcare environment. As the foundation for long-term hospital and health system performance improvement sustainability, care transformation is necessary to generate financial rewards and drive added value by improving care outcomes, eliminating unnecessary variation and ensuring consistent application of evidence-based practices across the continuum of care.

In this white paper, Premier®, a leading healthcare improvement company, uniting an alliance of more than 4,000 U.S. hospitals and health systems, provides an overview of the five strategic elements behind creating a healthcare culture that is centered on optimal care delivery.

Did you know that Kaiser Permanente selected a new chairman and CEO and that Tenet Healthcare promoted Saum Sutaria, MD, to president and COO? There were also a handful of unique positions filled as of late.

The last few months continued to have exciting healthcare executive moves. Altogether, at least 123 hospital and health system C-suite executives were on the move during this time of the year.

Keep track of all the recent executive moves with this report

In today’s competitive market, it is more critical than ever to attract and retain top talent.

Read the article to learn key strategies on reducing the staffing burden, including:

• Talent acquisition
• Retaining and engaging rehab talent

The work of dental professionals is time intensive and hands-on, and the last thing they want is for their bookkeeping to be equally demanding. KPMG Spark is a small and medium-sized bookkeeping and tax service that provides dentists with real-time financial statements and personal bookkeepers to make running their practice easier than ever before.

Dental professionals can now focus on what they do best and leave the finances to the professionals. Tax services, business licensing, and payroll are just a few services that can be powered by KPMG Spark.

Read more about how we can partner together and help your practice continue to grow, with these 5 strategies.

Whether you’re opening a new location, updating your practice, or beginning a multi-office project, planning all aspects of your ideal dental space and work flow can be daunting.

Boyd Industries, an industry-leading manufacturer of dental specialty equipment and cabinetry, has created this guide to collaboration during the design process.

Learn how to build a comprehensive vision of your project, and how expert consultation can ensure success when considering the needs of a specialty practice.