Financial Sustainability Report: October 2020

The October 2020 Financial Sustainability Report, sponsored by Kaufman Hall, explores aspects of healthcare’s transition to value-based payment, including how to pursue a value-based approach to maternity care, and how the transitional approaches differ among hospitals and health systems based on each organization’s unique circumstances.

Value-Based Payment

Why effective maternity care requires an innovative, value-based strategy
By Tessa Kerby, MBA, MPHE, Rachel Bidgood, MHA, and Dana Le, MHA 
An episode-of-care approach may be the best way to address cost variation in maternity care and promote partnerships across the healthcare continuum.

Lessons learned from the transition from volume to value
By Bonnie B. Blanchfield, CPA, ScD, Gregg S. Meyer, MD, MSc, Anjali Thakkar, MD, MBA, Michelle Howell, MPH, and Catherine J. Meyer, MSc
If ACOs are to continue to effectively lead the transition to value, they must fully grasp the success factors that will determine future success, including success with downside risk. Findings of a research study provide insights into key organizational, financial, market and other characteristics that support the decision to take on risk.

Performance improvement

COVID-19 deals a severe blow to hospital performance
Sponsored by Kaufman Hall
By  Lance Robinson
Health system executives and finance leaders responding to a recent survey expressed concern about the financial viability of their organizations amid the ongoing COVID-19 crisis.

Revenue Cycle

How keep silent denials from eroding your hospital’s margin
By Kurt Hopfensperger, MD, JD
Avoiding payment denials by commercial health plans has long been a priority for hospitals. Yet even as they have implemented process improvements to prevent denials, commercial payers have upped the ante, increasingly issuing denials for clinical reasons that are difficult to overturn because doing so requires a clinical perspective.

Commentary

Why healthcare providers should rethink their approach to self-pay collections
By Eric Fry
Self-pay collections present one of the core revenue cycle challenges for hospitals. Healthcare organizations should consider a new approach to meeting this challenge, involving prepayment by healthcare consumers.