Service line accounting
With more patient care taking place in outpatient settings at lower cost, the acute care patient mix and revenue mix are liable to change. Indeed, many healthcare establishments examine accounting structures as they reorganize service lines. Says Victor DiPilla, vice president and chief business development officer at The Christ Hospital, a 425-staffed-bed not-for-profit acute care facility in Cincinnati, Ohio, "We are trying to capture the whole service line from a P&L perspective, so you get a better measure of the true profit and loss of each of the service lines, as opposed to just the hospital portion or the outpatient portion."
Physician alignment is certainly a consideration when modifying service-line accounting. "It's not as easy as you might think, to align those P&Ls by service line," says DiPilla. "It's a process, you have to bring the physicians along. You should continually work with them to make sure they understand the business side of the equation. It's about how you share information so that they understand what it is that you are presenting. They have been pretty receptive to the approach."
When large health systems approach their service lines from a population-health perspective, they must consider casting aside hospital-centric thinking.
For the time being, health systems seem to be on the forefront of developing tactics for delivering healthcare along the care continuum. "We already have that continuum of care in our mind-set," Rogers observes. DiPilla offers, "It may be that the smaller systems don't have the total continuum to address. In addition, it may be they are more focused on operational day-to-day performance on the financial portions of their business, as opposed to looking at a more global view of the world, perhaps because of not having the resources to do that."
This article appears in the June issue of HealthLeaders magazine.