At HFMA, themes of payer collaboration, operational leadership, and smarter investments are dominating the conversation.
HFMA attendees are settling in on day two of the annual conference, discussing key issues that are focused on the deep-rooted finance issues in healthcare.
Three of the most pressing topics for finance leaders in the sessions so far are:
- Working better with payers (and what that really means);
- Stepping into the role of operational transformation leaders, and
- Making the most of health system investments in today’s heated economical and regulatory climate.
Pacing Payers
Payers and prior authorization are on everyone’s agenda, with sessions focusing on denial prevention, simplifying claims creation and prior authorizations, and strategies for taking the friction out of payer-provider relationships.
Providers are rapidly embracing AI and automation in claims processing, but they’re also aware that payers are using the same technology, and more often than not, they’re faster and more efficient. So instead of sinking into a battle of the bots, both parties should be working together to create a claims/prior authorization process that revolves around the patient.
From aligning managed care and revenue cycle, to uncovering better claims processes, to digging into more comprehensive (but more efficient) coding practices, providers are searching for new ways and new perspectives to approach their relationships with payers.
Overall, it’s clear the industry wants a faster, standardized method for processing claims. The tone is overall hopeful: if both parties can save time, both parties can reduce costs and provide better patient-centric care.
Operational Leaders
CFOs are realizing there is a cost to inaction. With the threat of small financial missteps turning into big operational pitfalls, CFOs must be involved at every operational step. On the flip side, both clinician and administrative teams also must understand how misaligned workflows can negatively impact finances.
The first step is defining performance improvement and what it means to a particular health system. CFOs need a proactive approach to tying financial outcomes with performance, one that involves strategic alignment, especially for the long-term.
Discussion on operational improvement should also include training and culture, and it’s clear to finance leaders that performance improvement is imperative in today’s market.
The message to CFOs: Don’t just improve the budget. Lead the system improvement.
Imperative Investments
To set their health systems up for clearing the (seemingly never-ending) industry hurdles, finance executives are taking a close look at, and in some cases overhauling, their investment portfolios. But finding liquidity is easier said than done.
To help, CFOs are turning to private market investments for returns, and leveraging peer comparisons to reassess risk exposure. Looking at the organization through an enterprise lens is vital; one session advised CFOs to ask their finance team: "Are we taking the right risk through an enterprise perspective?"
For CFOs looking to leverage their health system’s portfolio as much as possible, some tips from the sessions were: try to align liquidity while limiting cash drag, grow and diversify sheet assets with private markets, and utilize peer group data for comparison.
Marie DeFreitas is the CFO editor for HealthLeaders.
KEY TAKEAWAYS
Finance leaders are pushing for more streamlined, tech-enabled payer-provider partnerships that prioritize patient-centric outcomes.
Today’s CFOs are being called to go beyond budgets, taking the lead on system-wide performance improvement and fostering financially aligned, cross-functional teams.
With economic pressures mounting, CFOs are exploring private markets, liquidity balancing, and peer benchmarking to reshape their investment approaches.