Three healthcare finance leaders shared their insights about reducing costs and improving quality.
Healthcare leaders are continually looking for proactive approaches to the financial challenges their organizations face, both in the short term and long term. These include utilizing data analytics to boost value-based care and employer-purchaser strategies to drive down costs and achieve quality outcomes.
HealthLeaders hosted its second Healthcare Finance NOW Summit Wednesday, which featured sessions for finance leaders to help them envision a road map for the future. The event was sponsored by ClearBalance HealthCare, UKG, and Vizient.
The virtual event kicked off with an opening keynote from Dan Carpenter, senior vice president and CFO at UnityPoint Health, followed by a mid-day presentation from Kevin Conroy, CFO and chief population health officer at CareMount Medical, PC, and concluded with a closing presentation from Suzanne Delbanco, PhD, executive director at Catalyst for Payment Reform.
Below are three takeaways from these sessions.
Data as the "true north"
At UnityPoint, the organization has used data analytics to attack the uncertainty prompted by the pandemic, according to Carpenter.
He said the Iowa-based health system has "disrupted tradition" by using its considerable data capabilities to serve as the "true north."
"For the organization, it was imperative that we identified elements and opportunities to intervene in a more timely manner than was our normal operational rhythm," Carpenter said. "So, we had to disrupt the way we thought about our business and the way we managed our business, in order to address the challenges that we were facing."
Given that COVID-19 presented UnityPoint with challenges that the organization had never encountered, Carpenter said leadership focused on two key financial metrics: cash burn and revenue growth.
“Our focus on cash burn and revenue growth through a period of recovery will continue to be a focus for us,” he said. “Enhancing that data-driven mindset and culture is probably the biggest piece that we're doubling down on and driving forward.”
In addition, due to ever-changing circumstances, finance leaders were asked to produce weekly forecasts rather than long-term models.
He also mentioned that the system has utilized its predictive models to have a greater focus on managing labor and instituting real-time tracking of supplies.
Achieving ACO success through data analytics
Much like UnityPoint, CareMount has relied on data analytics to drive its population health efforts.
CareMount's journey into value-based care began five years ago, according to Conroy, the organization is aiming to go into fully delegated capitation in 2022. Conroy explained that the journey takes a while and stressed that "you can't teach value-based care overnight."
He said CareMount had to build the infrastructure to host its data analytics platform but also required a change in the culture as well, which was embracing the tenets of a "payer mentality" within a provider organization.
Conroy said that CareMount's population health data-science platform supports the clinical decision-making process and shift to value-based care, adding that he couldn't overstate the importance of analytics.
"What I've recognized is that as we go out and talk to other groups in terms of joining our IPA and participating through CareMount Value Partners, that it's an easy decision for the CFO that I'm talking to to say, 'Hey, you've already built this [platform]. If we can arrange a mutually beneficial type of contractual relationship to manage these lives,’ they're willing to do it. And this investment is key in order to do that."
Conroy said his advice for converting skeptics about a move toward value-based care is to align provider incentives with value-based payments.
He noted that it is “not easy” changing a physician compensation model but also added that physicians understand the importance of aligning these incentives.
How employer-purchasers are procuring high-value healthcare
From the employer-purchaser perspective, there's a desire for a health insurance marketplace that is both more effective and transparent in terms of prices and benefits associated with their packages, according to Delbanco.
She said employer-purchasers are increasingly interested in taking control of their negotiations for health benefits rather than sitting back, specifically citing self-insured employers.
"It's more important than ever that self-insured purchasers take the reins and demand accountability and high-value healthcare," she said.
But doing so is not an easy task, as Delbanco noted because the market power of insurers per geography “will affect how effectively” employers can negotiate.
However, she said that using purchasing strategies, coordinating broadly with other self-insured purchasers, and utilizing the combined spend/covered lives is a way to affect change.
"When enough purchasers align their ask, they can achieve a critical mass of demand," Delbanco said.
She added that going forward, there will likely be a heightened demand for narrow networks and tiered networks.
Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.
"For the organization, it was imperative that we identified elements and opportunities to intervene in a more timely manner than was our normal operational rhythm," Dan Carpenter, CFO at UnityPoint Health, said.
Kevin Conroy, CFO and chief population health officer at CareMount Medical, PC, said that the organization's population health data-science platform supports the clinical decision-making process and shift to value-based care.
"It's more important than ever that self-insured purchasers take the reins and demand accountability and high-value healthcare," Suzanne Delbanco, PhD, executive director at Catalyst for Payment Reform, said.