In the value-based reimbursement environment, healthcare organizations may be susceptible to higher levels of financial risk compared to traditional volume-based, fee-for-service reimbursement. Revenue based on outcomes can be less predictable. Therefore, cost control represents the number one variable healthcare organizations can actively address to reach financial targets in 2018.

To remedy falling patient numbers and revenues, providers need to consider more effective cost management strategies that seek to:

• Reduce waste in care delivery
• Maintain quality outcomes
• Establish a more accurate view of costs at the case level

The speaker recommends technology and process improvements that better support data analysis, cost management and care coordination.

Learning objectives:

1. Determine new cost management actions and data analytics needed to minimize the potential impact of falling revenues and risking risk.
2. Review strategies to define cost per case, identify most expensive patient cohorts, and gain visibility into expenses across multiple care settings.
3. List key, organization-specific considerations that should influence contracting and payment re-design. ​
4. Assess how to identify risk and better manage costs, time, and revenue cycle processes in value-based contracts with a checklist of enabling technologies.
5. Explore the revenue cycle process improvement areas and staff training initiatives needed to support the transition to value-based models.

Jon Melling, Partner at Pivot Point Consulting
Peyman Zand, Partner at Pivot Point Consulting