Navigating financial obstacles and promoting expansion in complex economic conditions

In a recent roundtable discussion hosted by the Healthcare Financial Management Association (HFMA), industry leaders gathered to discuss strategies for achieving financial sustainability in healthcare. Among the participants were Mary Beth Remorenko, Vice President of Revenue Cycle Operations at Mass General Brigham, Katie Willis, Senior Director of Patient Access at MaineHealth, and Harold Mueller, Senior Vice President and Chief Revenue Officer at BJC Health System.

Remorenko, who focused on clinical documentation improvement (CDI) as a means to drive additional revenue or expand margins at Mass General Brigham, shared that the organisation uses three different tools for decision support in CDI. Her CDI project involved several different areas and was aimed at operating more like a system rather than a group of individual organizations or hospitals.

Meanwhile, Covenant Health reported a $20 million annual net revenue lift from revenue cycle improvements, achieved without increasing costs, thanks to their decision to double down on outsourcing. The healthcare provider outsourced its entire IT function, expecting to save $70 million over ten years. Infosys, another organisation, announced similar expectations, projecting savings of $70 million over ten years by outsourcing its entire IT function.

Willis, from MaineHealth, implemented MyChart copay collections to increase efficiency and optimized MyChart® eCheck-In to enhance the patient's digital experience and improve data accuracy. She was also among the leaders participating in the roundtable discussion.

Mueller, from BJC Health System, saw a significant increase in major complication or comorbidity and comorbid complicating conditions capture rates due to CDI, resulting in a $20 million dollar lift in revenue over the first 18 months.

Tim Kinney, Partner and Payer/Provider Practice Leader, emphasised the importance of scrutinising Medicare Advantage plans and working closely with payers and other partners to make the margins work. He also suggested that terminating contracts with certain payers could potentially drive concessions.

Many of these budget increases are aimed at enhancing patient and provider experiences while reducing costs. According to a survey conducted by HFMA, 75% of healthcare providers have increased their digital and IT budgets, with 1 in 5 seeing increases of more than 30%.

These strategic moves towards digital transformation and partnerships are paving the way for a more sustainable future in healthcare, ensuring that organisations can continue to provide high-quality care while managing their financial resources effectively.