Hospitals & Health Systems

Organizational Support to Boost Quality Care

The health care industry faces significant financial and operational challenges following unprecedented disruption. Pressure mounts to adapt industry standards as labor costs increase, organizations struggle with retention, reimbursement drops without gaps covered by commercial payors, regulation becomes more complex, and value-based care is prioritized over traditional fee-for-service models.

To maintain operations, hospitals and health systems must proactively stay ahead of change and focus on more than simply reducing costs. Hospitals and health systems should enact initiatives that strategically address service lines—whether they should be retained, centralized, or even eliminated—and consistently grow revenue.

Discover how our industry-focused services can help your organization address evolving challenges so you can focus on what matters most: delivering quality care.  

Solutions for Health Care Challenges

Explore how our professionals can help your hospital plan for what’s next.

Evaluate Service Lines

Counter the mounting financial challenges related to heightened revenue pressure, increased accountability, and intensified cost containment by assessing the effectiveness and efficiency of your service lines.

Improving service lines not only has potential financial benefits, but can also strategically position your organization to be more competitive. Drive profitability by identifying opportunity areas so you can make informed decisions for short- and long-term planning and organizational evolution.

Service line focus areas include:

  • Departmental expense allocation design
  • Expansion assessments, including financial feasibility analysis and service line complement design or redesign based on market analysis
  • Hospital service line financial performance analysis
  • Multispecialty medical group specialty analysis
  • New service feasibility analysis
  • Operational assessments
  • Physician compensation analysis
  • Physician integration services, particularly helping develop hospital-owned physician practices for the benefit of all parties
  • Turnaround assessments and assistance

Navigate Transactions

Evaluate strategic alternatives, conduct thorough operational and financial due diligence, and confidently navigate the transaction process end to end—whether your organization is considering buying, selling, or affiliating or already entered preliminary discussions with another entity.

Develop a thorough understanding of your position and readiness for alignment, evaluate options, and assess the cultural and operational fit if you’re approaching due diligence—so you can make informed transaction decisions.

Strategically position your organization to take advantage of a transaction should opportunity arise even if one isn’t currently part of your short-term strategy.

Transaction support can include:

  • Acquisition impact analysis
  • Affiliation analysis and support, including strategic and partner-affiliate options
  • Buy-side operational due diligence
  • Sell-side alignment analysis and preparation
  • Foundation development for hospitals and health systems or other corporations interested in physician employment and network development
  • Full financial impact analysis, including independent, blinded analyses
  • Merger operational and cultural fit assessments
  • Turnaround assessments and assistance
  • Regulatory landscape assessment to maintain compliance with emerging laws

Enhance Contracts

How you draw up contracts is a key component in your revenue cycle when you partner with another provider or payer. For example, contracts can be written to boost and protect cash flow and efficiency with your billing and collection departments.

Working closely with your contracting team and legal counsel, we analyze how your contracts affect your organization operationally and financially. Gain insights that can help provide greater leverage in negotiation and contract processes.

Managed care assessment and negotiation focus areas can include:

  • Assistance with financial and operational terms
  • Capitation contract analysis
  • Contract reviews and financial performance assessments
  • Model contract development
  • Negotiation support

Improve Reimbursement

Enhancing your organization’s reimbursement requires a deep understanding of the cost report and coordination across people, systems, and processes.

Support your organization’s overall strategy and operations as you navigate Medicare and Medicaid’s ever-changing landscape—whether you seek full enterprise outsourcing solutions or help in a specific area.

In addition to staying alert to the latest regulations, our professionals understand how your organization’s operations—whether revenue cycle or billing practices—impact reimbursement and can provide insights on:

  • Revenue cycle processes such as payer mix management, charge master, and billing
  • Regulatory interpretation of federal and state provider-based and outpatient service line assessments
  • Clinical pathway reviews for inpatient and outpatient service lines
  • Application of overhead rates including indirect cost for federal grant funding, managed care plans, and the correlation to fee-for-service calculations

Our provider reimbursement enterprise services include:

Maintain Compliance

Avoid the consequences of noncompliance by addressing the complex nuances and requirements related to government compliance.

Identify improvement areas, correct billing errors, and prevent future oversights with a focus on four key areas:

  • Regulatory compliance
  • Coding validation
  • Coding department redesign
  • Electronic health record internal controls

Improve Performance

Transform your organization’s processes and improve results through lean health care, a management approach that empowers clinicians, frontline leaders, and employees to understand and solve problems sustainably.

Lean health care coaches leaders to unleash the potential of your best resource—the frontline employees and providers who deliver care—thoroughly examining your current processes rather than relying solely on quick fixes. Envisioning and facilitating improved processes and promoting organizational learning through lean methodologies can help bring sustained success into the future.

Lean can help:

  • Improve quality and patient safety, prevent adverse safety events, and improve overall care through workshops
  • Develop continuous improvement
  • Evaluate and improve processes
  • Reduce burnout and improve workflows

Who We Serve

Organizations across the health care landscape look to us for support including:

  • Integrated health and hospital systems
  • Rural and critical access hospitals
  • Pediatric hospitals
  • Academic medical centers
  • Independent community hospitals
  • Rehabilitation and long-term acute care facilities
  • Specialty and surgical hospitals

Expansive Health Care Expertise

Going beyond just audit and tax services, our professionals take a holistic, comprehensive approach to your business challenges—delivering customized solutions unique to the nuances and needs of your organization.

Collaborating closely with your leadership, we listen to the needs of your organization and adapt and pivot solutions as new business opportunities or challenges arise.

We view challenges from the perspective of hospital leaders because many of our professionals previously worked in executive roles within the health care industry and possess first-hand experience and knowledge of what it takes to pursue your goals.

2024 Executive Health Care Conference

2024 Executive Health Care Conference

Explore pressing issues facing health care leaders and how your organization plan for what’s next at our 2024 Executive Health Care Conference.

Watch Webcasts Related to Hospitals & Health Systems

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