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Situational Awareness
Unlocking Data for Market Assessments and Strategic Planning
O C T O B E R 2 4 , 2 0 1 8
Gulf Coast HFMA Fall Institute
2
1 Data’s New Value Proposition
Strategic Planning
Market Assessments
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3
TODAY’S ROADMAP
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Financial• Cost accounting and service line profitability• Revenue cycle• Contract management (utilization and PMPMs)• Growth (geographic and services)• Provider owned health plans & self insured with TPA
Operational• Performance improvement • Dashboards and visualization tools• Benchmarking• Affiliation
Clinical• EMR• HIE• Quality reporting• Population health
• ACOs
• Bundled Payments
1Data’s New
Value
Proposition
Insight:Value-based care
ties each of these
three together
Wh
ere
is d
ata
havin
g a
n im
pact?
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1Data’s New
Value
PropositionFinancial: Revenue Cycle
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1Data’s New
Value
PropositionFinancial: Revenue Cycle
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1Data’s New
Value
PropositionFinancial: IP to OP Shift
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1Data’s New
Value
PropositionFinancial: IP to OP Shift
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1Data’s New
Value
PropositionFinancial: IP to OP Shift
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1Data’s New
Value
PropositionClinical: Accountable Care Organizations
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1Data’s New
Value
PropositionClinical: Accountable Care Organizations
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1Data’s New
Value
PropositionClinical: Accountable Care Organizations
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1Data’s New
Value
PropositionClinical: Bundled Payments
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1Data’s New
Value
PropositionClinical: Bundled Payments
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1Data’s New
Value
PropositionClinical: Bundled Payments
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1Data’s New
Value
PropositionClinical: Bundled Payments
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1Data’s New
Value
PropositionBundled Payments
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1Data’s New
Value
PropositionClinical: Bundled Payments
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1Data’s New
Value
PropositionClinical: Bundled Payments
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2Strategic
Planning
The concept of strategy has roots in both political and military history. The Greek verb strategomeans “to plan the destruction of one’s enemies.” Consider the terms associated with strategic planning:
• Objective
• Mission
• Strength
• Weakness
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2Strategic
Planning
1960s-1980s
Focus on
physical plant as
cost-based
payments
spurred
expansion efforts
1980s-2010s
Focus on
physicians and
scale due to
managed care
and ACA
2015- current
Focus on the
consumer
Evolution of Strategic Planning
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2Strategic
Planning
• Providers will assume increased risk in the transition from FFSto value based reimbursement
• Pressure to grow cost-effective ambulatory services over costly inpatient services
• Mergers and acquisitions: Only unique or geographically isolated providers will remain independent
• Technological advances will enhance and challenge the delivery model
• Physician recruitment and retention issues
Trends for the Future
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2Strategic
Planning
The Strategic Planning Process
Mission Vision
Situational Analysis
• Internal
•External
Competitive Position
(SWOT)
Strategic Goals and Objectives
Action Planning
Implementation
Where are we now?Where are we
going?How do we get there?
Situational analysis is where data analytics
best supports the strategic planning process
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2Strategic
Planning
Operational Analytics• Access
• System structure
• People: staffing, recruitment and retention
• Quality Position
Market Analytics• Demographics
• Payer analytics
• Market share: IP and OP
• Utilization
• Physician referral patterns
Consumer Analytics• Segmentation
• Demand
• Consumer experience
• Cost of care
Financial Analytics• Credit profile
• Debt capacity
• Capital position
Elements of a Situational Analysis
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3Market
Assessment
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Thank You!
Eric Rogers MEd.RT(R)
Director
BKD Healthcare Performance Advisory Services
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