Technology and Ensuring You Are Investing in The Right Thing… · (Help me get well - Physical or virtually) Expert / specialists (Fix me – acute, dental, …) Consumers are pushing

November 21, 2017 1© 2017 DXC Technology Company. All rights reserved.

Technology and Ensuring You Are Investing in The Right Thing…

Mary Mirabelli, FHFMA, 2016-2017 National Chair

Vice President- Strategic Healthcare Advisory Services

DXC Technology


For Today…

• Setting the Stage- US Affordable Care Act and Meaningful Use

• United States HFMA Focus

• Innovation That Matters- Meeting Triple Aim

• Return on Information

• Using A Business Value Framework

• Disruption in the Market and Value Gained

• Business Case Lessons Learned

• Summary and Close



Innovations That Matter- Meeting the Triple Aim


HFMA in the United States

OUR MISSION

Lead the financial management of health care

OUR VISION

HFMA will bring value to the industry

as the leading organization for healthcare finance

HFMA believes we must lead

healthcare stakeholders to meet the

challenges of today while creating a

sustainable healthcare industry.


How Technology Investments Can Look to a CFO…


So where do we as finance professionals fit in this innovative“digitally transformed” world?


And Yet, We Need to Build on Finance Professionals’ Change Leadership Strengths and Skills as We Assess Innovation Investments

“CFOs are often better

leaders than they think

they are. They are good

at setting goals,

measuring results, and

looking at variances.”

-Quint Studer, CEO

& Founder, Studer Group

“The CFO is really in a role

to help the various

stakeholders understand

how the pieces fit together.” -Noblis Health Innovation

Senior Principal, Paul Breslin

“When asked what role finance

officers can play in transforming our

healthcare system, David Walker

said to remember what the ‘P’ in CPA

stands for.” -HFMA Board member Edward Giniat,

quoting the former U.S. Controller General

& CEO of the Peter G. Peterson Foundation

© 2017 DXC Technology Company. All rights reserved.

November 21, 2017

Return on InformationThe Newly Defined ROI


https://nam.edu/perspectives-2014-return-on-information-a-standard-model-for-assessing-

institutional-return-on-electronic-health-records/

https://nam.edu/perspectives-2014-return-on-information-a-standard-model-for-assessing-institutional-return-on-electronic-health-records/


Key Components on Return on Information Discussion Paper

Benefits

• Reduction in Operating Costs

• Reduction in Capital Expense

Costs

• One time costs

• Ongoing costs

Overall Value

Benefits

Expenses

Revenue Impacts


November 21, 2017

A Business Value Framework To Assess Impact of Technology Solutions


Use a One Page Business Value Framework (BVF) to Connect the Dots

Executive KPIs

Financial and Operational KPIs

Industry Strategies and Initiatives

Business and Clinical Processes and Functions

Operating KPIs


September 8, 2017DXC Proprietary and Confidential

Sample Business Value Framework for the Healthcare

Provider

Industry

Strategies

Industry

Initiatives

Going ‘Digital’ Improve Clinical & Operational Efficiency

Adapting to outcomes-focused financial models

Move towards consolidated healthcare delivery model

Preventing cyber attacks on networked devices

• Customer engagement• Patient apps & portals• Data infrastructure & Analytics

• Internet of Things (IoT) & real-time health system (RTHS)

• Intelligent EHR systems

• Digital Provider Solutions

• Revenue Cycle Management• Quality & Performance Measures• New diagnostic technologies• Clinical & Operational Analytics

• Outcome-focused & data-driven governance structure

• Wellness programs

• Establish evidence-based clinical pathways

• Redefine quality & performance measurement systems

• Outcome-focused & data-driven

governance structure

• Integrated health & social caresystems

• Measure Outcomes• Develop a partner ecosystem

• Implement ecosystem-wide system integration

• Achieve higher bargaining power/ economies of scale

• Data security & privacy• Regulatory compliance

• Network & Infrastructure security

Executive

KPIs

Financial/

Operational

KPIs

Patient Access Outcomes & Cost of Care Patient Engagement Population Health

Quality of Care

Regulatory

Compliance

Capacity &

UtilizationRevenue Cycle

ManagementPatient Mix

Reimbursement

Modalities

Capital

Management

Productivity &

EfficiencyOutcomes/Cost

Consolidation

Clinical Operations and logistics Payments and finance HR IT Business development and customer service

Population Health

• Clinical errors & adverse

events

• In-patient mortality rates

• Re-admission rates

• Length of stay

• Frequency/Type of

communication between

provider/patient

• Patient follow-up

• Hospital acquired Infections

• Referrals

• Patient Wait times• Bed Turnover rate• Occupancy rate• Asset utilization rates• Capacity gaps

• In-patient vs out-patient

• Cost per discharge

• Revenue days due to coding

• Payment denial rates• Claims processing time• Total Operating Margin

• DSO / Days of Payables outstanding

• Cash on hand

• Revenue per patient/physician

• Staff-to-patient ratio• Staffing costs

• Trainingsper department

• Staff turnover rates

• Staff productivity metrics

• # of IT employees

• TCO / realized ROI on IT projects

• # process of digitized

• IT budget as a percentage of total revenue

• # of standalone systems• System downtime• # of IT security events• Cost per security event

• Capex vs. Opex

• Market Share• Payer Mix• Service-line mix• # of media mentions• Public health initiatives

• Patient awareness programs

• Patient Satisfaction• # of Complaints

• Patient confidentiality

• Healthcare spending per capita

• Premature mortality rates

• Quality of life for patients with LTCs

• Deaths attributable to healthcare system

• Mortality due to lifestyle

& other risk factors

Business

Processes

&

Functions

Operating

KPIs


November 21, 2017

Disruption and ROI


Today’s digital disruption in healthcare is happening at the edges, but it will accelerate and change tomorrow’s clinical business operations.

Healthy

living

& preventDiagnose Treat and

intervene

Recover

and

rehab

Home care

monitor

& manage

Research and development

Aging in place Sharable and

interoperable

Digitization 3-D printing Population

health

Data is owned by

the consumer

Analysis of

data

Metabolic

analysis


Level / complexity of care

Co

st

Self

service

(there is an

app for

that)

Assisted/

monitored

(Tele-…)

Coached

(Help me get

well - Physical

or virtually)

Expert /

specialists

(Fix me –

acute, dental,

…)

Consumers are pushing “Self Service” capabilities enabled by digital technology for patients,clinicians and support functions.

Preventive wellbeing

• Apps supporting the

whole care continuum

• Digital Healthcare

transactions anytime,

anywhere

• Consumers will drive

the use of technology

for simple diagnostics

and self-monitoring

• Less in person, more

virtual interactions

• “Acute” care will change


Given this Framework- Let’s Look at a Few Examples Healthcare “Disruptors”…Where do they fit in the BVF?


Know also that there are tools to let you know what actually works and is mature enough to generate benefit.

Telemedicine Hype Cycle- Gartner 2015


Evaluating How to Assure a Solid Return on Digital Investments

21


Assure a business case that includes a solid rationale, clear clinical, financial and operational measures and outcomes, and all costs- and links to the business value framework.

•Clinical Outcomes

•Population Outcomes

•Patient Engagement

•Patient Satisfaction

•Revenue Stream

•Investment Required

•Cost Avoidance and Cost Savings

•Added Value

•Shared Savings

22


A Few Business Case Lessons Learned from Technology Implementation

• Be specific on costs- incremental new vs. current resources

• Estimate the contingency and build a process for overage

• Tie benefits to the chart of accounts and general ledger

• Measure regularly to assure costs don’t creep back in

• Be transparent on the way in which opportunity costs will be handled

• Require a feedback loop post implementation on benefit

• Unexpected benefits- order sets, blood product usage, antiobioticstewardship


This is really where we as finance professionals shine- it’s our role.althcare Industry

24

I Think this is

PEE-PEE!


Thank you.

Documents

Technology and Ensuring You Are Investing in The Right Thing… · (Help me get well - Physical or virtually) Expert / specialists (Fix me – acute, dental, …) Consumers are pushing