WHAT IS THE FUTURE OF VALUE-BASED CARE?

Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.

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Research

The Finance Leader's Resource Guide

Leaders in Congress and the Trump Administration are reassessing their approach to repealing and replacing the Affordable Care Act. No matter the outcome, one thing is for sure: there will be serious and long-lasting financial consequences for hospitals.

This guide is intended to help you and your finance teams operate in this uncertain time. Inside, you'll find the information and no-regrets strategies needed to support mission and margin in any regulatory environment.

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What you'll find inside

This guide is divided into four sections:

  • Observations and priorities for finance leaders (p. 4)
    An overview of Advisory Board's expectations for the political and market landscape going forward
  • 20 recommendations for revenue cycle performance (p. 11)
    Proven best practices for revenue cycle management, a topic that will only grow in urgency in view of current developments
  • Cost control atlas (p. 33)
    A three-pronged strategy for cost reduction, including a set of near-term tactics, principles for long-term fixed cost management, and insights on the finance leader’s role in driving out costly variation
  • Medicare risk strategy primer (p. 57)
    Step-by-step decision guidance on the current menu of Medicare risk options, as well as advice on quickly reacting to any new programs that may be offered in the future

You can explore each of these sections in depth below.



Observations and priorities for finance leaders

Learn Advisory Board's expectations for the political and market landscape going forward, including the likelihood of major Medicare restructuring, why MACRA is important for all leaders, and why underinsurance is as critical as uninsurance. Read more starting on p. 5.

Next, understand the no-regrets priorities that must be at the top of every finance leader's agenda—regardless of policy changes. Learn where to focus your efforts on p. 10.

20 recommendations for revenue cycle performance

Many unknowns remain surrounding the details of future reimbursement. But regardless of the reimbursement climate, we can predict with certainty that the need for effective revenue capture will be essential.

Explore Advisory Board's extensive expertise and proven best practices for revenue cycle management, a topic that will only grow in urgency in light of current developments. The 20 recommendations included here direct finance executives to a more efficient use of revenue cycle resources to advance three system-level margin improvement goals:

You can also jump to p. 32 to find additional Advisory Board resources on revenue cycle performance.

Cost control atlas

Health system leaders should push hard to surface near-term savings opportunities while relentlessly pursuing long-term cost discipline. The most successful organizations will pursue a three-pronged strategy that combines an aggressive menu of short-term savings opportunities with ongoing efforts to slim fixed cost structures and reduce the costs of unwarranted clinical variation.

Learn how to bring this strategy to life with:

Medicare risk strategy primer

In order to keep up the momentum toward risk-based Medicare payment, finance leaders should take the opportunity to carefully assess their organizations' preparedness and their local markets' suitability for various Medicare risk models, including the Medicare Shared Savings Program (MSSP) and the Medicare Advantage (MA) market.

Get step-by-step decision guidance on the current menu of Medicare risk options, as well as advice on quickly reacting to any new programs that may be offered in the future:

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