Overview
While a Health System’s Employed Provider Network is a source of tremendous strategic and financial value, investment into the Employed Provider Network’s practices must still be optimized in order for health systems to have a healthy bottom line. Flat reimbursement combined with escalating costs and scarcity of resources has burdened many health systems financially and demands that every dollar of investment be scrutinized.
Improving financial performance within an employed network requires a comprehensive understanding of internal performance versus benchmark. HSG helps health systems identify, prioritize, and execute upon operational issues that ultimately drive financial performance. HSG works with health systems to comprehensively assess the Operational and Financial Performance of the Employed Provider Network and create action plans for getting to a sustainable level of investment. Getting there requires a robust view of both halves of the Profit and Loss Statement – investment cannot be optimized through looking at expenses alone.
How We Work
HSG Employed Provider Network Assessment process focuses on comprehensively evaluating opportunities to increase revenue, reduce expense and increase efficiencies and utilization. Once opportunities are identified, HSG partners with health system leadership to build a realistic, actionable plan to progressively pursue optimization. HSG supports these efforts with a mixture of project-based efforts as well as onsite leadership resources to ensure bandwidth is available to take on these incremental challenges outside of day-to-day operations.
- Productivity/Access Improvement
- Alignment of Productivity and Compensation
- Scheduling Templates
- Ambulatory Revenue Cycle
- Coding and Documentation
- Provider Credentialing
- Advanced Practice Professional Utilization
- Staffing Utilization
- Practice Care Model Transformation
- Management Infrastructure and Organizational Design
Additional Analysis and Consulting
Network and Practice Turnaround
When a network, practice or functional leader departs, major disruptions to operations and financial performance can occur. HSG’s experienced Interim Management brings on-site leadership supported by HSG’s Employed Provider Network advisory team.
Revenue Cycle
Ambulatory Provider Revenue Cycle frequently finds itself under resourced within a health system; with resources diverted towards Inpatient and focused on larger dollar outcomes. However, many health systems stand to realize significant financial gains with increased performance on the Ambulatory side and without significant investment in personnel or other fixed resources to achieve it.
Coding and Documentation
Paying adequate attention to and investing in a professional service coding program is crucial for employed network sustainability. An effective program directly supports patient care revenue generation, provider productivity determinations, and corporate compliance assurance. While technical services coding and billing are also important facets of the network revenue cycle – especially in provider-based billing scenarios, many networks experience greater inadequacies in the professional services elements as these differ significantly from other hospital billing practices.
APP Utilization
Advanced Practice Professionals (APPs) are an increasingly important part of care delivery and make up an increasing percentage of a health system’s employed provider networks. However many health systems struggle to effectively integrate APPs and utilize them at top-of-license within the care delivery environment.
Related Resources
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How to Utilize Outpatient and Ambulatory Claims-based Insights for Strategic Growth
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Does Your Hospital Wish to Remain Independent?
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Key Primary Care Considerations to Drive Access and Patient Capture (SHSMD Educational Session)
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