PRACTICE OPERATIONS
Master the Art of Quarterly Planning with These 7 Steps
ABSTRACT: This article is built on recognizing the critical role of quarterly planning meetings that go beyond routine updates. Effective planning sessions bring team leaders together to reflect on past performance, analyze market trends, and make informed decisions about the future. It is your best opportunity to align everyone’s goals in support of the organization’s overall mission. The author recommends seven steps for organizing and executing effective planning:
Reflect on performance. Gather relevant, key metrics and review outcomes of the previous quarter.
Assess the situation. Analyze data about your market, including competitors and customers. Understand any changes in your market that call for adjustment or revision in your plans.
Update strategy. Make those revisions — update your strategic plan.
Address issues. Identify any critical issues within the business that may point to root causes for sub-par or failed performance. Use this analysis to uncover and resolve underlying problems.
Set priorities. Come up with three to five key priorities you believe should drive your strategy and business success over the next quarter. Cut out items that are more distracting than helpful to meet your goals. Ask, “What matters most?”
Map the quarter. Chart out the next quarter by month, week, and day to create a map to guide your plan for the upcoming period. It provides manageable expectations around the “milestones,” and helps avoid last-minute pressure immediately before the next meeting.
Establish accountability. Clearly define who is responsible for what, and establish a routine rhythm of check-ins and reports throughout the next period. It provides opportunities for timely problem-solving and fosters a culture of accountability where team members take “ownership” of the goals and projects that support them.
EXPERT COMMENTARY: Most of the “wise sayings” I learned as a child were attributed to Benjamin Franklin — including a few questionable attributions. One of those questionable quotes came to mind as I read this article: “Those who fail to plan plan to fail.” Whether the famous founding father actually said it or not, the axiom remains demonstrably true. And once again, we see that good advice offered to today’s managers and leaders typically rests upon fundamental principles of leadership.
New books, fresh presentations, and numerous articles written by modern business advisors and gurus present leaders — from workgroup leaders to Fortune 500 CEOs — with marvelous new ideas and innovative processes to help them in their “success journeys.” The most experienced of us — whether jaded or gracious — can see that the best of the new stuff stands firmly on the foundation of basic management and leadership principles. It is hard not to say, “I told you so,” but it is always a waste of breath, time, and energy. It adds nothing to the immediate conversation.
On the other hand, a very good use of breath, time, and energy could be spent on making sure that fundamental principles are collected and protected — curated, to use a contemporary buzzword — and deeply embedded in all training and education for today’s and tomorrow’s leaders. Old principles are often at risk, because veteran leaders can make the mistake of presupposing that everyone knows the long-standing concepts. They can hardly imagine a developing leader who might not instinctively know and use the fundamentals in his or her role.
Instead of assuming everyone knows, how about using this article’s seven steps to assemble your colleagues and plan your strategy for introducing, reviewing, and training all leaders in your organization on foundational management principles? (By the way, ChatGPT lists the following top five management principles:)
Planning
Organizing
Leading
Controlling
Decision-making
Source: Bruce Eckfeldt, Inc., September 20, 2024; https://www.inc.com/bruce-eckfeldt/master-art-of-quarterly-planning-with-these-7-steps.html
FINANCE
Three Ways AI Can Improve Revenue-Cycle Management
ABSTRACT: According to a survey recently released by HFMA, about 46% of hospitals and health systems use artificial intelligence to some degree in managing their revenue cycles. The number jumps to about 74% when you consider automation that includes non-AI processes. Similar to other AI-assisted administrative functions, new technology promises increases in efficiency. For example, call centers have seen 15% - 30% jumps in productivity after implementing AI tools.
The RCM landscape provides multiple opportunities to see similar results:
Automated coding and billing. AI tools efficiently translate clinical notes into diagnosis and procedure codes for billing. “Claims scrubbing” becomes part of the initial process.
Predictive analytics in denial management. By assessing the history of denials, AI can predict denials and proactively address the coding/billing issues that have caused previous denials.
Revenue forecasting and financial management. Constant tracking allows the system to make accurate projections and forecasts to aid overall financial management.
Patient payment optimization. AI can create personalized payment options and track patient payments, as well as automate reminders and notices.
Enhanced data security and compliance. AI can enhance the system’s vigilance in guarding against suspected fraudulent activity.
Operational efficiency. The most tedious and repetitive tasks can be removed from employees’ responsibilities.
The article showcases three health systems that have leaned into AI and other RCM automation, including: Auburn (New York) Community Hospital, Banner Health, and Community Healthcare Network in Fresno, CA. Organizations like these report successes in:
Optimized staff time. Health systems have increasingly found themselves to be understaffed (and/or undertrained) for resource-intensive processes. AI can overhaul the work distribution.
Improved accuracy. Accuracy in coding and documentation is more challenging and complex than ever. AI can bring new levels of thoroughness and accuracy throughout the revenue cycle.
Risk-factor assessment. The new technologies do not come without risk. Developers, health systems, and users must continue to establish and maintain guardrails that will mitigate risks of bias or unintended outcomes that may arise from automated output not reviewed and validated by humans.
EXPERT COMMENTARY: Sci-Fi has provided us with plenty of dystopian tales about domineering AI turning the planet into Dante’s Inferno. A large segment of society has a real fear about where machine learning and artificial intelligence development may be heading. So do not be surprised to run into resistance when you try to convince your organization of the benefits brought by the AI-driven tools emerging within nearly every software update to your clinical and billing systems.
I do not pretend to know where we are on the Skynet apocalypse-timeline, but some of the new capabilities demonstrated by large-language AI systems are amazing. Here in the “Information Age” we are overwhelmed with the sheer volume of data coming at us at the speed of quantum computing. The definitions of “thorough search” or “exhaustive study” are disintegrating. How much searching is enough? At what point have we “exhausted” all the relevant study resources?
Good news! Searching, collecting, parsing, ranking, and analyzing mountains of data is AI’s greatest strength. Many of us remember trying to wrap our heads around “gigabytes” — who would ever need a billion bytes of data? Now my laptop has a terabyte hard drive that is three-quarters full. Next, we will talk about “petabytes” … then “exabytes” (a million terabytes), followed by zettabytes and yottabytes.
Fast computers with massive hard drives and multicore processors will do the tedious, but heavy, lifting and present intelligently curated information to humans.
Does that mean we do not have to worry about renegade AI? No — that is the reason for the committees and study groups hammering out guidelines for ethical AI development.
Source: AHA Center for Health Innovation Market Scan, June 4, 2024; https://www.aha.org/aha-center-health-innovation-market-scan/2024-06-04-3-ways-ai-can-improve-revenue-cycle-management
PHYSICIAN ISSUES
How Doctor and Doula Partnerships Transform End-of-Life Care
ABSTRACT: The author of this article, Bob Uslander, MD, is a board-certified emergency medicine specialist who has transitioned to private practice that focuses on palliative and end-of-life care. His practice blends hospice-style care offered as a “concierge” (direct-pay) service. Through his experiences, Uslander has learned the value of approaching palliative care with a multi-discipline team of caregivers.
For example, partnering with an end-of-life doula can revolutionize a physician’s care to transform how people — patients, family members, and community — experience the final chapters of life. An article published by Sage Journals in its Palliative Care and Social Practice found that “patients who received care from an end-of-life doula (or ‘death doula’) increased their death literacy, leading to a sense of personal empowerment, positive end-of-life experiences for the family, and personalized deaths for patients.”
Traditional, insurance-financed hospice care does not cover critical elements of care needed by end-of-life patients and their loved ones. These elements include:
Companionship and presence. Just being there for the patient and loved ones provides solace, guidance, and support to reduce feelings of anxiety and isolation.
Comprehensive care. The partnership with a physician helps assure holistic care covering all aspects of the patient’s (and family’s) well-being.
Emotional and spiritual support. Non-physical care helps patients and family find peace and meaning as they approach the end of their lives.
Education and advocacy. This relationship provides opportunities to ensure patients and family understand options and expectations. Clarifying wishes and advocating for those final wishes are a big part of doula care.
Rituals and resources. For many — particularly those without religious experience — a well-trained death doula can provide ideas and resources to incorporate appropriate rituals during this journey.
Enhanced communication. The connections and relationships that grow between patients and doulas open up wider opportunities for effective communication between medical providers and patients, as well as other service providers as appropriate.
EXPERT COMMENTARY: Not only does this article offer another success story about a doctor creating an alternative career, but it also provides insight into how he managed to address problems that he saw first-hand from day to day. As an ER physician, Uslander watched a lot of patients and family members suddenly caught up in the throes of end-of-life questions, obstacles, and emotional trauma. That awareness — fueled by a partnership (and marriage) with a social worker/spiritual advisor — uniquely prepared him for diving into hospice and palliative care. They established a brand new provider organization that did not have to depend on the highly limited guidelines and resources provided by third-party payers.
Their multi-disciplinary marriage became a multi-disciplinary care model for people managing end-of-life services. This Psychology Today article describes the benefits of including a “death doula” in the care team — something rarely, if ever, paid for by insurance. But like the better-known “birth doula,” these professionals bring tremendous value to the care being offered. The Uslanders’ services are made possible, in part, through funding raised through their related 501(c)(3) foundation.
There is a recipe for success in all of this: A reliable partner who shares or co-develops your vision for a particular endeavor; a good, broad network (the Uslanders leveraged connections in hospitals, physician groups, and the counseling/social work industry); creative determination to find a way when it appears there is no way (the non-profit angle in their case). These elements empowered the Uslanders to raise awareness of needs that they have been equipped to meet.
Source: Bob Uslander, MD, Psychology Today, October 2, 2024; https://www.psychologytoday.com/us/blog/permission-to-choose/202410/how-doctor-and-doula-partnerships-transform-end-of-life-care
HUMAN RESOURCES
Salary Report Reveals Gender Pay Gap in Health Services and Policy Research
ABSTRACT: AcademyHealth, with about 3,000 members, serves as a professional society for individuals who work primarily in health service research. It is the result of a merger that took place in 2000, bringing together the Alpha Center and the Association for Health Services Research (AHSR).
In support of its membership, the organization conducted a survey of its members to examine how compensation varies across geographic regions, career levels, and gender. The survey also considered other components of compensation like work culture and satisfaction in the field. The survey conducted back in 2023 received responses from 545 health services and policy researchers (a 7.6% response rate).
Some of the results proved predictable. For example, variations by career level broke out with the following median annual salaries:
Executive level: $230,238
Mid-career and senior level: $138,602
Early career: $104,562
Salaries were reported as higher in the Northeast and West compared to the South. Other variations were noted by professional specialty areas. Health economists earn the most, while those focused on health policy made about 26% less.
Other observations include data showing teleworkers making significantly less than those who must show up at the office. Government employees earned significantly less than those who worked in academia.
Women reported compensation averaged about 15% lower than their male counterparts, but the gap slightly decreases through the stages of career development — with the gap showing about 10% for senior career level workers. Interestingly, the gender gap was highest among government employees, averaging about 24%.
AcademyHealth used the survey report release as an opportunity to launch its Salary Comparison Tool, which enables researchers to compare salary by career level, geographic location, and many other factors to bring into salary negotiations. However, the tool and report are open exclusively to AcademyHealth members.
EXPERT COMMENTARY: AcademyHealth has a clearly stated commitment to diversity, equity, inclusion, and accessibility, but this small sampling of its members indicated fairly typical disparities. The average gender gap was about a 15% lower pay for women than men. It is interesting, however, that the more senior the worker, the narrower the gap. Understand that the survey participants were not simply employees of AcademyHealth — they were in the health research industry, employed by many organizations — from private and public systems, non-profit and for-profit concerns, and government agencies. So, finding out what is behind the differences between men’s and women’s pay is almost impossible to diagnose.
For health leaders taking the time to read this report, the smart response to this kind of information is two-fold:
Keep talking about pay differences. If we do not discuss it and analyze it — especially within our own organizations — we will never understand and solve it. But make sure you discuss it thoroughly: If you note disparities in pay at your practice, study all the factors. Do not just look at gender.
Make absolutely certain that you do not have any inequities in how you treat employees depending on gender. When you find differences that cannot be understood, keep working on them until you do get it. Then act swiftly.
Finally, consider having focus-group-like discussions with everyone in your practice. Help both men and women by providing a safe method to express their concerns about fairness. Involve them in designing corrective measures, and achieve as much employee buy-in as possible. It will be worth the effort.
Source: Angélica Rodríguez, Nabil Natafgi, MPH, PhD, Maushmi Patel, and Brad Wright, PhD, MS, AcademyHealth, October 9, 2024; https://academyhealth.org/blog/2024-10/salary-report-reveals-gender-pay-gap-health-services-and-policy-research