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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

2

3

TODAY’S ROADMAP

3

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?

4

1Data’s New

Value

PropositionFinancial: Revenue Cycle

5

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

10

1Data’s New

Value

PropositionFinancial: IP to OP Shift

11

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

14

1Data’s New

Value

PropositionClinical: Bundled Payments

15

1Data’s New

Value

PropositionClinical: Bundled Payments

16

1Data’s New

Value

PropositionClinical: Bundled Payments

17

1Data’s New

Value

PropositionClinical: Bundled Payments

18

1Data’s New

Value

PropositionBundled Payments

19

1Data’s New

Value

PropositionClinical: Bundled Payments

20

1Data’s New

Value

PropositionClinical: Bundled Payments

21

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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Thank You!

Eric Rogers MEd.RT(R)

Director

BKD Healthcare Performance Advisory Services

erogers@bkd.com

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