CHICAGO--(EON: Enhanced Online News)--Huron Healthcare today released perspectives on the Healthcare Information Exchanges and how providers can prepare their organizations for the potential impact of the exchanges.
“Ten Overlooked Opportunities for Significant Performance Improvement and Cost Savings”
The open enrollment period for Healthcare Insurance Exchanges (HIEs) began Tuesday, October 1. Healthcare coverage through the exchanges will begin in January 2014. Over the next three months, providers will continue to face a significant amount of uncertainty: How many previously uninsured Americans will enroll through the HIEs? Will employers drop their sponsored coverage in favor of sending their workforce to the exchanges? What will be the true top-line and bottom-line revenue impact of patients who gain coverage through the exchanges?
HIEs Accelerate the Need for Significant Performance Improvement:
“By improving access to insurance coverage, we believe that there is likely to be a near term increase in demand for healthcare services, in part driven by patients with chronic illnesses who have been deferring care. HIE products are likely to push hospitals and health systems to participate in new narrow networks. This reaffirms the need to continue on the journey to deliver high quality, affordable care. We continue to see opportunities to achieve 20-40% improvement across the enterprise."
Increased Volume from HIEs Highlights the Need for Optimal Efficiency in Physician Groups:
“To accommodate volume from a group of newly-insured patients, physician groups need to be sure they are operating at high levels of efficiency while focusing on expense management. In addition, health systems and medical groups must remove any barriers that either slow or prevent new or returning patients from accessing care providers. This includes ensuring that access protocols for Patient Centered Medical Homes and specialist services are designed to allow quick responses to requests for care. Optimal efficiency in care access and delivery are essential for ensuring that organizations can attract - and more importantly, retain - this potential new source of patients."
Newly Insured Patients Through HIEs May Access Primary Care Through EDs:
“We need to watch and see if some of the trends seen in Massachusetts will hold true for patients newly insured under HIEs. For example, many patients who were newly insured under the Massachusetts state health reform legislation continue to experience problems finding access to primary care physicians. When patients cannot access primary care, they tend to utilize emergency departments as a primary site for care. To prepare for this possibility as exchanges evolve, organizations will need to consider their ED's preparedness for significant volume increases, and their ability to effectively and efficiently manage wait times, staffing and clinical resources."
Revenue Cycle Processes Must Flex to Accommodate New Patient Populations:
“The near-term impact of exchanges on revenue cycle is two-dimensional. First, an influx of consumers who are in new plans will make the identification and verification of insurance more complex and more important for providers. This trend puts further emphasis on effective design and efficiency of access processes. Second, trends suggest that consumers will likely enroll with higher deductible plans, placing increased pressure on hospitals to understand and collect the patient’s liability. This introduces the dynamics of price comparisons, better expectation setting regarding patient liabilities, and more bad debt coming from patient balances. Well thought out and carefully executed process changes will be required to address these emerging dynamics."
- Market dynamics around HIEs are another factor accelerating healthcare organizations’ need to stay laser focused on improving overall performance in the range of 20-40%.
- In particular, HIEs may put additional stress on physician group, emergency department, and revenue cycle operations.
This year, Huron Healthcare has released several reports addressing the important issues facing hospitals, health systems, and academic medical centers including:
- “Inventing the Future of Healthcare: Top CEOs on the Real Work of Transforming the Healthcare Industry,” which provides insights from 30 leading healthcare CEOs on their visions for the future. Read the 2013 CEO Forum report at: http://www.healthcareceoforum.com/.
- “Ten Overlooked Opportunities for Significant Performance Improvement and Cost Savings,” which provides cost saving tips and highlights 10 areas for performance improvement at hospitals and health systems, along with insights on key challenges of implementing change in each of these areas and self-assessment questions providers can use to identify opportunities.
- “Innovation In Action: Insights on Achieving Healthcare Transformation,” which highlights three key areas around healthcare transformation, focusing in particular on revenue transition, clinical transformation, and the underlying strategic changes necessary to put innovation into action from Huron Healthcare executives and Huron Healthcare’s Advisory Council.
For additional information or to speak with one of Huron Healthcare’s experts, please contact:
Jennifer Frost Hennagir
About Huron Healthcare
Huron Healthcare is the premier provider of performance improvement and clinical transformation solutions for hospitals and health systems. By partnering with clients, Huron delivers solutions that improve quality, increase revenue, reduce expenses, and enhance physician, patient, and employee satisfaction across the healthcare enterprise. Clients include leading national and regional integrated healthcare systems, academic medical centers, community hospitals and physician practices. Modern Healthcare ranked Huron Healthcare third on its 2013 list of the largest healthcare management consulting firms. Learn more at www.huronconsultinggroup.com/healthcare or follow us on Twitter: @Huron.
About Huron Consulting Group
Huron Consulting Group helps clients in diverse industries improve performance, reduce costs, leverage technology, process and review large amounts of complex data, address regulatory changes, recover from distress and stimulate growth. Our professionals employ their expertise in administration, management, finance, operations, strategy and technology to provide our clients with specialized analyses and customized advice and solutions that are tailored to address each client's particular challenges and opportunities to deliver sustainable and measurable results. The Company provides consulting services to a wide variety of both financially sound and distressed organizations, including healthcare organizations, leading academic institutions, Fortune 500 companies, governmental entities and law firms. Huron has worked with more than 95 of the top 100 research universities, more than 400 corporate general counsel, and more than 385 hospitals and academic medical centers. Learn more at www.huronconsultinggroup.com.