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Customer Experience and Design

HIMSS 12: Healthcare Analytics & BI “Follow the Money”

On the floor of HIMSS, day one – late afternoon and not even half way through the booths. Thus far I have felt much like Alice in Wonderland, LOST and wondering which way to go!

As I made my way through the crowd, I stumbled into a booth where the banner “Follow the Money” was displayed; it intrigued me (which, I guess, is why they had the banner) like a moth to a flame. So I walked around a bit and then I realized what this was all about – this was a vendor focused on Business Intelligence (BI) Analytics.

Standing before me was a tall, well dressed executive banker looking gentlemen explaining to a couple of Hospital CFO’s why BI Analytics was so important to them. I became a fly on the wall and caught one of the most compelling explanations one could want to share with the likes of a Hospital CFO.

The story focused on what the current healthcare financial leaders should be collecting information on for the foreseeable future – initiatives that will help them increase their organization’s margins in 2012 and beyond, such as:

  • Payment policing and standardization of contract requirements
  • Contract performance modeling
  • Shift in volume and cost risk to hospitals
  • Consumer-directed health plans, price transparency and pay for performance
  • Health plan consolidation
  • Value-driven health care

As the discussion continued it was brought out by the vendor that the healthcare industry is at a crossroads. Healthcare spending is growing three times faster than wages and is expected to double from current levels to exceed $4 trillion by 2016, according to a Health Affairs article. As he went on, he pointed out that there is tremendous pressure on key industry stakeholders (here is where the two CFO’s started to become fidgety) to mitigate this cost growth.

This cost pressure means that hospitals need to extract additional efficiencies out of their operations and spend more time on revenue strategies. Hospitals will need to work with their respective leadership teams toward achieving more controlled growth in medical spending. Stakeholders, including government, employers, payers and providers are forging ahead with several models to contain the growth of healthcare costs and ensure quality of care. Price transparency, consumer-directed health plans (CDHPs), pay-for-performance (P4P) programs, health savings accounts and the payment incentives of the Centers for Medicare and Medicaid Services (CMS) are all moving healthcare in that direction. Regardless of which model reigns, in the future a greater emphasis will be placed on the value of healthcare services with the demand for transparency of service price.

These cost-saving and cost-shifting initiatives require hospital financial and clinical leaders to spend more time analyzing the data, but how is this to be done with the tools currently being used by the overwhelming majority of hospital financial systems? I was holding my breath waiting for the answer, when the vendor emphasized – YOU CAN’T! Now he had everyone’s attention…

Then, like a bolt of lightning, the vendor uttered the word, no different than that memorable scene in ‘The Graduate’ when, (I am sure it was this vendors dad who said this in the film) at a party, the vendor told Dustin “in a word Plastics.” So when the current vendor uttered the word ANALYTICS – we got it. To make all this happen he said, “you have to follow the money.” And how do you do that? You do it with Healthcare BI Analytics.

The moral of this story for me was get back out on the floor and search out those consultant firms that specialize in Healthcare Analytics because one thing is for sure: we need to better enable our healthcare financial leaders to FOLLOW THE MONEY better! And the way to do that is with BI Analytics.

Signing off from the floor of HIMSS 2012. Now go find that firm who will help you Follow the Money!

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