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Customer Experience and Design

Healthcare and Hybrid Costing

Traditional and innovative costing models can enhance or inhibit accuracy and efficiency in costing processing. An introduction of a hybrid system may fortify the acceleration in new regulations and modifications to existing operations and methodologies. Since both organizational costing methods and service line billing and payment systems have intrinsic advantages, a hybrid cost methodology would include the intersection area that would fulfill clinical and financial aspects that are not yet optimized by traditional cost or clinically focused service line modeling. Foundational intersection areas would potentially include the bridge between capturing chronic disease management in conjunction with hospitalizations, prevention of acute disease manifestation in reduction of emergency room services, and provider specific billing and payment that highlights expertise and efficiency of patient management.

In more detail, a hybrid cost methodology can be broken into detailing definitions of what is termed as allowed, billed, and paid, that is accompanied by a continuous process of verification and remodeling. A data modeled bridge between key service line data elements to revenue objectives at an organizational level will have core objectives of improving clinical outcomes, while improving on current cost methodology deficiencies. The initial layers of a hybrid cost methodology system are reliant on mapping core service line data elements with similar elements in organizational financial methodologies. A concurrent mapping enables a real-time assessment of clinical and financial health of the organization, while opening channels for regression, predictive analyses, and implementation.

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David Hastoglis

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