A Data-Driven Approach to Healthcare Cost Savings and Improved Clinical Quality

To keep up with the rapid pace of industry change, healthcare organizations can no longer operate under “business as usual” assumptions. Organizations manage financial, operational, and broad business disruption on a near-daily basis and must evolve into a multi-tasking enterprise to keep up, reduce costs, and improve clinical outcomes.

Multiple Business Imperatives to Manage in Healthcare Today

What are healthcare organizations up against? Several key business imperatives must be managed in healthcare today:

1. Face the pressure of COVID-19. Unprecedented business and operational disruption drive financial pressure to recover.
2. Address competitive threats. New, well-funded competitors enter local markets, increasing competition based on convenience and cost.
3. Transition to value-based care. The relationship of cost to quality is vital to understand as organizations take on more financial risk.
4. Bend the cost curve. With downward pressure on reimbursement, cost transformation is critical to long-term financial stability.

Cost transformation is a strategic priority for many organizations, but achieving results is a challenge. Successful cost transformation requires coordination across financial, operational, and clinical teams.

Finance’s Strategic Role in Cost Transformation and Clinical Quality Improvement

Finance teams play a multi-faceted and increasingly strategic role in cost transformation and clinical quality improvement. As a strategic advisor to the business, finance must understand and communicate the financial realities and impacts of every strategic decision, which requires robust data — such as costing or comparative data. This helps finance teams deliver key insights based on real information to operational and clinical leaders, so the various departments can work collaboratively to identify, quantify, and prioritize performance improvement initiatives.

Despite the different lenses through which finance and clinical teams view improvement opportunities, successful transformation requires both teams work together in identifying the opportunities that will have the greatest impact.

The Partnership Between Finance and Clinical Teams

On the clinical side, responsibilities look a little different. Clinical performance improvement team members advocate for patient care, ensuring each patient receives timely, safe, and effective care. These teams also drive outcomes across patient populations, engage providers, and improve the management of high-volume, high-risk, and high-cost clinical conditions.

Clinical teams must also uphold their end of the partnership with financial and operational leaders. Together, these teams can take an interdisciplinary approach to value-based care. Optimizing patient outcomes has a direct impact on financial performance. Centralizing data, analytics, and reporting is vital to managing several previously mentioned business imperatives — transitioning to value-based care and successful cost transformation.

Data’s Role in Cost Transformation and Performance Improvement

Data plays an integral role in care delivery and the organization’s overall performance, yet many healthcare organizations struggle to provide useful performance information to clinical teams. A Syntellis report revealed that 87% of leaders view clinical quality data and insights as critical to their performance reporting initiatives and goals, yet 86% indicated clinicians lack actionable information on unwarranted care variation and cost/quality impacts.

A balanced approach to data, analytics, and reporting is key to a successful partnership. Teams must view all components equally rather than focusing on one area while allowing another area to fall short. For example, clinicians need access to cost information to see how the bed size decisions they make can help move the needle. On the other hand, financial teams need data to understand how patient outcomes impact profitability. Reporting and visualization tools help communicate performance across teams and bring that information together from disparate sources.

Clinical data should be standardized, trusted, actionable, transparent, drillable, and severity- and risk-adjusted. Only then can operational and finance teams leverage clinical data to improve decisions around quality and financial performance improvement.

Axiom Enterprise Decision Support Leverages Clinical and Financial Data to Fuel Insights

Integration of data and metrics from disparate systems helps clinical and finance teams solidify their partnership. An effective data management system also incorporates engines to transform, enrich, and tag encounters with measure detail, including readmissions, mortality rate, length of stay, and more.

Understanding the incremental impact of quality of care on financial performance is possible with the help of Axiom™ Enterprise Decision Support (EDS). Offering role-based dashboards, EDS is designed to help finance teams succeed under value-based care while giving clinical teams access to the data they need. To learn more about how to leverage clinical and financial data to reduce costs and improve quality outcomes, request a demo of our Axiom EDS solution.