3 Contracting Strategies to Accelerate a COVID-19 Financial Recovery

While U.S. providers have suffered profound financial losses because of COVID-19, health insurance companies have actually benefited from the pandemic. Providers require effective strategies to achieve a more equitable balance.

Healthcare utilization has dropped sharply as a result of COVID-19, causing most hospitals to experience a major drop in revenue and margin. But for most commercial payers, lower utilization has slashed claims expenses and created a  huge financial windfall.

For example, United  Healthcare’s net income doubled during the first  wave of the pandemic, jumping from $3.3 billion  (2019 Q2) to $6.6 billion (2020 Q2).a 

Although these market dynamics clearly seem unfair to providers, there is no reason  that providers should simply accept the status  quo. As they struggle to recover financially from COVID-19, hospitals and health systems should  not hesitate to look to insurers to share their  excessive surpluses. 

Right now, the biggest potential opportunities for providers are in contracting with insurers. Financial leaders should focus on three broad areas where they should seek to renegotiate existing contracts and lay the groundwork  for beneficial new partnerships. 

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Turning Conflict into Collaboration: How to Manage Workplace Disagreements

As their organizations make major adjustments to operations, healthcare leaders should be prepared for increased levels of workplace conflict. Fortunately, taking the right approach can turn a conflict into an impetus for positive change.

Healthcare organizations are experiencing change at a rapid pace as technological innovations and alternative payment models greatly impact operations — and people. As a leader, you can expect these changes to create workplace conflict. But you also should be assured that you can manage this conflict, and make it a productive rather than disruptive force, by using the following approaches.

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How to Plan For and Profitably Operate Telehealth Services

“By failing to prepare, you are preparing to fail.” ― Benjamin Franklin

The COVID-19 pandemic has forced every industry to rethink how they do business — and the healthcare industry is one of the most heavily impacted. In this ever-changing set of circumstances, providers are challenged to determine the best way to adapt the delivery of care.

One tool they increasingly are turning to is telehealth services.

The appeal of telehealth right now is obvious. Patients appreciate being able to receive healthcare without risking exposure, while physicians appreciate being able to provide safe and convenient care.

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Telehealth Q&A with Lumina Health’s Lucy Zielinski and Dan Marino

Lucy Zielinski and Dan Marino follow up on Zielinski's successful Virtual Conference presentation by tackling some of the most challenging aspects of telehealth during the COVID-19 pandemic. 

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Lumina Health Partners Aiding Healthcare Heroes During COVID-19

By Daniel J. Marino | Posted in Insights, News

Chicago, IL - Throughout the continuing COVID-19 pandemic, healthcare organizations have taken the lead, tirelessly caring for their patients, our communities, and our nation in unparalleled fashion.

Lumina Health Partners, a long-time advisor for hospitals and physicians who are transforming clinical care to a value-based world, has developed a playbook to help these organizations launch a financial recovery strategy, involving the alignment of key finance, contracting, strategy and clinical leaders.

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Provider Strategies: 5 Steps to COVID-19 Financial Recovery

While physicians as well as hospital clinical and operations staff are focused on patient care and the clinical side of health care, the financial leaders—including CFOs, financial analysts, business, strategy and contracting/payer relations teams—have their own focus: beginning to forecast the pandemic’s effects on the bottom line.

This forecasting and future planning is essential to ensuring the health care system is still viable and strong as leaders manage through the crisis. Understanding and modeling the financial impact is challenging, however, what with so many critical forces in play from all avenues and key stakeholders.

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Lumina Health Partners Launches No Cost Webinar Preparing Healthcare Providers to Use Telehealth Visits to Treat Patients

By Lucy Zielinski | Posted in Insights, News

Chicago, Ill. – Lumina Health Partners is launching a no cost webinar for healthcare providers to guide them in launching telehealth services. This webinar, taking place on March 26 at 10 a.m. CT will offer practical solutions on establishing telehealth services as well as information on how to properly document, code and bill for such services.

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How Healthcare Providers Can Avoid Being at a Disadvantage When Negotiating Risk Contracts

Risk stratification is an effective short-term strategy for providers seeking to negotiate risk contracts from a position of strength.

To gain leverage in risk-based contracting, healthcare finance leaders require a means to identify the true cost of care at the patient level based on actual care services and supplies delivered. But most organizations are years away from possessing such a capability, so their finance leaders require an interim solution to help them gain an advantage in their contract negotiations with payers.

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Managing Today’s Ambulatory Revenue Cycle

There are many mechanisms healthcare organizations can use to accelerate their financial recovery efforts post-COVID-19. 

When examining these mechanisms, financial leaders' questions often boil down to two essential concerns: How effective is it? And how long will it take for us to see results?

The revenue cycle lands at the top of the heap when it comes to quick but highly effective ways to accelerate revenue. It also plays a critical role in improving the patient experience and health of populations while reducing the cost of care. 

By improving revenue cycle efficiencies, healthcare financial leaders can gain a vital "quick win" in their financial recovery timeline.

I recently taught a 2-day HFMA seminar on Revenue Cycle Essentials and KPIs (key performance indicators). Here, I’ll summarize the challenges revenue cycle leaders are experiencing today, as well as key factors for success. 

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Your Healthcare Team Is the Key to Value-Based Care

Value-based care (VCB) requires a keen focus on the Triple Aim: achieving better quality and patient outcomes while bending the cost curve. This is not done in silos; VBC is a team sport that requires collaboration across providers in all settings of care, from the doctor’s office in the ambulatory setting to the hospital to the post-acute setting, including effective transitions from one setting to the next. Coordinating care across the continuum and across all settings is key.

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