ViewPoints Blog

Whether it’s conducting managed care-themed seminars or speaking one-on-one with executives, I receive a lot of questions about the negotiation process. Everyone wants tips and tidbits they can take to their next payor negotiation.

At this week’s Rural Health Policy Institute in Washington, DC, we presented key findings from our INDEX analysis regarding hospital closures. Forty-seven rural hospitals have closed since the beginning of the decade and in October, we leveraged the Hospital Strength INDEX to evaluate these 47 hospital closures and developed the Vulnerability Index™ with NRHA.

Last week, HHS Secretary Sylvia M. Burwell announced ambitious plans to move from “volume to value in Medicare payments” by accelerating the share of Medicare fee-for-service (FFS) payments that are tied to quality and value and reimbursed through alternative payment models. For rural hospitals in America, the implementation of Medicare’s Value-Based Purchasing (VBP) program has long loomed as a financial time bomb.

While the calendar may have changed to 2015, much of the uncertainty and adjustment to change that defined last year will persist. This prolonged state of fluctuation only further emphasizes the importance of measuring opportunity and risk across specific payors, service lines, and markets.

When I joined iVantage a few years ago, discussions with strategic planners about market share always focused on other hospitals. But today, that conversation is more complex. Urgent care clinics and “doc in the box” facilities are sprouting up in strip malls and inside retail pharmacies nationwide.

The challenges and uncertainty surrounding rural healthcare are well-documented. And having participated at various events this year – from the Rural Health Policy Institute to the NRHA and NOSORH annual conferences and many regional events – I am excited to see that there’s a real sense of collaboration and commitment to solving these complex issues.

Healthcare leaders have long been living in conflicting worlds governed by contrary incentives. What is operationally good for physicians may not be in the best interest of hospital staff or patients. What is best for a patient may not be supported by family or even allowed by state and federal laws. And what is good for the overall health of an organization may not be in its long-term best financial interest.

Market data is vital for making strategic growth decisions, preserving net revenue and securing better outcomes in payor negotiations.But for hospital executives, getting their hands on this data is easier said than done.