Operations & Performance Excellence
Institutional care providers face increasingly complex issues and challenges that can have management, financial, restructuring or legal consequences. FTI Consulting senior professionals are well equipped to help clients meet these challenges and capitalize on short- and long-term opportunities for growth and enterprise improvement.
How We Help
The biggest challenge facing healthcare organizations today is managing high-quality, cost-effective patient care under diminishing reimbursements. Seamless clinical integration and flawless operational execution are essential — they maximize quality clinical outcomes and revenue. Clients turn to our team to deliver integrated approaches to these challenges. We address operational dependencies such as evidence-based medical care, clinical team operational processes and limited resources. When you partner with us, we detect and captures the inherent clinical and financial opportunities within your organization by identifying and addressing the root causes. By systematically coordinating every aspect of a patient’s movement through the care continuum, the result is integrated processes that significantly improve patient care and financial performance.
We provide the following offerings to our clients:
- Diagnostic assessment: Comprehensive assessment of social services, utilization review, care coordination, care transitions, patient flow, length of stay management, and resource management opportunities
- Operational improvement: Improvement of utilization review processes, discharge planning, care transitions, patient flow and care coordination activities to achieve improved quality outcomes, reduced length of stay, and decreased readmissions
- Clinical resource management improvement: Reductions in cost of inpatient care and resource utilization, moving appropriate care to outpatient arenas while maintaining and improving quality of care provided.
- Clinical coverage: Comprehensive assessment and analytical data review of current physician and midlevel deployment and staffing
- Quality and patient safety: Comprehensive assessment of quality, risk management and performance improvement functions and operations
Labor & Productivity
To deliver quality care within today’s tight operating margins, it is critically important to optimize an organization’s workforce, ensuring the right employees are deployed to the right job at the right time. Often, there are opportunities to more fully leverage existing talent. Our expert teams understand hospital, ambulatory and practice operations, and partner with clients to create nimble, responsive, competent and efficient staffing plans and processes. Collaborating with technology partners, we can customize an approach based on client need and environment.
Our clients rely on us to help them sustainably enhance operational productivity with the following approaches:
- Flexible services structured to meet the needs of your organization, such as accelerated productivity analyses and detailed operational reviews and process improvement initiatives
- Benchmarking against industry standards and best practices
- Implementation and optimization of labor productivity management systems
Our professionals are experienced health system operators who work with your managers to improve performance by eliminating non-value-added work and by offering sustainable recommendations. These operational changes often have a positive ripple effect throughout the organization.
Performance Improvement & Transformation
Working in cooperation with senior management, we become your “partner in excellence” in the multiple dimensions of your hospital’s operations — revenue cycle, supply chain, labor productivity, clinical resource management, strategic positions, service lines, quality of care, and physician support. Rely on us to deliver the tools, training, expertise and focused commitment to achieve sustainable change and positive outcomes. This proven approach re-energizes your hospital’s culture by nurturing its most important asset — its people — while building a solid foundation for long-term financial strength. Let us help you:
- Conduct a comprehensive assessment
- Develop EBIDA improvement projections
- Create a detailed management action plan
- Implement a progress tracking dashboard
Operating rooms (ORs) are the engine of a health care system, and financial success is built around effective perioperative/procedural services. These services contribute nearly 65% to the bottom line. Therefore, for facility leadership under tremendous pressure to improve financial performance, it is imperative to improve performance within the operating room environment.
We apply a systematic approach to increase OR capacity and growth by implementing comprehensive solutions inside and outside the OR. Our goal is to increase patient, physician and staff satisfaction while improving quality and bottom line results for the hospital or health system. Healthcare systems of various sizes have successfully enhanced perioperative/procedural performance by partnering with us, significantly improving the most critical operational aspects, such as schedule management, preoperative process management, postoperative process management and support services management.
Our team of experts has many years of experience within the perioperative continuum, healthcare strategy and technology management. We assess and implement solutions related to: strategic volume growth, service line development, capacity management, throughput/performance improvement, day of surgery/procedure cancellation reduction, pre-surgical testing, benchmarking, dashboards and reporting, information system efficiency, block management and scheduling, surgeon/proceduralist scorecards, and policies, procedures and guidelines.
Pharmacy Business Transformation
The average hospital or health system’s pharmacy department budget is comparable to that of a mid-sized business in the U.S. today. Yet within health systems it is often treated as no more than an ancillary department. This significant but often untapped resource offers several expense reduction and revenue generation opportunities that health systems can leverage as part of an overall strategy to improve financial and clinical outcomes. FTI Consulting is a leading-edge provider of pharmacy business transformation services focused on identifying these opportunities and supporting our clients in leveraging their pharmacy operations, processes, staff and strategies.
Clients engage us for:
- Inpatient expense reduction: In-depth analytics of medication utilization, clinical formulary and supply chain data to identify areas of expense reduction and implement leading practice operational approaches designed to reduce inpatient pharmacy costs
- Retail and specialty pharmacy business development: A comprehensive assessment of the financial and value-based factors involved in operating a high performing retail or specialty pharmacy, identification of opportunities to improve cost containment and revenue generation, and review of clinical outcomes such as patient adherence to medications
- 340B audit, compliance and strategic optimization: A full-service approach to managing the 340B drug pricing program through an audit-readiness assessment, and compliance review. This includes identification of strategic opportunities to improve contract pharmacy relationships and provider-based qualifications for program optimization
- Drug diversion risk assessment: Targeted, predictive analytics to identify areas of potential risk as part of the opioid crisis and support of inpatient pharmacy drug diversion monitoring programs to mitigate these risks surrounding providers, patients and employees
- Compliance-related guidance and best practices surrounding The Joint Commission, DEA, HRSA, CMS, FDA and State Boards of Pharmacy
- Revenue integrity analyses focused on outpatient medication billing, providing management with clear insight into medication specific revenues and uncovered charges that may go unnoticed by finance
From operations, compensation planning and valuation, to productivity measures and leadership mentoring, our senior professionals have expertise in every aspect of the physician enterprise. Partner with our experts for tailored services that address:
- Physician practice operations review. Pressures from managed care plans, competitive organizations and other entities are forcing physicians in both individual and group practices to focus on areas strategic planning, contract negotiation, and management and office management. We can provide a comprehensive view into an individual practice or to health system affiliate practices with an eye towards leveraging talent, geography and technology in order to bring a system or organization’s vision to life. Let us help you bring about better alignment with our services that include physician network development, co-management agreements, physician practice acquisition guidance and integration support, and non-provider staffing optimization.
- Physician partnership alignment. New incentive models such as Accountable Care Organizations (ACOs), Pay 4 Performance, quality programs, and gain sharing change the way hospitals and physicians work together and are aligned. Best-in-class organizations have physicians who are aligned, engaged and committed to partnership or affiliate organizational priorities and improvement strategies. Our professionals are highly experienced in developing and executing mutually beneficial hospital-physician alignment models and strategies. Let our experts assist you in cultivating better alignment with services such as physician network development, co-management agreements, physician practice acquisition guidance and integration support, leadership coaching and mentoring, and ACO strategy and development.
- Professional revenue cycle. The lifeblood of every physician practice is its ability to bill and collect for services on a timely basis. We are expert in delivering services that improve revenue management, including: revenue cycle performance benchmarking, net revenue and cash flow performance improvement, patient access assessment and implementation, patient financial assessment and implementation, cash acceleration, denial management improvement, charge capture improvement, managed care contracting and rate benchmarking, and revenue cycle dashboard and workflow tools.
- Information technology optimization. Physicians and advanced practitioners understand that to achieve their clinical and business goals, they must introduce and integrate information technology (IT) with their strategic goals, people and processes. IT is the primary engine for achieving cost containment while positively impacting patient care and enhancing collaboration with other healthcare organizations and practitioners. Our senior professionals have decades of experience delivering optimized IT solutions for individual practices, groups and healthcare organizations.
- Productivity compensation. There are many ways to calculate physician productivity and compensation, including volume-based metrics attached to the number of patients seen or the amount of revenues billed or collected. More recently, physician productivity and compensation are moving toward models based on relative value units and influenced by quality outcomes and overall performance. To analyze operational productivity, our professionals provide the following services: productivity opportunity improvement analysis, establishment of custom staffing standards/benchmarks, productivity monitoring systems, organizational assessment, and fair market value assessments.
- Interim physician group management. Our experienced healthcare professionals can fill the full array of support roles on an interim basis. Whether serving as transitional personnel or supporting a full turnaround, our professionals bring a wealth of management experience to a practice, enabling it to achieve results in an accelerated time frame.
- Professional Performance Analytics. To assess physician group performance and make sustainable change, health systems and physician group practices must be able to receive and analyze raw data and benchmarks against industry standards. Through Physician Enterprise’s Instant Informatics (i2), physician practices may transform their revenue cycle using this billing and scheduling business intelligence software. This standard healthcare reporting solution contains two primary components. The first, healthcare analytics dashboards, provides snapshots of the key metrics that gauge the health of an organization’s provider group’s performance, providing meaningful and consistent statistical feedback to leadership, including variance to budget or target, industry benchmarks and historical performance. These dashboard offerings include: provider performance dashboards; group, department and division performance dashboards; department patient access/scheduling dashboards; and healthcare analytics reporting tools, The second component, PowerPivots, is used for ad-hoc reporting and offers unparalleled drill-down capabilities into financial and patient access details such as transaction, accounts receivable, service analysis, charge lag and scheduling.
- Customer access centers. Customer access centers (CACs) are centralized/consolidated customer-centric service areas that are professionally managed to deliver exceptional quality of service to customers through telephony and other media sources. These centers create the economies of scale to move to 24/7/365 customer access operating hours, employing professionals who measure, manage and continually improve the services provided to customers on a real time and predictive basis. High performing CACs improve customer satisfaction, throughput, revenue and reduce the cost of delivering care and collections. Services range from system-wide scheduling and pre-service activities (pre-registration, authorization/referral, financial counseling, price transparency, etc.) to fully mature centers providing clinical triage, telemedicine, marketing campaigns and population health management outreach. CACs give health systems a competitive advantage while providing a significant return on investment (ROI). We provide a phased approach to CAC development. Phase 1 includes engaging educating and empowering key stakeholders; a current state assessment focusing on gap analysis to best practice; and gap closure roadmap and return on investment from a financial and customer satisfaction perspective. Phase 2 provides full implementation project services including management, subject matter expertise, implementation resources, change management and risk remediation, collaborative design and consensus building to migrate service areas to the CAC, and building a self-supporting and continuous-quality-improvement-focused management team. Phase 3 focuses on hardwiring decision support tools and key performance indicators (KPIs) to refine process to optimize and become an industry leader in defining best practices.
- MACRA/quality/value-based analysis. For years, clients have relied on our team to deliver valuation services that assist them on issues related to regulatory compliance, transaction planning, strategic planning, tax compliance, financial reporting, and litigation/arbitration support. Whether you are entering into various physician-related agreements, contemplating a joint venture, acquisition or divestiture, or responding to a regulatory/compliance investigation, we are highly equipped to provide the valuation services your organization needs.
- Patient access consulting and analysis. We are a market leader in innovative access management model development. The impact from access management improvement initiatives is 1 to 2 percent of net revenue improvement, generally within 12 to 18 months of implementation. These outcomes can be achieved through concentrated efforts to engage all stakeholders (most notably patients and physicians) by implementing workflows and practices to address revenue that impacts activities at the point of initiation in the revenue cycle. Our coordinated approach to access management performance improvement and service redesign focuses on opportunity identification, solution creation and improvement support.
Supply Chain Management
With continued pressure on reimbursement and payment methodologies, healthcare executives must focus on cost reduction more than ever. Non-labor/supply spend is typically one of the biggest expenses accounting for a large share of total operating expense. Awareness and availability of information in non-labor/supply chain has upped the demand for enhanced infrastructure, complex data management, and effective collaboration among executives, supply chain leaders, clinicians and suppliers.
A strong supply chain management program optimizes pricing, standardization and utilization of supplies and services. Industry leaders must achieve new levels of supply chain integration to realize quality, cost and outcome objectives. These leaders rely on our advisory because we understand why it’s imperative to address critical areas to control non-labor-/supply-related expenses, such as harvesting physician preference items (PPI), enhancing supply chain infrastructure, and targeting purchased services. To enable the most savings and improvement in the shortest amount of time, we analyze your healthcare system’s non-labor expenses, clinical and purchased services spend, and complete market comparative analysis.
Our supply chain experts provide the following services:
- PPI management
- Clinical Integration of supply chain
- Strategic sourcing and supply chain process optimization
- GPO strategy — evaluation, selection, and optimization
- Value analysis design and implementation
- New product and technology management
- Clinical preference items
- Commodity supplies
- Service contracts
- Supply chain performance
- Purchased services evaluation
- Contract management
- Service level assessment
- Service delivery model assessment
- Process improvement
- Request for proposal management
- Total cost of ownership appraisal
- Procure to pay process optimization
- Procure to pay recovery audit
- Data management assessment
- Price parity audit
- Item master audit
- Contract data management
- ERP optimization for procure to pay process
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