How can you be sure that you are putting your financial resources where they will have the most beneficial impact, while also preparing for crises that have not yet occurred (and may never come to pass)?
Robert Simione, SimiTree’s Principal, SVP Consulting, has a wealth of experience in financial management, operations, and data analytics in support of the home health care, hospice, and behavioral health industries. His advice to leaders who are engaged in budget mitigation planning is to focus on four key areas: growth strategy, processes, personnel, and documentation.
1. Growth Strategy: Where Are You Going & How Will You Get There?
Growth without purpose or direction may briefly look like success, but failing to develop a data-driven growth strategy can undermine your organization’s long-term stability.
Or, as Simione put it, “It’s not enough to simply grow. You need to grow in an intelligent manner.”
This involves not only determining your organization’s short- and long-term growth goals but also identifying the internal and external factors that will influence your ability to achieve these objectives.
As you are developing your growth strategy, here are three elements to keep in mind:
- Payer balance: What does your payer mix look like? How much does it cost you to service your payers, and which ones are most likely to help you grow?
- Strategic partnerships: Which of your referral sources should you focus on for the purpose of developing the most beneficial relationships?
- Market intelligence: Are you properly tracking customer demographics, industry trends, regulatory developments, and other concerns that can affect the growth of your organization?
Are you a behavioral health organization?
You might benefit from our data analytics solutions, which empower you to make more informed decisions about your organization.
Are you a post-acute agency?
There are many internal and external factors that could be holding your team back from growth. Read how to increase your home care, home health, and hospice admissions quickly.
2. Processes: Where Can You Find Cost Efficiencies?
Focusing on cost efficiencies doesn’t mean that you will be trying to find ways to cut corners or otherwise sacrifice quality. What it does mean is that you will be taking an honest look at how your organization operates, with the goal of determining how you can improve your overall effectiveness.
Cost efficiencies, Simione said, can be found in three general areas: people, processes, and technologies:
- People: Are you maintaining appropriate staffing levels?
- Processes: What tasks can easily be outsourced?
- Technologies: Have you optimized your use of technology, and are you using the right systems?
“You need to assess every function within your organization,” Simione said. Many agencies are struggling with increased workloads, new data sets, requirements, and more.
Read about the top three struggles with OASIS-E and how to overcome them now. Or, watch this video about common EHR challenges behavioral health organizations have with their EHRs and how you can approach them strategically.
3. Personnel: Are You Recruiting & Retaining the Right People?
In terms of personnel, staffing levels are by no means the only concern that can impact your mitigation planning.
You also need to make sure that you have the right people in the right positions – and that you’re taking the appropriate steps to ensure that these individuals remain with your organization. These are competitive times, and there is no time for staffing shortages or retainment issues. Read our four ways to attract and retain top talent.
Here are three ways you can accomplish this:
- Review your productivity expectations: Have you established realistic standards? Setting the performance bar too low can prompt high-performing personnel to seek more challenging opportunities elsewhere while making unrealistic demands can quickly lead to burnout.
- Conduct a detailed compensation analysis: Is your pay scale commensurate with the duties your employees are performing and competitive with other organizations in your industry? Learn how to build a magnetic compensations model in home health.
- Differentiate your organization from your competitors: You can easily describe your organization’s unique value proposition to potential clients and customers. But have you considered this concept from the perspective of your staff? How are you earning your employees’ loyalty through means other than their paychecks?
“People want to work at a place where they feel like the organizational culture is aligned with their values,” Simione said.
4. Documentation: Are You Leaving Money on the Table?
To maintain a stable organization that can continue to meet the needs of your clients or patients, you need to make sure that you are receiving full payment for services rendered.
Reimbursement, Simione said, is impacted by both the quality of the care you provide and the quality of the documentation that you deliver to your payers.
When training your staff on documentation standards, be sure to emphasize the following:
- Technology can streamline the documentation process, but you should not rely on standardized boilerplate updates. Payers want to see unique information for each patient.
- Your documentation should address the acuity of the patient’s needs, evidence of their progress, and a detailed plan for their future care. Post-acute readers: Did you know that you can improve the quality of care and services provided to patients by outsourcing your QAPI needs? What is QAPI?
- Be sure to accurately describe the full scope of services that you are providing to the patient.
- Keep your documentation current, so it is always ready to be reviewed, even on short notice if necessary.
In addition to preventing your organization from receiving full funding, failure to provide complete, accurate, and timely documentation can also negatively impact your relationship with your payers. Learn how to avoid the #1 claim rejection, insurance eligibility.
SimiTree Is Here to Help
Developing an effective mitigation plan can be a complex endeavor. If your organization can use a hand with any of the areas described above – or if you have questions about a related topic that isn’t addressed here – Robert Simione and the rest of the SimiTree team are here to help.
Call 1.800.949.0388 to speak with an expert today, or fill out our Contact Us form to learn more.