Par for the Course: Why Rightsizing Your Operations to Fit the Level of Reimbursement Can Help You Earn The Best Score

August 2, 2016

// By Dennis Knox //

Dennis KnoxAs any golfer knows, even the most powerful swing won’t get your ball where it needs to go if you don’t follow through on the backswing. This premise also holds true off the golf course. In fact, health care organizations today need to keep the idea of follow-through in mind when they are working toward reaching both big and small goals. And part of the secret to success—both in health care and in golf—may be in knowing when to find the best partner who can help you earn your best score.

The Changing Marketplace

As the Affordable Care Act continues to alter the profile of health care in America, hospitals are challenged to meet the objectives of the Triple Aim and offer access, quality, and affordability in their care delivery even while reimbursement continues to be ratcheted back. In many communities, the hospital is looked upon, and is being held accountable, to be the central source for “hosting” or coordinating much-needed services, including emergency care, skilled nursing and long-term care, community and rural health clinics, adult day care, senior services, mental health, chronic disease management, health education, medical transportation, home health, hospice, and more. This responsibility can be daunting, but clearly in this day and age, hospitals and health systems cannot always be “all things to all people.” To provide this comprehensive level of care, they must partner with other community organizations.

Partnering is one form of “external” rightsizing of your organization’s capabilities. If you liken it to the golf swing, you should “swing within yourself” and just concentrate on completing the swing. Swing within your hospital’s capability and make it innate and a natural facet of your organization that meets the needs of your community.

Exploring “Internal” Rightsizing Strategies

With a large part—if not the majority—of reimbursement for hospitals typically coming from the government programs of Medicare and Medicaid, it can be a challenge to fund operations in your institution. Your efforts to tailor your operations to your level of funding eventually need to be innate—part of the lifeblood and culture of the hospital. It’s definitely a team effort not only by your hospital staff but your medical staff, as well. It requires the expertise of such savvy marketing folks who can help you to communicate your strengths and your needs more effectively, and can help you determine how best to work with other groups around common goals.


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