Healthcare Provider Financial Sustainability
Baker Tilly offers a proactive set of solutions that help identify, mitigate and monitor the financial and operational pain points of healthcare providers. With our wide range of interconnected services, our team can help organizations increase margins, market share and quality-of-care, which in turn facilitates future investments and innovation and contributes to their goal of financial sustainability.
Helping providers on their path to a more financially sustainable future
Healthcare providers across the U.S. have been consistently focusing on improving financial performance. There have been countless challenges, from changes to Medicare to complicated payer contract negotiations to the addition of new revenue models in value-based care (VBC) programs. The effects that were shown by the coronavirus pandemic have also amplified these issues by illustrating the enormous shortfalls that fee-for-service (FFS) models generate when customer event traffic disappears.
At Baker Tilly, we help our clients navigate the changing healthcare landscape by developing sustainability strategies based on your company's historical data and strategic goals, coupled with our comprehensive market knowledge and experience. Our team of healthcare industry professionals leverage these analytics to effectively inform your negotiations, optimize all aspects of your revenue cycle operations, and establish value-based revenue models that minimize FFS risks – setting your organization on the path to financial sustainability.
Our solutions
Baker Tilly's team of healthcare specialists create an interconnected set of solutions that helps providers drive financial sustainability now, and tomorrow.
Managed care dollars can represent a significant percentage of a healthcare organization's revenue. In addition, negotiating and successfully managing FFS and VBC contracts with managed care payers can optimize revenue and moderate expense outlays.
At Baker Tilly, our team of managed care and reimbursement specialists can provide your organization with experience and knowledge in payer contract analysis, reimbursement strategies, contract negotiations and monitoring of payer performance. Our team can also help your organization manage costs and improve patient outcomes by transitioning from traditional FFS payment models to VBC arrangements. Whether your organization is assessing the feasibility of implementing a VBC model of care or if you need help optimizing established VBC arrangements, our team can provide custom solutions for your unique situation.
- Managed care contracting
- Medicare and Medicaid reimbursement strategies
- Value-based contracting
- Continuum-of-care network optimization
An efficient and effective revenue cycle is critical to the survival of any healthcare organization. However, the management of all the activities that support revenue – from the initial intake of the patient to the final payment of their balance – can often be complicated and tedious.
At Baker Tilly, we help you better understand the end-to-end performance of your company’s current revenue cycle operations and how it adjusts to ever-changing regulations and reimbursement models/contracts. With our experience and state-of-the-art technology, we can help provide clear visibility and actionable insight into your current operations/systems, correct problem areas, optimize productivity, reduce costs and increase annual net revenue.
The cost of healthcare is rising, and maintaining a competitive cost profile is critical to the financial success of your business. In today’s ever-changing and competitive healthcare environment, your current-state cost structure will likely not deliver future success.
At Baker Tilly, we are able to help your organization reimagine and implement a wide range of cost containment strategies to help lower the operating expenses of your business. From automating mundane/repetitive operational tasks with automated intelligence (AI) to pinpointing controllable costs and revenue to streamlining workflows and supply chain networks, our team is here to help.
- Healthcare automation services
- Physician resource consumption strategies and productivity
- Clinical transformation assessments and workflow optimization
- Service line analytics
- Supply chain strategy, planning and optimization
- Workforce and labor productivity
The demands from healthcare IT systems are rapidly changing, and a strong network infrastructure is essential to maximizing the performance of enterprise applications (e.g., electronic health records, telehealth services, etc.). Optimal technology operations are also important for appropriate resource allocation and to ensure system agility and resiliency.
At Baker Tilly, we can assist your provider organization by helping evaluate, design, implement, integrate and enhance your IT systems, which can improve your clinical, operational and financial performance.
Continually monitoring and remediating emerging risks is critical to protecting the viability of provider organizations. By proactively detecting and responding to potential risks that threaten the organization and its operations, providers can have confidence they are on track to remaining financially resilient.
With the help of Baker Tilly’s team of healthcare risk advisory specialists, we can help your company address emerging risks, streamline business processes, strengthen internal controls and protect your patients’ critical data.
- Healthcare information security
- Internal audit
- Cybersecurity
- Enterprise risk management (ERM)
- Corporate compliance
As with most industries, growth is key to achieving financial sustainability for healthcare providers. Corporate growth and development and gaining market share is a complex process that requires creative vision and robust knowledge and experience.
At Baker Tilly, we are able to help your organization identify the right future investments and innovations by addressing your strategic growth challenges today. Whether it’s allocating funds for a large-scale IT project or campus expansion, gaining market share through strategic initiatives, or preparing to acquire or be acquired by another company, our team of professionals can assist you with your unique strategic growth goals.
Today’s healthcare enterprises face new challenges and pressures not faced by their predecessors. In order to increase margins, boards need to respond to the rapidly changing healthcare environment with proactive leaders and innovative solutions.
At Baker Tilly, our team can assist in developing board leadership by strengthening your board for present and future challenges. From governance best practices to healthcare fraud and abuse mitigation to fostering a environment that encourages diversity, inclusion and belonging as well as corporate social responsibility, our team can help.
Healthy Outcomes: A Baker Tilly podcast
Listen and subscribe to Healthy Outcomes, a podcast series from Baker Tilly, that discusses hot topics in the healthcare industry. This podcast series brings together Baker Tilly’s team of Value Architects™ and other healthcare industry leaders to talk about issues and opportunities that can help your healthcare organization win now, and anticipate tomorrow.
Featured insights
Health system optimizes Medicare reimbursement rate by reclassifying hospitals
This case study highlights how Baker Tilly helped a health system reclassify select hospitals to maximize their Medicare reimbursement rates.
Baker Tilly enables large health system to realize more than $150 million in incremental revenue opportunities
Learn how Baker Tilly helped guide a health system unleash its market potential by conducting a service line and managed care contracting assessment.
Healthy Outcomes: The Inflation Reduction Act and its effect on healthcare providers
Listen to our Healthy Outcomes podcast episode for a discussion about the Inflation Reduction Act and effect on healthcare provider organizations.