Healthcare team meeting to discuss financial sustainability

Healthcare Provider Financial Sustainability

Proactively improve and maintain the financial health and outlook of your healthcare provider organization.

Healthcare Provider Financial Sustainability

In today’s challenging environment, it is more imperative than ever for healthcare leaders to take a proactive approach to monitoring financial health.

Healthcare leaders must be able to rapidly identify and target opportunities for service line financial performance optimization, and quickly pivot to creating specific, actionable improvement efforts in order to achieve healthy operating margins.

With advanced analytics at the core of our financial sustainability solution, Baker Tilly’s framework helps our clients discover, optimize and sustain financial health opportunities, including:

  • Providing transparency and actionable insights into direct, controllable cost and revenue constraints​, allowing our clients to review contributing factors to current performance across service lines and identify areas for optimization​
  • Bringing together expense and reimbursement data at the encounter-level​, to support the rapid detection of patterns and/or differences among similar encounter types that can be attributable to variances in areas such as supply or labor activity
  • Enabling flexible and detailed service line opportunity exploration to support long-term goals and inclusive of advanced revenue cycle performance, value-based care optimization, and managed care contract improvements.

It is essential that healthcare providers are being competitively compensated when negotiating reimbursement rates with health plans and managed care organizations (MCOs) if they are to remain, or become financially resilient. Not only must their focus be on the financial language in contracts, but also on the non-financial terms related to performance that can effect compensation.

Through Baker Tilly’s experienced professionals and our licensed IBM® MarketScan® Research Databases – one of the largest proprietary U.S. claims databases – we are able to provide a full range of managed care consulting services and benchmarking capabilities that are tailored specifically to the unique needs and situation of each organization, including:

  • Pricing transparency strategy
  • Payment transformation
  • Marketplace evolution
  • Fee-for-service (FFS) managed care contracting
  • Outsourced managed care support
  • Physician optimization services
  • Mergers and acquisitions (M&A) and joint ventures

With the implementation of data analytics as well as understanding strategic planning and the components of interoperability, healthcare providers are able to make more informed, data-driven decisions to conform their delivery models, operational plans and reimbursement strategies.

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 remain financially resilient.

With the help of Baker Tilly’s team of healthcare risk advisory specialists and our risk advisory, internal audit and cybersecurity solutions, we are able to assist healthcare providers address emerging risks, streamline business processes and strengthen their internal controls.