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What Hospitals Must Do to Thrive -- Not Just Survive -- on Medicare Margins
Date:12/1/2011

ents necessary.  Rather, successful margin enhancement efforts will require a balanced approach including each of the following seven levers:

  • Sustained focus on rationalizing labor spending;
  • Standardization of clinical protocols;
  • Development of team-based care models;
  • Best-in-class revenue cycle operations;
  • Demonstrated performance on all value-based purchasing contracts;
  • Gains in effective capacity by improving throughput and investing in less-costly outpatient facilities; and, most importantly,
  • Proactive efforts to manage case mix by re-evaluating service line portfolios, deflecting avoidable medical admissions, and capturing share in procedural service lines.

Health systems preparing their own road maps for financial sustainability in the decade ahead are working with The Advisory Board Company through its Medicare Breakeven Project to quantify the margin impact of forthcoming changes, design comprehensive margin enhancement plans to improve both financial health and market position, and implement proven tactics and care models that yield value in the form of more effective, efficient service delivery.   

Meeting the New Performance Standard

"In every scenario we ran, hospitals and health systems will need to gain several percentage points of margin improvement across the next five years from vigorous outpatient management of chronically ill patients, while concurrently backfilling inpatient capacity with procedural cases," says Mr. Cassels. "Unfortunately the demand for inpatient surgery just will not grow like the demand for inpatient medicine, so these replacement cases will come from capturing a mix of organic growth and shifts in market share."

Despite the analysis, Mr. Cassels is hopeful: "While there is no getting around the fact that this represents a challenge for providers, the good news is that organiz
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SOURCE The Advisory Board Company
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