It is essential to keep the risk at a minimum especially in the ‘percentage of premium’ type of contracts. Read further to learn how introducing some organizational elements can help you achieve this feat as well as improve the profitability, quality, and outcomes of such contracts while maintaining complete compliance at the same time.
Managing the risk in a healthcare setup is a task that can only be accomplished when all the stakeholders involved focus on common goals. Making improvements at an organizational level is the first step toward realizing these goals. Such changes cut across different areas within the organization and can help iron out processes so that the risk level is maintained at the lowest possible level. A strong network and platform can help facilitate the following initiatives to reduce the overall risk quotient:
- Train Front Office To Improve Patient Outreach – With proper training and support, the front office staff can prevent miscommunications, ensure that wait times are short, referrals are processed smoothly and patients are satisfied. All of these tie into the most significant benefit of all – lowered risk.
- Gain A Better Knowledge Of Contracts – Contracts with various entities like hospitals, SNFs, specialists, and ancillaries are a common feature in the realm of health care. Understanding the nuances of such contracts is, therefore, critical. An IPA that has been around for a while usually has substantial reserves of its own and can spread out the risk across a large population. Such a collaboration tends to also have letters of credit and good reinsurance contracts in place.
- Invest In A Robust IT Infrastructure To Reduce Risks – The ability to collect data in real-time and to analyze this data at will can help lessen the possibility of errors. Besides, automated utilization management processes, a centralized referral system, and data-driven case management initiatives are all instrumental in avoiding situations that lead to adverse outcomes in the long run.
- Get The Right People In Leadership Positions – It is critical for those in the driver’s seat to be fully aligned with the goals of the organization. Without a good team in place, even the best of processes and systems will flounder. Well-trained, motivated, and informed professionals who believe in building a learning organization can make the risk in risk-contracts shrink considerably.
- Study Expenses And Profitability Regularly – It is vital to have a good idea of what is going out (expenses) and what is coming in (revenue) to prepare for catastrophic cases. Establishing a system of recovery for invalid claims, cost-reallocations, and subrogation with accounting, data and reporting analysts can mitigate many high-expense items.
Mirra Health Care, a healthcare management organization, can assist you in implementing all of the above steps successfully. Armed with a team of trained professionals with years of experience in the healthcare space under their belt, Mirra® can swoop in and help you reduce your risk quotient, regardless of the type or size of your organization.