Healthcare providers have long used both outside and internal management. However, it is more often the case that healthcare has been an industry that has relied heavily on internal staff to get its work done in the past and, in theory, saved itself what is perceived to be the high cost of consulting.
Although this can and does work, there have been enormous changes across healthcare the last 5 years in particular. This has been driven considerably by the implementation of the Affordable Care Act, but there are other factors – quickly changing patient demographics and technology, to name just two.
In such circumstances, external consultants may not only make more sense but could also be a way to both survive and thrive in a business where direct and new disruptive competition in this very fast changing world.
So, if the general need for external consulting is now much more compelling than it has ever been, what tangible benefits can a healthcare provider expect? How do they ensure that they hire people who can truly add value?
Most reputable management consulting firms will meet clients without any costs for a first meeting, and offer explicit ideas about where they may immediately be able to add value. In order to get the most from these first meetings, its important for a healthcare provider of any kind to know what type of consultant they may most need.
Although some large consulting companies may cover many areas, the vast majority of consultants specialize in one or two of seven key business functions:
Strategy and business consultants aim to add value to make sure the overall strategic approach and goals of the healthcare provider are well-crafted and fit for purpose to succeed in the future. This may include an assessment of the current business model, the quality of the value proposition, and any needed changes to the current vision, mission and values.
This is often most important when a provider is either struggling to compete or has growth plans of any kind (and therefore wants to avoid costly mistakes).
Revenue Cycle Consulting
While all healthcare organizations need to manage their revenue flow tightly, healthcare providers that have large or dominant reimbursable revenues on the payer side often need considerable help with keeping the revenue cycle efficient.
At the most extreme this can be a “sink or swim” issue (especially in the light of even more billing codes to have to use) but even when it appears to be relatively under control, it is not unusual for external consultants to be able to accelerate payments significantly and make large cash savings quite quickly.
There was a time when a healthcare providers’ “market” or customer base was largely determined by their location, and faced little or no competition. Not only have these days long ended, but patient needs and expectations are now very sophisticated.
Every provider needs to fully appreciate not only the different needs and risks of their current population served, but also who else could be a “profitable” consumer of products/services they provide. The marketing consultant can create strategies to access and appeal to these new customers.
Consulting across the operational healthcare area is essentially concerned with how effective and efficient the healthcare providers’ business processes function. This can be a very big deal in time and resource realms and result in much waste in the system that has significant profitability implications if not addressed.
Strategies such as total quality, lean management, just-in-time, six sigma and supply chain optimization have all made their way into healthcare somewhat, but there is much specific operational best-practice available from other industries that has not made it into healthcare. Process and operational consultants are often the best source for this.
Even as little as a decade ago, technology consulting was probably the smallest field of these seven and mainly involved IT system selection, installation and support.
Today, the scope of technology has expanded, and is now much more focused on effective data management and security, electronic medical record systems consulting, integration of devices, and even how providers may benefit from very new technologies such as machine learning systems, artificial intelligence and virtual reality software. This can all be very expensive and time consuming to install and protect so getting it right early is a huge benefit.
As much as we have considerable technology and systems across healthcare today, it is still fundamentally a people business. Consider that healthcare is often the largest collective employer of people in a given country!
This means that healthcare providers need best-practice ways to hire, develop, retain, and promote the right employees at all levels. Today, these people may come from all over the world, be socially diverse, and come from four very different generations.
They will need good management and policy to work well in teams with minimal conflict. Healthcare has always attracted people who want to help people to be well but the strategies to help them to coordinate their efforts to do this, once again, can come from many other industries that are doing this more effectively.
Regulatory and Legal Consulting
Due to the sensitive nature of healthcare, the industry is regulated by a considerable number of laws, to which providers need to carefully adhere. Not only does this include frequently passed new laws, but many amendments to existing ones, which can have dramatic affects on people, process, and profits.
The laws and regulations in healthcare are some of the most voluminous and complex of any industry. Experienced consultants can often quickly help to spot where there are gaps and risks to a provider and when sound legal knowledge needs to be brought in.
As a whole, healthcare is a large and complex industry, which has done well in the past to rely mostly on internal resources to help manage the business and organizational challenges they face.
However, the big changes and risks that now have to be addressed may benefit from an external and out-of-industry perspective. External management consulting is not only a good path forward to do this work, but can be a value adding approach – especially if a provider is clear about the skill set they are most in need of bringing in. As the first meeting is usually free, what has any provider got to lose?
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CEO-RX4 Group-The Business of Healthcare