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Financial Planning in Healthcare

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Healthcare is a behemoth, unwieldy system.

A convoluted payment structure, complex regulations and exclusive reliance on in-person engagement have long separated it from the rest of the U.S. economy, according to a PwC report.

But this massive industry might be on the cusp of change, as it grapples with a growing skills gap, crippling spending costs and polarizing politics at the state and federal level. Today, even this unique industry is looking more like any other industry, as it begins to adapt to change, champion efficiency and lean more heavily on emerging technologies to find efficiencies and harness data.

The Importance of Financial Management in Healthcare

Massive pressure to cut costs can lead to mishaps in any industry. In healthcare, the stakes of a slip in quality are much higher, as the level of patient care can be eroded by cutting corners. As it turns out, quality financial management goes hand-in-hand with patient safety and quality, according to one study. The study found that many financial metrics, including hospital profitability, financial leverage, operating efficiency, costs and asset liquidity were all influencing factors in care quality.

Broadly speaking, the study noted public hospitals tend to provide lower quality care than nonprofit hospitals, and rural areas typically have lower quality score than their urban counterparts. Why? Likely due to a ballooning effect. Hospitals that earn more profits can finance future investments and offer higher wages, which in turn attract more skilled staff, and the quality of care rises. Rising quality lends itself to better profits and more capital to invest in both innovation and expertise.

Financial Challenges in Healthcare

Financial challenges are the most pressing concern for hospital CEOs, according to an annual survey from the American College of Healthcare Executives (ACHE). Specifically, some of these financial challenges include:

Maintaining Financial Health and Flexibility

Sizable health systems come with sizable fixed costs, which can make it difficult to maintain financial flexibility. And spending is only expected to rise, thanks to economic forces like an aging and expanding population, advancements in technology and clinical approaches, and increased labor costs. Pressure to reduce out-of-pocket costs has boosted the desire to enrich public health systems.

Increasing Outpatient Care

More care is focused in the outpatient arena, but most revenue-generating care comes from facilities-based care, according to Athena Health. This is driven by patient request, financial incentives and innovations that now allow minimally invasive surgeries that no longer require a hospital stay.

Even moving to an acquisition of these outpatient facilities may require most hospitals to face a deficit for the first several years, not to mention the challenge of aligning incentives.

Increasing Costs

Most (70%) participants in the ACHE survey said increasing costs of staff and supplies were an issue for their hospitals. Looming tariffs may also pose issues in supply chains for the healthcare industry. For example, the pharmaceutical and medical device sectors rely on the ability to move raw materials and products abroad back to U.S. buyers. Supplies necessary for producing drugs may also increase in cost, according to the PwC report, particularly chemicals.

Insurance Reimbursement

Overall, the industry has seen a dip in private health insurance, particularly among younger patients, according to a Deloitte report. This is impactful because the longer it takes for the hospital to receive payment, the less efficient its finances are, as the services provided have essentially been a loan. This can also hamper innovation if insurance providers refuse to reimburse emerging procedures.

With healthcare spending on an upward trajectory and pressure from patients, insurers, and governments to clamp down on costs, savvy financial management is paramount to the healthcare sectors success. Everyone stands to benefit from a financially sound healthcare system equipped to weather the disruption and uncertainty to be expected in the next decade.

The Healthcare Manager’s Role in Financial Planning

Achieving a strong financial performance is a goal of every healthcare organization. In pursuit of this objective, healthcare managers often use a multi-faceted approach of proven techniques and best practices, including:

Comparative Benchmarks

Benchmarking is a process of learning good practices from other organizations, implementing the practices and setting measurable standards to track progress. Obtaining and analyzing external benchmark data for costs and productivity can help a facility set its own criteria. Annual reviews enable healthcare managers to identify opportunities for savings and ways to fill budget gaps.

Accurate, High-Performing Budgeting

Based on benchmarks and past performance, healthcare managers set accurate budgets for each department. Low-performing departments may be given targeted cost-per-workload goals and be evaluated more often to help them improve.

Establishing Accountability

Experienced healthcare managers know that reaching target budgets should be an expectation, not a vaguely defined target. They often collaborate with department managers and the finance team, instilling accountability into the process from senior management, down. Improving financial planning for healthcare organizations means that each department is required – not encouraged – to meet its budget.

Tracking and Managing Expenses

By analyzing national statistics and trends for medical practice expenses, healthcare managers can establish their own standards for expenses. Proper tracking of each cost center is essential for proper budget management. Department managers must be held responsible for holding down expenses at every opportunity. Saving money is often easier than bringing in more revenue – and every dollar saved goes right to the bottom line.

Monitoring Variances

By tracking expenses properly, it’s easier to catch variances immediately. Monitoring variances enables healthcare managers to enact corrective action quickly, before a cost center gets out of control.

Achieving Balance

While reducing costs is a primary objective, healthcare managers must also help the organization deliver continuously improving quality, patient satisfaction and employee fulfillment.

How can individuals interested in pursuing an advanced career in healthcare learn the high-level financial expertise required to manage costs and deliver effective care? The targeted education provided by an MBA program with a concentration in Healthcare Management is a great place to begin.

Pursuing an MBA in Healthcare Management Can Lead to a Career

The advanced financial planning and budgeting ability described here are required knowledge for many healthcare administration jobs. While some entry-level healthcare management positions require at least a bachelor’s degree, many employers show preference to candidates with advanced degrees, such as a Master’s degree in Business Administration (MBA). Acquiring specialized knowledge by earning an MBA in Healthcare Management could give you a competitive edge when pursuing senior-level jobs in healthcare administration.

An MBA in Healthcare Management program provides the depth of knowledge required to succeed in health services organizations such as physicians’ groups, hospitals and long-term care facilities. Students enrolled in an MBA in Healthcare Management program are given the opportunity to hone critical thinking, teambuilding and communication skills, as well as to learn the specific concepts and management techniques unique to the healthcare industry.

Coursework may include managerial economics, financial management, healthcare policy, strategic management and organizational behavior. The curriculum is designed to combine practical leadership with a solid understanding of today’s complex healthcare system. Graduates of MBA in Healthcare Management programs are typically well-positioned to contribute to the ongoing sustainability and profitability of a wide variety of healthcare organizations.

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