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In this Business Profile, Lisa Schneider, CFA, managing director, non-profits & healthcare systems at Russell Investments, offers insights on today’s asset management environment and what to look for when working with a solutions provider to optimize a healthcare organization’s portfolio strategy and manage risk.
Russell Investments is a leading provider of multi-asset investment solutions, managing more than $250 billion worldwide. The healthcare industry represents 15 percent of the assets Russell manages for U.S. institutions. In fact, we have more than 30 years of experience advising and implementing investment programs for hospitals and health systems that range from small community hospitals to those that rank among the nation’s 50 largest not-for-profit health systems. Although we do advise and consult, the core of our business is actively managing assets as a co-fiduciary for outsourced pools of capital.
Managing complexity! Increasingly, clients tell us they are facing serious time and resource constraints due to the Affordable Care Act, as well as other regulatory and legislative challenges. As organizations evolve to make a successful transition from volume- to value-based care, CFOs are highly focused on managing the impact of changing reimbursement rates, revenue cycle management, and related IT challenges.
In addition, just as financial managers are finding that they have less time and fewer resources available to focus on investment portfolios, the market environment has grown increasingly complex and their investment portfolios need more attention than ever in order to maximize returns and manage risk.
A decade ago, when the landscape was more stable, a “set-it-and-forget-it” strategy may have been enough for asset allocation. But now, market volatility demands real-time portfolio management—the ability to react to changing market conditions. Making portfolio management decisions at quarterly committee meetings leaves too much on the table in terms of missed market opportunities and less than optimally managed risk.
Our outsourced management solution affords the CFO and treasury staff the breathing room they need to focus on larger organizational issues while Russell manages the details. In our experience, it’s possible to not only delegate many current duties to a trusted provider, but also to dramatically enhance the operation and oversight of the investment program at the same time.
We act as an extension of our clients’ staff, not only advising, but actually implementing the investment program and helping clients fulfill their fiduciary duties. Russell can take on responsibility for decisions all along the value chain of the investment process, from selecting investment managers, designing strategy, implementing that strategy, and even assuming discretion over asset allocation, if desired. This enhances the oversight of the program and ensure a robust governance structure is in place.
By accepting fiduciary responsibility for decisions that are delegated to us, Russell accepts increased accountability (versus a consultant, who may make recommendations only). We start by listening so we understand your goals, and then we customize a program to meet your needs.
Best practice in managing portfolios requires multiple areas of expertise. You need rich capital markets insights, a really deep program of manager research, strategic asset allocation skills that will let you identify the exposures that will help deliver the portfolio outcomes you need, and the ability to bring these all together effectively and efficiently.
Portfolio managers must be experienced in building and then managing multi-asset portfolios—which is very different than just recommending a manager. It’s important to have the implementation expertise of multiple managers as well as index expertise to design specific market exposures in a portfolio.
When selecting a solutions provider, we think there are some key questions you should ask to ensure that their capabilities align with your needs. For example, if you’re looking for someone to take on accountability for investment decisions, does the organization draw the line at offering advice only? If they do offer investment implementation and asset management, how long have they been in that business?
Other important questions: Will they limit your investment options through the use of captive programs that limit choices? Will they dedicate portfolio managers to actively manage your assets? Are they focused on beating asset class benchmarks at the expense of outcomes that matter most to your organization? Performance is good, but progress toward your financial goals is better! You can exceed your return benchmarks in every asset class and still lose ground in funded status, days of cash on hand, and other goals that matter most to your organization.
Find out how strong they are in manager research and portfolio implementation. You deserve industry-leading research and award-winning implementation. Your committee deserves thought leadership and access to innovative, results-oriented strategies. And last, how customized is their customized approach? Can they tailor the level of outsourcing discretion to suit your committee’s appetite? Will they incorporate only those program elements that you want, without charging you for those you don’t need? These types of questions are key, and can help you identify an outsourcing provider whose capabilities are a good match for the needs of your organization.
Our website has three excellent case studies featuring a health system, regional hospital, and healthcare facility that detail a specific challenge each type of organization was facing, the strategic solution that was implemented, and the results achieved. I think these really demonstrate the Russell difference.
Readers may also be interested in a reprint of my recent interview in Becker’s Hospital Review (“How Should Health Systems Manage Their Investments Today?”), which appears on the website, as well as the article “Fiduciary Solutions for Hospitals and Healthcare Systems: Outsourcing Options for Your Investment Program.”
Publication Date: Tuesday, July 01, 2014
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
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