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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
In this Business Profile, Bruce Haupt, president and CEO of ClearBalance, discusses how a patient loan program can increase patient collections, reduce bad debt, and speed cash flow.
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.
In this Business Profile, Jerry Bruno, principal with Deloitte Consulting LLP, discusses the importance of choosing revenue cycle solutions that help an organization meet the challenges of a quickly evolving healthcare environment.
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.
In this business profile, Lane Jackson, a partner in the Grant Thornton LLP Health Care Advisory Services practice, with extensive experience in overseeing system implementations and revenue cycle reorganizations, discusses best practices for elevating revenue cycle performance during an EMR implementation. Grant Thornton LLP is a sponsor of the Large System Controllers Council Affinity Group.
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.
In this business profile, Amy Gross, senior vice president of Key Government Finance, discusses the benefits of private placement transactions to support large-scale financing projects.
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.
In this business profile, Doug Polasky, executive vice president at Xtend Healthcare, explains the importance of having sound workflow processes in a consolidated business office to ensure optimal performance and reduce costs.
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.
In this business profile, sponsored by SSI, Jay Colfer, vice president of sales and marketing, shares how patient access solutions are reversing the trend toward increased bad debt resulting from the rise in high-deductible consumer health plans.
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.
In this business profile of Deloitte Consulting, Matthew Hitch and David Betts explore the potential benefits of elevating the customer experience and outline strategies to change service delivery.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
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.
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.
Announcements from several commercial payers and the Centers for Medicare and Medicaid Services (CMS) early in 2015 around increased efforts to form value-based contracts with providers seemed to point to an impending rise in risk-based contracting. Rather than wait for disruption from the outside in, health care providers are now making inroads on collaborating with payers on various risk-based contracting models to increase the value of health care from within.
Yuma Regional Medical Center (YRMC) is a not-for-profit hospital serving a population of roughly 200,000 in Yuma and the surrounding communities.
Before becoming a ZirMed client, Yuma was attempting to manually monitor hundreds of thousands of charges which led to significant charge capture leakage. Learn how Yuma & ZirMed worked together to address underlying collections issues at the front end, thus increasing Yuma’s overall bottom line.
Kindred Hospital Rehabilitation Services works with partners to audit the market and the facility’s role in that market to identify opportunities for improvement. This approach leads to successes; Kindred’s clinical rehab and management expertise complements our partners’ strengths. Every facility and challenge is unique, and requires a full objective analysis.
As the critical link between patient care and reimbursement, health information enables more complete and accurate revenue capture. This 5-Minute White Paper Briefing shares how to achieve cost-effective revenue integrity by your optimizing HIM systems.
Speedier cash flow starts with better CDI and coding. This 5-Minute White Paper Briefing explains how providers can improve vital measures of technical and business performance to accelerate cash flow.
Qualified coders are getting harder to come by, and even the most seasoned professional can struggle with the complexity of ICD-10. This 5-Minute White Paper Briefing explains how partnerships can help improve coding and other key RCM operations potentially at a cost savings.
The point of managing your revenue cycle isn’t just to improve revenue and cash flow. It’s to do those things effectively by consistently following best practices— while spending as little time, money, and energy on them as possible.
How Lucile Packard Children’s Hospital Stanford increased payments received within 45 days by 20% and reduced paper submission claims by 70% by using ZirMed solutions.
The reasons claims are denied are so varied that managing denials can feel like chasing a thousand different tails. This situation is not surprising given that a hypothetical denial rate of just 5 percent translates to tens of thousands of denied claims per year for large hospitals—where real‐world denial rates often range from 12 to 22 percent. Read about how predictive modeling can detect meaningful correlations across claims denials data.
Emergency Mobile Health Care (EMHC) was founded to be and remains an exclusively locally owned and operated emergency medical service organization; today EMHC serves a population of more than a million people in and around Memphis, answering 75,000 calls each year.
Since the Physician Quality Reporting Initiative (PQRI) introduction, CMS has paid more than $100 million in bonus payments to participants. However, these bonuses ended in 2015; providers who successfully meet the reporting requirements in 2016 will avoid the 2% negative payment adjustment in 2018, so now is the time to act! Included in this whitepaper are implications of increasing patient responsibility, collections best practices, and collections and internal control solutions.
Getting paid what your physician deserves—that’s the goal of every biller. Yet even for the best billers, achieving that success can be elusive when denials stand in the way of success, presenting challenges at every turn. Denials aren’t going away, but you can learn techniques to manage and even prevent them.Join practice management expert Elizabeth W. Woodcock, MBA, FACMPE, CPC, to: Discover methods to translate denial data into business intelligence to improve your bottom line, determine staff productivity benchmarks for billers, and recognize common mistakes in denial management.
Physician practices must improve organizational efficiency to compete in this era of reduced reimbursement and escalating administrative costs.
Many healthcare organizations are pursuing next-generation health information systems solutions. Learn more about Navigant's work with University of Michigan Health System.
The proper implementation of healthcare information technology systems is crucial to an organization’s financial health.
HFMA’s Buyer’s Resource Guide is a comprehensive vendor directory that helps healthcare finance professionals find products and services.
HFMA's print, email, online, and mobile opportunities provide you maximum reach and impact. We will work with you to build a plan that meets your needs. Contact a sales rep.
HFMA's MAP App is a web-based application that helps organizations track results, compare data with peers, and improve revenue cycle performance. Schedule a demo.
Access all the tools and resources you need to develop your personal skills. Organized into distinct career levels, this tool creates a career plan specific to your career goals.
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