Re-Engineering Your Hospital Risk Management Department for a Post Health Care Reform Era

healthcare reform

Health care organizations are facing increased pressure, driven by the Accountable Care Act, to move into a value-based purchasing care delivery model. In the world of decreasing reimbursements, not-for-profit hospitals will have to reengineer themselves to do more with less revenue.

Risk management departments are not immune from this pressure. With staffing shortages and decreased resources, risk managers are going to have to work diligently to show their value to the organization.

For more depth on this subject, read my article in the Journal of Healthcare Risk Management, co-authored by Chrystina M. Howard

For more depth on this subject, read my article in the Journal of Healthcare Risk Management, co-authored by Chrystina M. Howard.

Hospital risk managers have a limited ability to determine required department staffing levels, based on current literature and a lack of quantifiable staffing models.  As a health care risk management consultant, I’ve been helping organizations establish a standardized methodology to determine workload and justify staffing levels in their risk management departments—and we’ve been applying this concept with success.

Digging Into the Data

One way to capture value is to quantify workload and how those efforts impact the achievement of hospital objectives. Below is a sample time allocation by activity chart to demonstrate the output of a risk management department employee:

Time allocation of a risk management department employee (chart)

Another result of the analysis is to quantify, using the above data, how many full-time hospital risk management employees should be employed per 100 licensed beds.

A Proactive Approach

Any organization can benefit from being different from their peers. Evaluating risk management activities and workloads is one way to deconstruct, simplify and optimize a department.  Also, it is always better to be proactive rather than reactive and this is especially true in hospital risk management.

Learn More

Later this month I’ll be discussing this topic at Willis Health Care Forum 2013 in Chicago, in a session entitled: Re-Engineering Your Risk Management Department in the Post Health Care Reform Environment.  The panel we’ve assembled at the forum will explore how the effective use of analytics can provide the necessary data to drive department redesign and restructuring and demonstrate the value that can be derived from this analysis.

About Kenneth Felton

Ken Felton is Senior Vice President / Senior Clinical Risk Management Consultant at Willis Towers Watson.  Ken beg…
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