Using innovation to address healthcare's pressing challenges.

Our goal is to provide the next generation of technology and services so healthcare organizations can rapidly accelerate their performance improvement goals, uncover hidden revenue potential, cut costs and expenses, and achieve sustained viability. In our experience, better financial practices benefit all aspects of healthcare. Providers are more effective at achieving their primary mission of providing quality patient care. While health plans are able to work with their members to stay healthy while receiving the best healthcare at the lowest costs.

Performance Improvement: A Means to an End

Whether you're a non-profit or for-profit hospital or health plan, performance drives the long-term viability of your enterprise. Sustainable operating margins are required to keep the doors open, unless alternatives sources of capital are available. Driving sustainable operating margins requires outstanding performance across the entire system - in admissions, revenue operations, cost management, payer relations, resource utilization, labor relations, procurement, supply chain management, and capital spending for providers and membership, provider relations, medical management, disease management, contract negotiations, and claims adjudication for health plans. Historically, healthcare institutions have struggled to gain timely visibility to meaningful metrics. As a result, performance has suffered. The results manifest themselves in the form of frustrated executives, ill-informed boards and unnecessary poor financial results.

The Emergence of Performance Management

In the past decade, a new field of Performance Management has emerged. Healthcare organizations embracing the discipline want flexible performance management frameworks that offer a starting point to measure and manage the business, with the ability to tailor the framework to their specific organization
and mission.

Unfortunately, the IT infrastructure implemented in the last 20 years was never designed to facilitate performance management. Built for transaction processing, a variety of system “silos” can make even the most advanced health systems a challenge to navigate, let alone develop performance metrics. Traversing
through multiple financial systems, contract systems, membership and provider databases can be a challenge for even the more intrepid power user, let alone "mere mortal" executives, managers or line staff. The result? Knowledgeable professionals are dedicated to non-value added data gathering and preparation, rather than analysis and taking informed action to improve performance.

The First Generation Performance Management Falls Short of Its Promise

The first generation of performance management solutions was created in the mid 1990s. Using a combination of ERP systems, data warehouses, scorecards and dashboards, large IT projects were launched. Consultants typically designed the metrics and large IT project teams worked on site for months or years to bring the system to life. A variety of technologies and software needed to be purchased, and
custom software programming and testing was performed, taxing even the most advanced IT shops.

Some projects resulted in successful initial deployment, but more often than not, the large project approach failed. More importantly, the systems were expensive, requiring years to deliver a positive return on investment. Only the largest institutions could consider developing them. And once up, they were inflexible and hard to change. Requesting a new metric could take months to implement. Once implemented, the usability of these systems left much to be desired. The consultants left exhausted but happy. Their clients felt like there must be a better way.

Introducing the Next Generation - Performance OnDemand

A new, disruptive technology is sweeping the software industry. The OnDemand model, also called software-as-a-service. While first-generation Application Service Providers (ASPs) simply "hosted" their on-premise software offerings, MedeFinance saw the opportunity that OnDemand represents to healthcare - an industry constantly struggling with adequate IT resources. Instead of healthcare organizations having to create their own systems, the system could be developed once and support multiple entities, but still allow for unique tailoring and security by enterprise. The development costs and maintenance could be shared across multiple healthcare systems - and those dramatic operating efficiencies shared with the client base.

Even more importantly, because the system is already built, no technology or software needs to be purchased. No custom coding is required to get started. Because the application was designed for rapid tailoring by the client, 85% of requests for new performance metrics or views are completed in less than 1 week. Those that take longer are typically a function of how long it takes to find the source data, not how long it takes to tailor the system. The result? A sustainable, adaptable, OnDemand platform to manage performance with real-time data on a daily basis.

Creating a Collaborative Culture of Sustained Improvement

We continue to listen to our clients to find new ways to apply the technology. We don't pretend to have all the answers, but we are inspired by our clients' ideas and successes. Because true success is the sum total of many individual efforts, we've continued to integrate the best practices and most advanced technology available. And with our partnership with The Advisory Board Company, many of our clients get the best of all worlds - advanced healthcare best practices, advanced technology, and "just right" client services - on site or online and always OnDemand.

In working closely with our clients, we have health system CFOs who are asking for enterprise-wide performance management solutions. PFS Directors and Denied Claims Managers are asking for better ways to manage their relationships with payers. Chief Medical Officers want better ways to manage medical costs and clinical effectiveness. Health plan executives working to build solutions to better their
provider relationships, contracts, and communication. They have great ideas, and we're actively collaborating to quickly bring new, next-generation healthcare solutions to market.

Next, meet our executive team, or learn more about our client success.