AArete is your partner for new approaches to increase profitability, allowing you to focus on providing the best quality of care. Our approach to healthcare provider consulting helps health systems, hospitals, and provider groups navigate the industry changes introduced by evolving payment models, the increasing demands of integration, and the need to do more with less. With AArete’s unique blend of industry-leading market intelligence, data analytics capabilities and subject matter expertise, we arm providers with proven ways to drive profitability, optimize revenue and bend the cost curve. Our healthcare provider solutions support and enhance efforts involving value-based contracts, supplier relationships, staffing alignments, strategic program investments and core operational improvement.
Strategic Cost Reduction
As providers seek new ways to reduce their cost to deliver care, leading organizations are embracing a clinically integrated supply chain in support of their healthcare supply chain management. Going beyond measuring individual supply component costs, the clinically integrated supply chain examines the total cost to deliver patient care based on their implant and supply decisions (supply costs, implant associated services, drug costs, clinician time, therapy, and other direct costs) and measuring these against cost, revenue, quality of care, and clinical outcomes. Many of these costs are not visible because they are either not documented or they are incurred within a different component of the care plan. This is especially important when contracting for bundles and value-based care. By taking this holistic view, providers can identify these hidden costs and understand how to manage them for revenue improvement and payer relationship optimization. For example, if you achieve lower unit cost for an implant, but the implant requires use of proprietary software or component or results in a longer stay or additional physical therapy visits, you’ve unknowingly added hidden costs and likely increased the chance of adverse events.
Achieving a clinically integrated supply chain may sound straightforward but reducing non-reimbursed charges while keeping a focus on clinical outcomes, revenues, and quality can be difficult in practice. The primary challenges in healthcare supply chain management come in the form of data management and insightful analytics. Our experience supports that providers are willing to make change when presented with accurate information, but with data spread among the EMR(s), finance, revenue cycle, and other systems, it can be difficult to aggregate and align all the cost, clinical, and reimbursement data. Here is where AArete’s mission to humanize data—and our experience linking sources of disparate data and connecting them to actionable business outcomes—becomes so valuable.
AArete has a long history of helping providers—from small regional hospitals and ambulatory surgery centers to the largest health systems—decrease operating expenses and increase revenue. We apply our extensive data strategy and analytics capabilities, deep market intelligence and bottom-line focus to help you to drive these hidden non-reimbursed costs.
Year after year, healthcare providers address the same systemic revenue cycle problems while making little headway in resolving them because they rely on the same old approach: throwing brute manpower at remediation.
AArete’s approach to healthcare provider consulting addresses these challenges differently. We rely on detailed analytics to identify your discrete problem areas and make those changes on the front end of the process — so the problems never reappear. Our approach enables us to identify areas such as denials and outlier cases within your revenue cycle process (such as scheduling, clinical documentation and coding, billing and collections, etc.) that warrant further investigation. As we identify trends, we target these outliers for remediation and process modification.
Alternative Payment Models
Among the many dramatic shifts affecting the healthcare landscape today, perhaps the most powerful is the switch to alternative payment models. While the transition has been at a modest pace, it’s clear that healthcare providers must either incorporate these new model components, or put themselves at significant financial risk.
AArete is your partner for planning a go-forward strategy that is both directionally aligned with the emerging models, as well as informed by the current realities of your volumes, rates and reimbursement. With our industry knowledge of value-based contracts, we help you identify the most valuable metrics to install in your new payer agreements and design a tailored solution for implementation and performance monitoring. Plus, we help you negotiate contracts with your payers, providing detailed analytics to support the baselines, targets and goals of these value-based agreements. With our extensive analytics capabilities, we’re able to inform, monitor and manage these relationships as they evolve.
Data Driven IDN Optimization
Healthcare provider-facing competition is coming from other modalities including integrated delivery networks (IDNs) serving your geographic area, non-traditional clinics, and ambulatory surgery and urgent care centers, in addition to physician and patient preferences for outpatient settings. Healthcare providers are constantly facing make-or-break decisions on where to allocate resources, where to make up on revenue gaps, where to invest and what approach to take. AArete can help identify areas of leakage, craft strategies for resource optimization and be a partner for designing and executing your evolving market strategy.
Our proprietary market intelligence and analysis will identify your revenue impact of regulatory changes and which services are overloaded or under-resourced in your particular market. With our extensive volume of claims data across many geographies, we possess unique insights into competition realities in your market that not only allow us to recommend areas of investment, but help you design a healthcare network that is a more optimal fit for your market and capabilities.
Quality & Revenue Alignment
Our provider experience tells us that health system investment in clinical and operational quality programs is not always aligned with the impacted revenue. That’s why our recommendations differ greatly from those aimed only at improving a quality metric. Instead, they are directly tied to a business case and inform your investment choices from a case management, reimbursement and regulatory standpoint to ensure you’re driving patient outcomes from both a clinical and financial perspective. At AArete, our core strength is increasing organizational profitability, which we’re able to achieve by making data-driven recommendations that have a direct impact on to revenue and reimbursement.
As new clinical evidence continues to pour in at an increasing rate, AArete is also able to provide insight into the opportunities and impacts of the shifting practice to new evidence-based states. We provide recommendations on the appropriate level of investment to change clinical practice and can negotiate on your behalf with health plans to identify new gain share and revenue streams. With data-driven decision-making and clear guidance on how to implement our recommendations and measure/monitor results, we give you the strategy to succeed — along with the tools to get there.
Analytics as a Service
Many healthcare providers desire to be performance- and data-driven, but many lack the resources and analytics delivery model to get there. Whether the analytics need is operational, regulatory, exploratory or ad hoc, AArete can provide Analytics as a Service (AaaS) to meet these critical needs.
We not only have data scientists and tools to extract insights, but also the industry experience that guides us in where to look and where to find the clinical and operational issues and opportunities unique to your organization. Our analysts and data specialists provide efficient management of everything from helping meet basic reporting requirements to handling advanced data enrichment efforts, such as aligning third-party data (including our own) with that of your own organization. By leveraging AArete for healthcare provider consulting, using this analysis and our own subject matter expertise, we develop unique insights and combine them with healthcare best practices to create specific performance improvement programs that drive outcomes and performance.
Our Provider Experts
Paul has an extensive track record of developing new and innovative approaches to complex clinical, IT, operational and market opportunities as a leader of AArete’s healthcare strategy and operations service lines. He has served in various roles as a business developer, senior executive, CTO and industry thought leader. He has extensive experience in and broad knowledge of clinical and business informatics and technology enablers and provides proven and successful approaches to clients in the healthcare provider and payer sectors. His recent focus has been on sustainable reduction of cost-of-care and advising health systems on the enablers required for bearing risk and improving outcomes on populations. Paul has Bachelors and Masters degrees from The University of Texas.
Luke brings over 13 years of healthcare consulting experience to AArete, with an extensive background in hospital performance improvement, operations management and change management solutions through analytical analyses. Prior to joining AArete, Luke helped numerous hospitals and health systems improve financial, operational and clinical performance through his work at Tenet Healthcare, Huron Consulting Group and Prism Healthcare Partners. He holds a Bachelor of Business Administration and Economics degree from Baylor University and a Master of Science in Healthcare Administration from Trinity University.
Ravi brings over 10 years of diverse experience for both payer and provider clients through revenue enhancement, strategic development and strategic profitability improvement perspectives. His expertise is focused on comprehensive performance improvement and leveraging deep data analysis to drive process redesign and policy implementation. He has led various solution deliveries through utilization optimization, contract management and Payment Intelligence™. Ravi holds a Bachelor of Science degree in Biomedical Sciences from Marquette University, a Juris Doctor with a health law focus from Indiana University and is a published author in Medical Economics and ThinkAdvisor.
John has over 30+ years of cross–industry consulting and operations improvement experience. His continues to provide profit improvement services to a range of companies including healthcare providers, healthcare payers, technology, retail, and other. His work includes strategic profitability improvement, revenue cycle improvements, gross margin improvements, process redesign, and technology implementation services. John has a particular focus on organizational change management supporting his clients in developing strategies for advancing their business to meet new business and regulatory challenges. He is a known innovator and driver of change that produces results by communicating to all levels of the organization. John has a Bachelor of Business Administration degree in Management Information Systems from Pace University, is a member of HFMA and is a published author in Managed Healthcare Executive, CFO and Financial Executives.
Scott has over 15 years of healthcare industry experience in consulting with extensive expertise in implementation projects for large health systems and complex consulting projects. He specializes in advanced analytics and modeling, regulatory requirements, pricing services, strategic planning and health systems revenue cycle. Scott has experience with multiple predictive modeling techniques as well as operational research / management science analytics such as time series forecasting, queuing theory, simulations and probability distributions. Prior to joining AArete, Scott worked in the healthcare practices of EY and Deloitte. Scott holds a Bachelor of Business Administration from Indiana University, a Masters in Hospital & Healthcare Facilities Administration from Indiana University, and a Masters of Business Analytics from University of Notre Dame.