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Opportunity for Big Data in Healthcare Revenue Cycle Operations is Enormous (ACEP Reimbursement & Coding Conference Take-Away)

San Diego Harbor

Edelberg & Associates concluded an excellent conference week in San Diego on February 7, 2013.  It is always exciting to meet with our friends, colleagues, partners and practices in the healthcare arena.  This conference was no different and featured equal parts education, networking and great conversations with thought leaders and decision makers in the emergency medicine field.  We couldn’t possibly begin to distill the entire event as we learned much and also had the opportunity to share much.  That being said, one interesting trend that we recognized was the significant conversation around business intelligence and analytics in the broader healthcare value chain.   As many business leaders know the topic of “Big Data” has been around for some time and has recently become a popular discussion topic across all business verticals.  The primary reason for the popularity of this topic can be traced back to its impact for business entities of all size.

We at Edelberg & Associates believe that that the impact of this new wave of business intelligence applications on the companies and clients we serve can be truly significant.  As many of our followers know, Edelberg & Associates focuses on the intersection of revenue and regulation for hospitals, providers and others in this value chain.  The impact of analytics in an environment where EMR (electronic medical record systems) adoption continues and the structured data it produces grows exponentially cannot be understated.  This new world order of data + regulation equals incredible opportunities for entities that are able to successfully adopt the infrastructure and expertise to harness its power.

At Edelberg & Associates our motto is “Reduce Risk & Increase Value”.  Sometimes this is easier said than done in a world where changes in coding and documentation requirements for payors change almost daily.  We have found that one of the best tools that our company has to deliver on our bold statement is to utilize and leverage our significant investment in business intelligence systems and the experts that run it.  Today, our company is seeing first-hand the benefits of this visibility for ourselves and our clients.  One of the key benefits includes marrying up medical coding information with our client’s EMR and billing systems.  When this data is linked together in a way that is meaningful and well thought out it provides insights that are truly important.  These insights can tell you things such as:

  • Encounter characteristics across facilities, by day, week, month, time of day, etc.
  • Average acuity based on geography, age, and time dimensions
  • Average patient charges for facilities, providers, acuities, chief complaints
  • Opportunities for documentation improvement across various dimensions (provider, facility, department, etc)

In a nutshell, the old methodologies of reporting are no longer relevant.  Among many take-aways that I had in San Diego was make sure you are with a medical coding and compliance company that understands fully the current environment of data reporting and where the market is headed and how it can not only improve healthcare operations but also reduce your risk & increase your enterprises value.

POST UPDATE….

Shortly after our conference broke up we saw this Tweet from the highly influential and visionary Vinod Khosla… Clearly he also sees a future where data and the science that makes it applicable becomes ever more important.

Tweeted by Bill Gross (@Bill_Gross) February 2013 – Get ready for a new wave of innovation-“In the next 10 years, medicine will be more affected by data science than by biology.” -Vinod Khosla

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