"On Long Island most of the job creation is really by small employers and the ones that have truly been, whether intentionally or not, targeted by penalties that will start in a year," he says. "… [Providers] are now going to have to chase an even greater amount of dollars for the self-pay portion…"
Dennis Dahlen, senior vice president of finance and CFO at Phoenix-based Banner Health
4.Managed Care Delivery Design
Dennis Dahlen, senior vice president of finance and CFO at Phoenix-based Banner Health says his organization's biggest difficulty is building the framework that is necessary to prepare for value-based purchasing and the move toward population health management.
"While it's difficult to isolate just one financial challenge among the many facing our industry, the one that is the least contained—to use a firefighting term—is the investment required to create a care management infrastructure that will provide sustained performance in a value-based revenue environment," Dahlen says.
Building this new infrastructure under the financial pressures created by risk-based payer contracts has not been easy, Dahlen adds.
"We have very mature and highly effective approaches to hospital cost management and moderately effective approaches to managing medical groups, but building an effective care management infrastructure while we're performing under risk arrangements has been more difficult than we originally thought. That infrastructure requires new elements, [such as] navigators, central referral capabilities, armies of care coordinators, and brand new technology that must all work seamlessly together if we're going to provide a highly-coordinated experience."