While the healthcare industry still debates the merits of a performance-driven system, payers are moving ahead vigorously with compensation strategies tied to clinical outcomes.
And if weren't apparent when these pay-for-performance (P4P) initiatives started gaining momentum that finance and clinical departments needed to align their objectives, Medicare's additional efforts to financially penalize organizations that fail to prove medical necessity have amplified calls for even tighter clinical-finance bond.
However, this remains a difficult proposition for many set-in-their-ways leaders who, growing up under fee-for-service and capitation payment models, maintained distinct roles, interacting only when necessary. After all, clinicians, often focused on cost-avoidance (with their budgets and all), and finance types, striving for cost recovery, (those darn balance sheets) don't always speak the same language.
"Some CFOs have been a little slow to embrace the fact they need to work more closely [with] clinical teams," says Joanne Webb, CEO & partner of J. A. Thomas & Associates (JATA), a clinical documentation improvement solutions provider.
Webb, who is also a registered nurse, isn't knocking CFOs, just stating what she's observed in some of 500 or so hospitals her firm has worked with. And her insights cut both ways. "Medical staff can be even more challenging to work with," she states. "Most simply want to practice medicine."