Not All is Well in Healthcare Industry…!!
Healthcare has become one of India’s largest sectors both in terms of revenue and employment. During 2008-22, the market is expected to record a CAGR of 16.28 per cent. The total industry size is expected to touch US$ 160 billion by 2017 and US$ 372 billion by 2022. Indian companies are entering into merger and acquisitions with domestic and foreign companies to drive growth and gain new markets. The hospital industry in India stood at Rs 4 trillion (US$ 61.79 billion) in 2017 and is expected to increase at a Compound Annual Growth Rate (CAGR) of 16-17 per cent to reach Rs 8.6 trillion (US$ 132.84 billion) by 2023. Healthcare industry today… Not All is Well in Healthcare Industry…!! This document highlights the behind the curtain challenges of a healthcare business across various functions and the key to solve them.
Focus, Concerns & Challenges…
While the top management of a healthcare focus on Infrastructure, Regulatory Compliance, Technology & Expansion as their prime focus. However there are under the surface functions and areas that raise the risks with long term implications…
- Infrastructure
- Equipment & Beds
- Devices
- Real Estate
- Expansion
- Regulatory Compliance
- IMA
- NABH
- NABL
- Environmental
- Patient Health Management
- Patient Retention & Customer Care
- Quality & Hygiene
- Sales & Marketing
- Patient Transport
- Corporate Tie-ups
- Mergers & Acquisition
- Doctors, Specialization and creation of COE
- Revenue Generation
- Business Applications
- ERP/CRM
- HIS/LIS
- Data Security
- Payables
- Doctors Accounting & Payment Calculation
- Commissions
- Services
- Expenses Recognition
- Receivable
- OPD, IPD
- Lab/ Investigation
- Pharmacy
- Auxiliary (Parking, Canteen, Shops)
- Medical Waste Sale
- Insurance
- Student Fee
- Research Aid
- Cash Accounting
- Inventory
- Issuance
- Inhouse consumption
- Shelf life
- Storage conditions
- Non consumed Returns
- Taxation
- GST
- Direct Tax
- Internal Financial Controls
- Human Resources
- Leave
- Attendance
- Reimbursements
- Overtime
- Payroll
- Stipend
- Fixed Assets Management
How to overcome the Challenges?
- Set your processes and controls right
Make your business processes and controls to avert risks, gain insight & increase efficiency… - Transform through technology
Make your ERP, POS, and other business applications align to the processes and the control framework - Adopt to the new
Leverage newer methods to automate and analyse the performance of the business and operations
What you achieve?
It is evident that on setting up the right processes and controls and nurture them through continuous review mechanism the stakeholders will eliminate the challenges. Transformation leveraging technology shall bring effectiveness, efficiency and greater insights. Following is the snapshot on areas where the business can achieve:
Accounting & Finance
- Elimination of revenue leakage from operations
- Lowest possible cost of operations
- Adhering to payer contract requirements
- Effective collection of patient liabilities
- Identification and Management of underpayments and denials
- General Accounting and Reporting
- Financial Transformation
- Financial Planning and Analytics
Operations
- Standardized Processes and Procedures
- Timely Charge Capture and Coding
- Technology-Enabled Workflow Management
- Accurate and Timely Payer Authorizations
- Strategic Sourcing
- Supply Chain Transformation
- Demand Management
- HR Transformation
- Workforce Transformation
- Talent Management
- IT Security
- Technology & Cloud Strategy
Patient Care
- Streamlined site-of-service check-in process, with minimal time required of patient prior to service
- Financial counselling for uninsured/underinsured
- Service delivered in the appropriate setting
- Flexible and fair community care policies and
- Optimal integration between physicians, hospital(s) and payers
How we can help…
Business Process & Risk Advisory
- Identify real issue by performing root cause analysis
- Introduce, document, implement and transform business processes identified under issue
- Performing area specific audit
- Development of SOP & policies
- Support in development of MIS structures to track business progress, sales by store, product etc.
“Our client have implemented, benchmarked industry processes and have reduced inefficiencies up-to 7% in operations”
Technology & ERP Advisory
“ Efficient integration of HIS & SAP has led to better data accuracy and control over financials and SOD, MIS/Reporting“
- Identify the functional and control gaps in the configuration
- Assess and identify conflicts in the segregation of duties
- Selection of ERP/POS/CRM Application and implementation partner
- Technology roadmap & project management
Consulting Services
- Establishing business intelligence & competency
- Adoption of internet of things (IoT) methods for tracking in-store inventory
- Finance controlling services
- Transformational outsourcing for significant cost reduction with improved overall efficiency & effectiveness
“We have designed new Processes to facilitate effective Billing, Doctor’s Payout calculations and incentives to medical partners referring patients.”