Written by Christa Shephard

In today’s workplace, employee engagement has hit a standstill. Recent Gallup polls show that many employees have become increasingly detached, leading to a phenomenon known as the “Great Detachment,” which is exacerbating burnout among healthcare professionals. In the sixth episode of Coachify Over Coffee, our certified leadership coaches Laura Baldwin and Savory Turman discuss the importance of coaching in combating disengagement among healthcare professionals. 

Employees are showing up, clocking in, and collecting paychecks, but they may not be engaged in meaningful ways. The Great Detachment is not just about productivity—it’s also impacting overall employee wellness, both mentally and physically. It has a ripple effect, reducing organizational growth and employee satisfaction. This phenomenon is particularly troubling in healthcare, where staff engagement is critical to patent care and safety. As healthcare workers become more detached, healthcare organizations face lower job satisfaction among staff, higher turnover rates, and a decline in the quality of care provided. In , The Real Impact of Leadership Coaching, Baldwin and Turman dive into the data that may hold the key to alleviating disengagement at work. 

According to a recent study, individuals who work with a coach experience 2.9% faster growth in their careers. Coaching provides the guidance and tools necessary to help employees re-engage with their work and, more importantly, their own professional development. Interestingly, only 23% of surveyed business professionals wanted their managers to serve as their coaches, while 56% preferred instructor-led coaching. These preferences illustrate the need for structured coaching programs that go beyond traditional, managerial feedback. 

One of the many concerns stopping individuals from asking for the professional coaching they desire is budget constraints. With companies no longer approving bonuses and raises and performing layoffs, employees who feel like they would like professional coaching—which could reinvigorate their emotional and mental connection in the workplace—may feel that asking for professional development opportunities of any kind is hopeless. It’s important for clinical leadership to understand that high staff turnover is more costly than investing in their current employees. Employee disengagement can place financial strain on healthcare organizations with higher costs for recruitment, training, and retention. Engaged employees are more likely to stay in their positions longer, saving the organization money it would have spent replacing an unhappy worker. One of the most important metrics to quantify return on investment (ROI) on leadership development coaching is employee engagement.  

When employees are engaged and connected with their work, they’re more productive. Increased productivity for all employees, regardless of where they fall in the organizational chart, directly benefits a company’s bottom line. Professional coaching is just one piece of the employee engagement puzzle, but it’s an important consideration for individuals who look for an organization that provides growth and development opportunities. Internal employee engagement surveys are an important step in determining the ROI on leadership development coaching. To get a baseline understanding of how this specific investment in your employees has affected engagement, an internal survey can provide insights into improved performance, satisfaction, and overall team productivity. 

Baldwin and Turman, leadership coaches at BSM Consulting (a division of VMG Health), reminded listeners that coaching isn’t just about career growth; it’s about helping individuals recognize the choices they’re making and empowering them to take control of their professional and personal lives. The coaching process often reveals how workplace issues bleed into life challenges, and vice versa. By addressing both, coaches help individuals achieve true transformation. 

Leadership development coaching offers an important pathway for re-engaging healthcare employees and fostering a more connected, motivated, and productive workforce. It’s an investment that benefits both the individual and the organization as a whole. If you’re looking to provide leadership coaching to your employees, Coachify Over Coffee offers valuable insights and actionable strategies. Apply a new approach to your leadership with the help of Laura Baldwin and Savory Turman, two certified coaches dedicated to sharing their expertise with listeners like you.

Written by Christa Shephard

As artificial intelligence (AI) surges forward as a useful tool in all sectors, its transformative impact is especially noteworthy in healthcare. Hospital management has undergone an overhaul with the implementation of AI-powered solutions, which automates repetitive tasks like scheduling, billing, and record-keeping to reduce administrative burden and prevent errors. While AI might seem like magic, its impact on hospital management is grounded in data-driven algorithms and practical applications that enhance efficiency and decision-making.

AI-powered tools are helping hospitals maintain compliance by improving billing and coding accuracy, but they’re also doing the heavy lifting when it comes to decision-making. These tools analyze vast amounts of data in seconds to provide evidence-based recommendations and identify patterns that might not be immediately apparent to clinicians. Through pattern recognition and predictive analytics, AI-driven solutions identify compliance risks and anomalies in billing and coding, helping hospitals stay compliant with regulations and avoid costly errors.

Challenges in Hospital Management

Issues with regulatory compliance can significantly impact hospital revenue and patient outcomes. Non-compliance with healthcare regulations, such as improper billing or coding errors, can lead to financial penalties, reduced reimbursements, and even legal actions. All of these consequences directly impact a hospital’s bottom line. Beyond financial losses, these compliance lapses erode trust with patients and payers, leading to reputational damage and a decline in patient volume. Regulatory issues often correlate with lapses in patient care standards, potentially compromising patient safety and outcomes. Ensuring strict adherence to regulations is essential for maintaining financial stability and for upholding the quality of care that patients receive.

These challenges are often the result of human error, which has been somewhat inevitable up until the implementation of AI-driven solutions in hospitals. With new software solutions designed to automate repetitive tasks, hospitals can take a proactive approach to mitigating compliance and audit risk.

AI-Powered Savings

AI-powered tools not only boost efficiency by streamlining processes and reducing the manual workload, but they also help save hospitals significant amounts of money. Automating routine tasks like scheduling, billing, and administrative duties allows hospital staff to focus on higher-value activities, improving both operational flow and patient care. By eliminating the need for manual interventions, AI-driven systems reduce the risk of human error, leading to fewer costly mistakes and enhanced overall productivity, ensuring day-to-day operations run more smoothly.

In addition to driving efficiency, AI enhances accuracy in billing and compliance, which can further reduce financial risk. AI-driven systems quickly analyze large datasets to identify potential discrepancies in billing, ensuring compliance with regulatory standards and avoiding penalties. This level of accuracy minimizes revenue loss from overlooked billing errors. Additionally, AI provides actionable, data-driven insights that enable healthcare providers to optimize their financial performance. These insights improve patient outcomes while identifying cost-saving opportunities, making AI an indispensable tool in maintaining a competitive edge while reducing operational expenses.

The CRA Advantage

VMG Health is proud to offer AI-powered solutions that proactively identify and eliminate compliance risk, alleviate the burden of some manual tasks, and offset their own cost by minimizing costly mistakes. Our Compliance Risk Analyzer (CRA) suite offers cutting-edge solutions designed to safeguard revenue and minimize regulatory exposure. It uses predictive analytics to identify potential areas of compliance and audit risk, empowering hospitals to take a proactive approach in mitigating costly mistakes—as opposed to having to react after those mistakes have been made.

CRA, combined with our coding audit experts, streamlines risk mitigation and creates an action plan for hospital teams, providing the option to fully outsource audit departments. Our tool’s easy implementation and user-friendly interface ensures hospital staff can quickly train and grow comfortable using it.

VMG Health offers two CRA tools to meet hospital management needs: CPT and DRG. Our CPT tool is designed to assess compliance risks associated with Current Procedural Terminology (CPT®) coding, ensuring accuracy and adherence to standards. The DRG tool specializes in managing compliance risks related to Diagnosis-Related Group (DRG) coding, providing a targeted approach for inpatient settings. Each solution offers a specialized solution to enhance compliance and efficiency.

Unlocking Success with New Technologies

Hospital management is fraught with repetitive tasks, compliance risk, and difficult decision-making. Alleviating these challenges empowers hospitals to enhance their operational efficiency, allow staff to focus on higher-value responsibilities, proactively identify and eliminate compliance risk, and boost their bottom line. AI-powered solutions like CRA pay for themselves when they identify risk areas like undercoding, which can often uncover significant savings.

While AI might seem like magic, its real power lies in the practical, data-driven insights it provides, enhancing hospital management and streamlining operations. Consider AI-powered solutions for your hospital. VMG Health’s Compliance Risk Analyzer suite is tailored to meet your needs. Protect your organization from audit risks, capture every dollar of revenue owed, and ensure compliance with VMG Health’s Compliance Risk Analyzer suite. Contact our Coding Audit & Compliance experts to learn more about our state-of-the-art solutions.

Written by Nicole Montanaro, CVA

The following article was published by the American Association of Provider Compensation Professionals (AAPCP).

Following the introduction of the Final Rules by the Department of Health and Human Services (HHS) at the beginning of 2021, VMG Health has seen a growing number of organizations prioritizing their value-based care (VBC) strategy through the creation of value-based enterprises (VBEs) and/or structuring arrangements in accordance with the safe harbor framework of the Final Rules. These value-based exceptions and safe harbors are intended to advance the transition from volume to value by allowing for more flexibility in structuring compliant arrangements. Since physicians are often the cornerstone of any VBC strategy due to their ability to drive savings and clinical quality, this added flexibility of the Final Rules has prompted many healthcare leaders to revisit and modernize their physician alignment models.

With the unwavering prominence of VBC in the market, there are already numerous alignment strategies where healthcare providers enter into value-based arrangements with physicians to improve clinical quality outcomes, coordination of care among providers and across care settings, and cost efficiencies in exchange for an incentive or bonus payment that is subject to performance metrics. In some cases, healthcare providers like hospitals and health systems are internally creating and self-funding these programs in anticipation of future changes to reimbursement. While in other cases, healthcare providers may already have payer contracts in place where they are eligible for value-based reimbursement and may want to share a portion of the incremental reimbursement and shared savings payments with the physicians who contributed to this achievement.

Regardless of the alignment vehicle, when structuring these arrangements with physicians, it is critical to ensure regulatory compliance, and one of the common themes in the Final Rules is the legitimacy of the performance metrics that will be used to trigger value-based payments. Specifically, there is an emphasis on clinical quality outcomes metrics and clinical evidence or credible medical support for these metrics. Additionally, from a valuation firm’s perspective, the credibility of the metrics is one of the primary value drivers in supporting value-based payments to physicians. The following provides insight on things to consider when selecting performance metrics for value-based arrangements and outcomes-based payment arrangements from a valuation firm’s perspective. 

What to Know About Value-Based Payment Metrics

It is important to prioritize the selection of the metrics when structuring new arrangements or dusting off old arrangements. The performance metrics should be aligned with the value-based goals of the arrangement to create a meaningful and impactful program and support regulatory compliance. Additionally, from an FMV perspective, having a substantive set of metrics is a key factor in supporting or justifying value-based payments to physicians. Performing an FMV assessment helps to mitigate compliance risks and supports equitable payment models that reward physicians for their level of contribution toward achieving the value-based goals. 

When it comes to determining the FMV of value-based payments to physicians, it is important to note that there is generally more flexibility if the payments can be tied to an external third party (such as effectively being funded by value-based reimbursement from a governmental or commercial payer). However, if the program is self-funded, there is generally more risk from a compliance perspective, so these programs may require more intense consideration of certain attributes of the subject program, such as the specific metrics to be utilized, to bolster support for the value-based payments.

Industry research related to value-based payment models in the market and regulatory guidance has consistently revealed the importance of key, metric-related attributes when structuring value-based payment arrangements with physicians. The following summarizes some of these key factors:

• Meaningful Number of Clinical Quality Patient Outcomes-Based Metrics 
• Nationally Measured or Industry-Endorsed Metrics and Performance Targets
• Performance Targets Based on “Superior” Performance 
• Difficulty Level of Achieving Maximum Payout (i.e., Stretch Goals)
• Demonstrable Physician Impact on the Metrics 

Analyzing the industry research from a valuation perspective, factors such as paying for the achievement of “superior” performance standards (typically consistent with the national top decile) and selecting physician-driven, patient clinical quality outcomes metrics that are supported by credible, medical evidence can help to justify higher value-based payments to physicians.

10 Questions to Help Get a Pulse on Your Metrics

Total Your Points to See How Your Metrics Score 

A = 10 points 

B = 5 points 

C = 0 points 

1. Do all of the physician participants have a direct and demonstrable impact on the selected metrics?

A. Yes

B. Some

C. No

2. Has management considered the needs of the facility and/or patient population in the selection of the metrics?

A. Yes

B. Some

C. No

3. Are the selected metrics supported by credible, medical evidence for improving quality, efficiency, and patient outcomes?

A. Yes

B. Some

C. No

4. Do the selected metrics overlap with or duplicate any services required under medical staff bylaws and/or other arrangements?

A. No

B. Some

C. Yes

5. Has management established meaningful performance targets for each metric that are difficult to achieve or based on a material improvement from baseline performance (i.e., stretch goals versus maintenance goals)?

A. Yes

B. Some

C. No

6. Is achievement of the selected metrics expected to improve your organization’s performance under value-based arrangements with payers (i.e., will it generate value-based reimbursement for your organization from payers)?

A. Yes

B. Some

C. No

7. Is achievement of the selected metrics expected to generate quantifiable savings on the total cost of care for your organization or for payers?

A. Yes

B. Some

C. No

8. Are the selected metrics outcomes-based (i.e., patient clinical quality outcomes)?

A. Yes

B. Some

C. No

9. Are the selected performance targets for each metric sourced from industry-recognized or national databases (versus internally derived or self-created)?

A. Yes

B. Some

C. No

10. Are the maximum performance targets for each metric consistent with or better than what is considered “superior” level of performance (often consistent with national top decile)?

A. Yes

B. Some

C. No

This article is not intended to be, nor should it be used as, a substitute for legal, valuation, or regulatory advice.

Sources

85 Fed. Reg. 77492 (Dec. 2, 2020) (CMS Final Rule); 85 Fed. Reg. 77684 (Dec. 2, 2020) (OIG Final Rule).