SaaS Brief

Financial Interoperability in Healthcare

Healthcare Finance Executive with Calculator

We’ve talked about it before, the role of the finance team in healthcare continues to change in new and exciting ways–from reporting on what happened, to being a trusted advisor on the future direction of the organization. More and more, this now includes having access to–and an understanding of–clinical, statistical, and regulatory data.

I was re-reading an article in Fierce Healthcare circa 2012, “The changing role of the hospital CFO. The article, while pegged to the Affordable Care Act, talks about CFOs being prodded to become more involved in daily operations. We have seen this play out over the years, accelerating quickly during the pandemic, due to the need for up-to-the-minute financial data for decision making. Talking regularly to healthcare finance folks has also uncovered that this trend has not lost speed–in fact, it is increasing.

Lack of data is not the problem to solve here, there is an amazing amount of healthcare data. Think about all the sources of data that currently exist: EMR, RCM, payroll, inventory, facility, social determinants, wearables, AR/AP, I could go on and on (and on). It’s the access to, and making sense of, that data.

Recently, the Health Innovation Alliance released a report on how the healthcare system can improve IT interoperability and data exchange (as reported in Becker’s Hospital Review). This highlights the importance of leveraging data to improve care. But how about using it to improve the financial health of the organization?

Many of our customers are doing just that. Call it Financial Interoperability.

This type of interoperability allows for KPIs and dashboards that reflect the true cost of care, like revenue per physician, location, bed, etc. It can also help predict what moves will need to be made if say a physician will be out for an extended period due to illness, if there is a downturn and less elective procedures will be scheduled, or if the organization is evaluating a new location based on demographics and social determinants of health.

One of our partners, Wipfli LLP, a top 20 accounting and consulting firm, launched EMRConnect (currently listed in the Sage Intacct Marketplace). It allows the seamless flow of information from electronic medical record (EMR) systems into our accounting system. This is a great example of Financial Interoperability. Leveraging this data allows for healthcare organization to pull in, understand, and act on the information to show revenue mix, day sales outstanding, revenue per procedure, etc.

Another key consideration of interoperability (clinical and financial) is HIPAA compliance. If you are going to leverage this data, it needs to be in a HIPAA-compliant way. And to ensure that it is, make sure a Business Associates Agreement (BAA) is part of the mix.

Both clinical and financial information is needed to ensure that the proper care is delivered in a cost-effective manner, and interoperability of data is the key.

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