Margin

Combatting Margin Compression: From Reimbursement to Risk to Reinvention

Written by Lincoln Intelligence Group | Jan 3, 2023 4:10:28 PM

Our LIVE roundtable Dec. 6-7 at the Gaylord National Harbor uncovered several valuable insights for our membership across the themes of reimbursement, risk, and reinvention. Headlines below.

Reimbursement

  • With workforce representing the key impediment to growth, staff retention leads everyone’s list of 2023 initiatives.
  • Awareness of the profitability of each unit of labor (a.k.a. “unit economics”) continues to heighten in parallel with the uncertainty of the reimbursement climate.
  • The MA contracting environment has, regrettably, led some providers to begin screening referrals and intakes based on payer source.

Risk

  • The revenue volatility inherent in upcoming payment models means that risk is no longer optional for Medicare providers – it is a built-in normal.
  • Building the stack of capabilities to take risk requires years, not months.
  • Intentional, deep alignment with referral sources is a key to success in value-based arrangements.

Reinvention

  • Ensuring a sufficient supply of direct care workers requires empowering caregivers both on and off the job.
  • To improve the current model in advance of additional systemic volatility: Map every process and question every business model assumption.
  • A partnership mentality, particularly in technology and clinical education, will be critical for scaling in the future.
  • Customer service is perhaps overlooked as a key functional discipline.