Today in health, it William Walder's workout musings. My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health, a set of channels, dedicated to keeping health it staff current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

Short test and artist site. Check them out today at this week. health.com. All right. So William mothers had a workout and following that workout, he shared some musings on Sunday morning and they're good. So I thought I'd share them with you. And then I think it's good for conversation as well. So here's what he had to say. Good morning, LinkedIn family. I wanted to share some Sunday morning post-workout musings that I had in a moment of clarity.

And after clearing a few hundred direct messages. A common theme of those unsolicited messages is what keeps you up at night. And how can I help while the answer is to help me with sustainability of healthcare at large. , why do you ask healthcare providers find themselves. At a challenging time as they face the headwinds of inflation, continuing labor pressures, geopolitical uncertainty.

Variability in the supply chain, three years of pandemic. Driven volume revenue loss, and still serving surgical numbers of triple demic patients needing care that said, here are some places healthcare has to focus. To shore up, , to shore against these demand signals. All right. So then he goes on to share a handful of them. Here we go.

Using technology helped me with using technology technology advances can help reduce costs and improve efficiency in healthcare. If you still need to see the benefits here. You have time. However, current fiscal pressures, forced technology initiatives out of the buzz of conjecture hyperbole, if theorial and into the IRR TCO ROI, reality of near-term pressure show real value in six to 18 months or shelf it.

Absolutely. Actually we've been talking about this since the start of the year, even. Late last year. , the ROI and our, , webinar as well. We talked about this, the C I O's are telling me essentially 12 months or less gets a green light. If it's 12 to 24 months, it's maybe we'll have to see. And if it's 24 months or greater, just forget about it. Not going to happen. So you.

If you're selling into. , healthcare? No, your TCO. No, your ROI. No, your IRR. If you have a 24 to 36 month ROI, then figure out how to get it lower, quicker. That is going to be key. , number two, increasing efficiency. Because what William has to say by streamlining processes and reducing waste healthcare organizations can lower costs and offset risks. Stern looks at revenue cycle management, supply chain peri-operative optimization and support services.

It HR legal facilities, security will yield some must do and long ignored inefficiencies. Again, couldn't agree more if I tried. , efficiency's going to be the big push. , labor hours are going to be a key. As we, , move forward. But, , I don't want to get ahead of myself here increasing efficiency. So whatever that is, it could be again, we're focusing on the intersection of technology and healthcare, and we have said essentially,

, You know, the projects around, , RPO. Projects around projects that are just going to save hours, improve efficiency. , reduce the amount of labor needed to produce the same results. These are going to be key projects moving forward. All right. Number three negotiating, better prices with suppliers, drug manufacturers, and service providers are table stakes. The time is now to leverage relationships, to ensure a discipline.

And governed value analysis practice. Which will yield immediate results. There's going to be pressure. And then I agree with this as well. There should be pressure. To continue to increase costs as inflation takes hold. On our economy. And, , the cost of supplies, the cost of drugs and other things are going to continue to want to edge up. The problem is that the reimbursement rates are not going up. And if the reimbursements rates aren't going up and the costs keep going up the.

, hell healthcare organizations that providers are gonna get squeezed in the middle. That's really unacceptable and not going to work. Long-term and that's again, what he prefaced this with. Long-term viability. And so if you can help in that area, by driving down those costs of supplies. Drug manufacturers, service providers. That's going to be key as well. All right, let's go to number four.

Reduce administrative costs, streamlining administrative processes, such as billing and claims will reduce costs and offset inflation and, and agree. Again, this can be done in a lot of different ways. RPO is one of those of just streamlining the process of, , the process of. Putting those claims in and whatnot. One of the areas we were focused in on about 10 years ago,

Was essentially to increase our success rate of those claims on the first try. And we were using a machine learning and AI looking at, , if we could predict if these claims were going to be kicked back and for what reasons, so we can make the adjustments ahead of time. And move money. , into the health system quicker. So anyway, again, agree. Reducing administrative costs and administrative costs are going to be the primary focus of cost reductions within healthcare systems because you can't reduce.

The clinical costs much without significant work. Right. You have to reduce variability. You have to, , and you, you can't get rid of nurses because they're already in short supply. , I mean, just, it's just not going to happen. The clinical side. It just takes a long time to really get orthopedist, to agree on a single knee replacement, to be that your standard or fill in the blank, whatever it is, those are very difficult conversations. Take a long time to.

Get through, not that we shouldn't be doing them. We absolutely need to be doing them in every health system and driving towards efficiency and operational. And, you know, quite frankly, if the outcomes are the same. Then we should just be doing things based on preference and whimsy. So I'm sure I'll take some heat for that comment, but it is what it is. Implementing optimizing value based care. The approach focuses on providing high quality cost-effective.

Care rather than simply focusing on service volume, it combination of VBC and wellness centric models. We'll be a win-win win for payers, providers, patients, and members. , here. I mean, we're, we're going to agree to disagree on this one only because not that I don't think there's going to be drive towards value, but providers are not going to win unless they're on the front end of that equation, unless they take risk. Unless they're part of the first dollar of care.

, that's being paid for coming to them. , they're going to lose in that equation. So they've got to break out and become payer providers, take on some risk and get paid that first dollar of care in order for value-based care to make sense for providers. Otherwise, it's just going to continue to squeeze them. Don't disagree with the direction and the focus disagree that a provider that is magically going to help providers, , next one, encouraging competition, allowing more competitors among healthcare providers can help to reduce costs by tearing down fiefdoms.

And service line monopolies. This is going to take courage and strong leadership. Right. Because most leaders of health systems don't want more competition and they don't want a drive towards lower costs. And, you know, as patients, they do. And as people who are members of the community, they do. And as you know, good citizens, they do. But as corporate leaders, they can't figure out how to make this work.

, how to make it work without it, because if we knew how to make the step from fee for service to value, , it would have been done a long time ago because almost everyone in their heart of hearts thinks. Yeah, we want to keep people healthy when want to keep them out of the hospital, but you have to change the economic model in order to get to that point. So encouraging competition while I agree with it as a patient, , I'm not sure if I were a CEO of a health system.

I would be jumping up and down unless it was a competition that essentially helped me to deliver better care at a lower cost at a higher quality. All right. Last one, government intervention through price controls, subsidies, and other means to control healthcare costs. Seems inevitable and intervention appears necessary to shift the equilibrium towards providers.

Thus checking the trend of rural, , small hospital closures. , specialty, , Let's see, what does.

reduction. I'm not sure he might be a misspelling. Let's see. And let's just say, especially reduction forces, extensive commute for secondary tertiary care and soaring supplies, labor and software costs, , you know, government intervention through price controls, subsidies, and other means to control healthcare costs.

Seems inevitable 30 in place. Quite frankly, we already had bundled payments. We already have, , we already have essentially reimbursements are checked. , at several places, , CMS only pays so much for certain things. , even the commercial payers only pay so much for certain things. And so healthcare organizations are going to get squeezed. , I think it was a Becker's article that somebody just quoted to me had a prediction that within the next 24 months, 600, some odd hospitals are going to be decreased, , are going to close essentially.

, Here's where I'm again, I'm going to differ in that. , they need to close. And this is where I'm really gonna get some emails. They need to close. They're highly inefficient. They're not providing high quality care in those rural facilities. And we need to find a different model. And I'm not saying that they don't need care in those facilities. And I'm not saying that they should travel long distances.

For that care. That's clearly not what I'm saying, but what I am saying is, , holding onto highly inefficient. , maybe not as high quality care. In rural locations, just to say, we have a hospital here when people are receiving potentially a less effective care and definitely less efficient care.

, it doesn't really make sense. And I think what happens in a, in a, in an economy, a free market economy is someone steps in either a tele-health provider, a rural healthcare provider, somebody like a Walmart, like a dollar general, like a, somebody will step in and essentially say, Hey, there's no care in this market.

, but there's a market for this care. Therefore we can deliver it in a way that, you know, essentially improves the lives of the people in that community. I'm not again. I'm not jumping up and down. That's 600, some odd hospitals are going to close. That's not, don't hear me saying that. But what I am saying is, , they're not making money. We shouldn't subsidized mediocre care. We should figure out a way to deliver great care.

In our rural communities and yes, that bar is high, but that's what we need to reach for. , we need to reach for a health equity. If you will. , an equity of care across the country. All right. So William Walder's thrown out some great wisdom. Use technology, negotiate, better prices with suppliers, reduce administrative costs. , what was the next one? Implementing optimizing value-based care, encouraging competition, government intervention, through price controls, subsidies, and other means and control healthcare.

Love the fact that he's throwing it out there being a part of the conversation and giving us something to talk about. And by the way, got a lot of likes and whatnot. It's out there on LinkedIn. , follow William Walder's, , a lot of great thought going on there and really appreciate his contribution to the industry.

All right. That's all for today. If you know someone that might benefit from this channel. Through conversations like this, or being made aware of the things that are going on in the healthcare ecosystem. Have them subscribe to this week health, go ahead and shoot them a note. Let them know that you listened to it. And you'd love to talk to them about it.

All right. , let's see. Oh, we want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders, short test and artist site. Check them out at this week. 📍 health.com/today. By the way, if you're looking to reduce your administrative costs and whatnot.

To great solutions. Thanks for listening. That's all for now.