Build a Business Case to Impact 8 Provider Data Management Areas

Your provider data is among the most critical components of your healthcare business. Without it, there is no onboarding, preparation, or monitoring of clinicians to safely care for patients. If your health system is unable to elevate provider data to ensure quality and help improve the organization's business health, it's time to refocus.

While provider data management software is a workhorse that powers patient care, the importance of the information within it historically has been overlooked. Thus, the software has been underfunded. Value-based care is changing that; outcomes from a privileged provider’s performance are tied to value-based payment incentives—or penalties. 

A case for provider data management investment

Today, hospitals and health systems are experiencing dramatic increases in labor and supply expenses. Greater than 50% are projected to have negative margins through the end of the year. And the outlook for next year isn't much better. The symplr Compass Survey of 132 healthcare technology leaders from top U.S. health systems shows that 40% of respondents expect financial pressure to be their biggest threat in the coming year.

Despite the dismal financial outlook, healthcare technology leaders appear ready to invest in  software. According to a recent Bain & Company and KLAS Research survey, 80% of provider organizations cite labor shortages, inflation concerns, or specific organizational situations as the motivation behind investments. Reducing unnecessary administrative burdens on staff through integrated solutions removes friction from workflow processes and allows caregivers and staff to better serve patients, resulting in improved operational outcomes.

Mining the value of provider data

One critical area of hospital operations is the credentialing and provider enrollment processes. The administrative work behind making providers available for every patient must be seamless for the patient and the provider. This is where the medical staff services department comes in, helping the organization to ensure that clinicians with the right credentials are vetted and available to care for patients. Often, this vetted provider data isn’t integrated or elevated to the same level of importance as patient data. This disconnect becomes a foundational issue when health systems pursue a digital front-door experience for consumers and creates internal efficiency challenges and missed opportunities for revenue growth.   

Unfortunately, staff often work with numerous siloed technologies lacking automation or are forced to make their process fit the technology, rather than the other way around. Technological inefficiency results in the need for additional labor, frustrated staff, potential compliance issues, and decreased financial health.  

Suppose healthcare organizations continue to manage provider data in the same manner...

Hospitals and health systems are exposed to risk, dissatisfied providers, and delayed revenue if medical staff professionals don’t have the right tools to credential providers confidently and quickly—and so patients can easily find and book care. If health systems continue on the trajectory of using the same siloed systems and technology (or no automation) and do not change, what will the healthcare landscape look like? Organizations will not be able to compete or survive to serve the communities that count on them. So, unfortunately, doing nothing is not an option. 

If you’re reading this, you’re immersed in provider data management challenges every day. So, let’s move on to what you can do—the solution, the path forward, and the next steps.  

Take our 15-second provider data management analysis  

Step 1on the way forward is to evaluate your organization’s provider data management process. Start with the following key questions: 

  • Are you experiencing extended credentialing timelines?   
    YES / NO 
  • Do you ever experience payer enrollment backlogs resulting in pending claims or write-offs?  
    YES / NO   
  • Does your credentialing team have to adjust its workflow around your technology rather than vice versa?  
    YES / NO 
  • Is your provider data locked in department silos, not centralized or shareable with other teams?  
    YES / NO 
  • Does your health system need to improve the consumer experience through avenues such as a find-a-doctor site, better patient-provider matching, and patient self-scheduling?
    YES / NO

If you answered “yes” to one or more of the questions above you are likely already feeling the pain of inefficient processes, systems, and data flow. What you probably can’t see through that pain is the amount of revenue your system is losing in the form of slow physician onboarding, delayed reimbursement, and patient leakage. Turning any ‘Yes’ to a ‘No’ could be worth hundreds of thousands in increased revenue.  

Let us help you build a provider data management business case 

If the self-evaluation identifies the need to change your approach to managing provider data, Ste

p 2is to build a business case. Investing in provider data management technology is a significant financial decision, requiring a business case to prioritize the decision and set expectations on the anticipated return on your investment (ROI).     

symplr recently partnered with Hobson & Company, a value consulting firm with over 20 years of experience, to build a custom ROI tool for this purpose. It is the result of independent validation of “sources of value” with symplr customers and identifies specific outcomes they achieved by leveraging the provider data management solutions of symplr Provider and symplr Directory.  

Impact 8 key provider data management areas  

The research identified eight benefits across two business objectives for symplr customers:  

Streamline healthcare operations
 1. Reduce time spent on credentialing, recredentialing, ongoing sanctions monitoring, and expirables management 
 2. Reduce time spent enrolling providers into commercial and government payers 
 3. Reduce time spent preparing for committee review meetings
 4. Reduce time spent adding referring providers’ information to the electronic health record
 5. Reduce health system call volume

“Before symplr Provider, the enrollment team would need to process a separate application for each of the 16 payers supported by the hospital network with the same information being shared over and over again. Now, all 16 applications are submitted simultaneously.” 

Grow and protect revenue

 6. Increase revenue with an accelerated provider credentialing process  
 7. Improve patient acquisition
Reduce patient leakage  

“We are committed to ensuring our patients have a best-in-class “Find a Doctor” search experience. symplr Directory’s Provider Search gives our consumers a user-friendly way to find the provider with the right expertise quickly that’s convenient and in-network.” 

Based on a health system with 800 providers, on average symplr Provider Data Management technology customers experience an ROI of 350% in one year and a payback on their investment in fewer than five months. Prioritizing and investing in your provider data management technology can deliver a trifecta of improvements—in patient safety, provider satisfaction, and financial outcomes. A solid provider data management strategy is also built on a strong foundation of technology that requires involvement and ownership at all levels of the organization.    
For these reasons, you’ll need a strong business case with clarity on ROI to gain alignment and move forward.   
Once you've received your personalized value calculation from symplr, Step3 is to connect with us. At symplr we have been working with healthcare organizations for over 30 years, navigating change while helping customers deliver outcomes. We will consult with your organization to make a strategic plan to create a provider data management approach that delivers enhanced financial and operational outcomes. 

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