Recommendations

Margin pressure is an enterprise risk.

Rising labor, claims, reimbursement, and innovation costs should be measured, compared, and analyzed together so leaders have visibility into each cause of margin pressure. From there, leaders are better able to make coordinated decisions and evaluate tradeoffs that affect operations, workforce, benefits, and insurance.

Update and rethink strategic and financial planning together.

Organizational leaders should take the opportunity to model multiple reimbursement, labor, claims, regulatory, and other cost scenarios. This can help organizations plan ahead and move quickly to respond to unexpected costs rather than react once the financial picture has already deteriorated.

Data-driven strategies can help identify where costs escalate the most.

Data from pharmacy trends, high-cost claims, workforce spending, and liability losses can inform where organizational leaders should intervene to bring costs under control.

Focus total rewards strategies on employee value propositions and clear communication

As benefits become more complex, organizations should focus on helping employees understand the full value of their total rewards. Clear, consistent communication can strengthen appreciation and engagement while helping employees get more from benefit offerings.

Work with a risk broker to reassess liability limits, retentions, and coverage terms to align with the current litigation environment.

Align insurance programs to the liability risk landscape by benchmarking against loss trends, jurisdictional risks, and severe exposures like sexual abuse and misconduct claims.

Align workforce investments with the talent and capabilities the organization needs most.

As healthcare organizations transform care models, adopt new technologies, and redesign operations, leaders should identify the roles and skills most critical to that transformation. Talent strategies should focus on attraction and emphasize retention, ensuring your organization is a desirable place to work, and investing in the areas of greatest value by ensuring workforce investments reflect what different employee populations value.

Revamp policies, training, and procedures to guard against misconduct allegations.

Organizations should provide clear reporting channels for employees and patients to relay concerns to leadership. Policies should include chaperone procedures for sensitive exams, clear documentation, and investigative methods to prevent, respond to, and provide defensibility to misconduct claims.

Prepare for an unpredictable regulatory and legal landscape.

Healthcare organizations, particularly their legal, audit, and compliance functions, should pay close attention to federal enforcement priorities and trends and work to proactively remediate any deficiencies. Coding and billing mishaps are a frequent source of False Claims Act actions, so investing in these capabilities can mitigate risk.