Priore Richard J. ScD MHA FACHE FACMPE - Improving Financial and Operations Performance: A Healthcare Leaders Guide

i ii iii Healthcare is an inherently complex industry. There are many facets that contribute to this, but at healthcares core, financial performance is often listed as one of the most essential. Of course, patient safety, quality, and efficiency also rise to the top as our industry continues with its transition to value-based care models. However, financial and operational performance are clearly needed before these priority areas are able to deliver optimal outcomes for healthcare delivery. It is on this latter point Dr. Priores new book focuses and provides such a valuable contribution. Readers will gain deep levels of insight and pragmatic direction for how best to grapple with the complexity of healthcare. As the industry adjusts to its next era, this book is a resource that should not be missed, nor overlookedmake sure to embrace its content with interest and commitment. Facilitating change in healthcare will result.

Peter Angood, MD
President and CEO, American Association for Physician Leadership
Washington, DC

In todays healthcare environment, it is critical for healthcare leaders to eliminate waste and liberate every possible dollar for direct patient care. Rich Priore gives operations teams and those new to healthcare finance a how to instruction manual from the basics of healthcare finance to developing business cases that are fiscally sound.

Michael Allen, CPA, MHA, FHFMA
Chair, Healthcare Financial Management Association (HFMA)
Chief Financial Offer, OSF Healthcare
Peoria, Illinois

Dr. Priores book comes at a critical and challenging time for healthcare organizations and systems, many of which are struggling financially as a result of a pandemic and at the same time facing increasing pressure to demonstrate value for their services. As the past chair of the Association of University Programs in Health Administration (AUPHA) dedicated to improving health and healthcare delivery by developing strong leaders through excellence in healthcare management, this work bridges the common gap between theory and application through real world cases, useful tips, and practical tools. Dr. Priores long tenure in the trenches enabled him to provide this invaluable resource for planning, assessing, managing, and monitoring optimal financial and operational performance regardless of the size of the organization or the healthcare sector it serves.

Mark L. Diana, PhD
Past Chair, Association of University Programs in Health Administration (AUPHA)
Professor, Department of Health Policy and Management
School of Public Health and Tropical Medicine
Tulane University
New Orleans, Louisiana

iv

Richard J. Priore, ScD, MHA, FACHE, FACMPE, is a leading international expert on health system transformation. The intersection of his extensive professional and academic backgrounds lends both a relevant industry perspective and an objective evidence-based management approach to driving measurable operational efficiency and expanded capacity for profitable growth and reducing unnecessary waste and cost. Dr. Priores leadership experience spans more than 27 years in the investor-owned for-profit, private not-for-profit, and government healthcare sectors with senior executive roles in integrated and academic health systems, physician-owned specialty hospitals, and large multispecialty group practices.

Dr. Priore has served as the CEO for several investor-owned hospitals and as a turnaround expert and managing director for the Hunter Group. As a regional executive for a five-hospital health system, he was a principal architect of the Centers for Medicare & Medicaid Services Acute Care Episode Demonstration project that pioneered shared savings and bundled payment policies and programs that incentivize providers to eliminate unnecessary services, improve coordination of care, and achieve better outcomes. Dr. Priore is the Founder, President, and CEO for Excelsior HealthCare Group, an outcomes-driven international management consulting firm specializing in the rapid assessment, focus on execution, and speed of measurable results in improving organizational performance through engaging and aligning the interests of key stakeholders.

Dr. Priore is a Distinguished Service Professor of management, finance, and economics in the Opus College of Business at the University of St. Thomas in St. Paul. He has taught and guest lectured adult learners at more than a dozen accredited universities and colleges. He is a frequent national speaker and facilitator of education and training programs for leading healthcare organizations, Fortune 500 companies, and associations including the Association of American Medical Colleges, American Association of Physician Leadership, American College of Medical Practice Executives, and the American College of Healthcare Executives for which he is faculty and teaches several 2-day seminars, including Integrating Quality and Cost in a Pay-for-Value Era, Making the Business Case for Quality, and Closing the Gap in Physician Engagement, Alignment, and Integration in a Value-Based Environment.

He earned a doctorate in Health Systems Management from Tulane University, the oldest U.S. school of public health, and a masters in Healthcare Administration from Baylor University. He is board certified in healthcare management and a Fellow in the American College of Healthcare Executives (FACHE) and a Certified Medical Practice Executive and Fellow in the American College of Medical Practice Executives (FACMPE). He is a proud U.S. Army veteran with tours of duty in Europe, Southeast Asia, and Washington, DC, where he served in the White House under two administrations.

v Improving Financial and Operations Performance

A Healthcare Leaders Guide

Richard J. Priore, ScD, MHA, FACHE, FACMPE

vi Copyright 2021 Springer Publishing Company, LLC

All rights reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, .

Springer Publishing Company, LLC

11 West 42nd Street, New York, NY 10036

www.springerpub.com

connect.springerpub.com/

Acquisitions Editor: David DAddona

Compositor: Amnet Systems

ISBN: 978-0-8261-4463-8

ebook ISBN: 978-0-8261-4464-5

DOI: 10.1891/9780826144645

Supplemental materials for the chapters and video content for Appendix J are available at http://connect.springerpub.com/content/book/978-0-8261-4464-5.

Supplemental material ISBN: 978-0-8261-4465-2

20 21 22 23 24 / 5 4 3 2 1

The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. The author and publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.