Topic Operations

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Why social determinants matter for children’s health: An interview with Michael Fisher

The president and CEO of Cincinnati Children’s Hospital explains how social determinants of health (e.g., education, housing, social support) affect children’s health outcomes, and how organizations that invest and intervene early can generate both near- and long-term value.

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The evolution of healthcare-provider profit pools

Why nonhospital-provider segments are primed for growth—and why that matters.

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Transformative healthcare growth through diversification

Five lessons to consider when moving beyond your core business

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Supercharging the ROI of your care management programs

Using advanced analytics and digital capabilities to improve the design and implementation of care management programs can promote better patient outcomes and an improved return on investment (ROI).

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To succeed in a healthcare transformation, focus on organizational health

In transformations, healthcare providers and payers must attend to their organizational health, not just their short-term performance.

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Automation at scale: The benefits for payers

Process automation at scale is now feasible for most payers. When coupled with other next-generation digital tools, we estimate that it may enable many payers to reduce operational costs by up to 30 percent within five years.

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The era of exponential improvement in healthcare?

Technology-driven innovation holds the potential to improve our understanding of patients, enable the delivery of more convenient, individualized care—and create $350 billion–$410 billion in annual value by 2025.

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The journey to a new tomorrow: A conversation with Ron Kuerbitz, CEO, agilon health

Ron Kuerbitz, Chief Executive Officer, agilon health, shares his perspective on consolidation of the sector, the role of technology, and what he’s most excited about for the future. He spoke with Neha Patel, Partner, McKinsey & Company in December 2018.

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The productivity imperative for healthcare delivery in the United States

Healthcare is a key component of the US economy, but healthcare spending increases consistently outstrips GDP growth. Improving productivity in healthcare delivery could change this dynamic without harming patient care.

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Performance transformation: Opportunities for healthcare payers

With increasing affordability pressure, finding opportunities to continuously improve performance is critical for healthcare payers.

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The seven characteristics of successful alternative payment models

To aid APM (re)design and support providers and payers in their value-based contracting strategy, this paper highlights seven characteristics that distinguish well-performing APMs from poorly performing models.

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Planning for the future of healthcare: A conversation with Penny Wheeler, President and CEO, Allina Health

Penny Wheeler, President and CEO, Allina Health shares her perspective on the importance of partnerships in increasing value and understanding the consumer with Jenny Cordina, Partner, McKinsey and Company in an interview conducted in June 2017.

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From revenue cycle management to revenue excellence

Technology and payment trends are reshaping the revenue cycle. Providers that want to improve yield must think about revenue cycle management in a whole new way, which we call revenue excellence.

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Revisiting the access imperative

Challenges with access continue to frustrate consumers and stunt health systems’ financial performance. Engaging clinicians and improving productivity are vital to address this dual issue.

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Underwriting excellence: The foundation for sustainable growth in health insurance

Excellent underwriting capabilities can make possible not only sustained risk taking but also greater efficiency, organizational growth, a better customer experience—and even improved patient health.

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The Medicaid Agency of the Future: What capabilities and leadership will it need?

Medicaid’s scale and complexity are unprecedented. State Medicaid leaders will need to innovate if they are to develop the capabilities that will enable them to steer their agencies into the future.

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Planning for the future of healthcare: a conversation with Benjamin Breier, President and CEO, Kindred Healthcare

Benjamin Breier, President and CEO, Kindred Healthcare shares his perspective on major trends in US healthcare and the value of an integrated approach with Shubham Singhal, Senior Partner, McKinsey and Company.

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Planning for the future of healthcare: A conversation with Ken Burdick, CEO, WellCare

Ken Burdick, CEO, WellCare shares his perspective on major trends and opportunities in US healthcare with David Nuzum, Senior Partner, McKinsey and Company.

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Escaping the turnaround trap

Done well, a recovery phase can be used as a catalyst—or jolt—to move a hospital trust towards a sustainable improvement in performance. Done poorly, it can leave the trust in a “turnaround trap”.

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Planning for the future of healthcare—Marc Harrison, President and CEO, Intermountain Healthcare

Marc Harrison, President and CEO, Intermountain Healthcare shares his perspective on overcoming challenges and his leadership priorities with Brendan Buescher, Senior Partner, McKinsey and Company.

How technology and payment trends are impeding revenue excellence
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How technology and payment trends are impeding revenue excellence

Recent trends are affecting providers’ revenue cycles and altering how providers should manage those cycles. Basic RCM is no longer enough.

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Looking ahead in Medicaid: Options for states and the implications for payors and providers

This paper explores opportunities states could consider to improve their Medicaid programs, both to control spending and improve the program's performance.

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Winning in private health insurance through technical excellence

In private health insurance, a focus on technical excellence in product development, pricing, underwriting, and claims handling can improve insurers’ bottom line—while easing their dependence on investment returns.

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Next-generation contracting: Managed Medicaid for individuals with special or supportive care needs

This new framework can help states improve their ability to design and contract for managed Medicaid programs for these individuals—and maximize the programs’ likelihood of success.

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Beating the odds: Hiring and retaining an RN workforce to optimize patient outcomes and minimize unnecessary expense

Effective workforce management can increase RN retention, reduce absenteeism, and improve patient outcomes and experience. Here's how to get ahead of emerging challenges.

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The next imperatives for US healthcare

Two steps—increasing healthcare-sector productivity and improving healthcare-market functioning to better balance the supply of and demand for health services—would likely produce sufficient savings to lower medical cost inflation to the rate of GDP growth.

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Achieving ROI from EHRs: Actionable insights that can transform care delivery

Traditional arguments for EHR implementation such as efficiency gains and meaningful-use incentives are insufficient to maximize a health system’s returns on its technology investments. However, clinically and operationally oriented sources of value can generate an additional $10,000 to $20,000 per bed in annual margin.

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Why digital transformation should be a strategic priority for health insurers

Digital technologies and applications have the potential to markedly enhance a payor’s profits. Leadership from the top is necessary to overcome the organizational resistance to change that can make a digital transformation difficult.

Short take

Clinical operations excellence – unlocking a hospital’s true potential

Our experience with clinical operations transformations in more than 200 hospitals across the US and overseas has shown that high performers tend to execute five things well.

Short take

Optimizing the nursing skill mix: A win for nurses, patients, and hospitals

An evolved approach to RN staffing, optimizing the nursing skill mix leads to lower costs, improved RN satisfaction and better patient outcomes. Here's how to get from 'here' to 'there.'

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The post-reform health system: Meeting the challenges ahead

This series of articles examines transformational imperatives specific to health systems in the post-reform era, drawing on extensive work with healthcare stakeholders across the value chain.

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Engaging physicians to transform operational and clinical performance

Health systems (and health plans) that are serious about transforming themselves must harness the energy of their physicians. To do so, they must develop a true ability to engage physicians effectively.

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Hospital revenue cycle operations: Opportunities created by the ACA

Although the ACA may make revenue cycle operations more complex, it also presents an opportunity for providers to improve, excel, and differentiate. By adapting their RCM operations and acquiring new capabilities, providers could open up opportunities to win.

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Clinical operations excellence: Unlocking a hospital’s true potential

A multiprong approach that puts physicians—and clinical care—at the heart of performance transformation efforts can help hospitals and health systems deliver more financially sustainable, patient-oriented, and physician-friendly care.

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Creating and sustaining change in nursing care delivery

By giving nurses more control over their work environment and more opportunities for professional advancement, hospitals and health systems can reduce nurse turnover, lower costs, and improve patient care.

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Using care pathways to improve health systems

Care pathways enable health systems (and other healthcare organizations) to make evidence-based decisions about where to focus improvement efforts.

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How IT can help fix hospitals

Mandated upgrades to healthcare IT will demand heavy investments by providers but will help them minimize waste and standardize best medical practice.

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The emerging market in healthcare innovation

Innovators—some from developing nations—have found ways to deliver care effectively at significantly lower cost while increasing access and quality.

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How sourcing excellence can lower hospital costs

Better procurement practices can help hospitals achieve rapid supply cost reductions of 20 percent or more and keep future cost escalations under control.