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Symbiosis Institute ofHealth Sciences

Enterprise PerformanceManagement for Healthcare

www.pwc.com

Strictly Privateand Confidential

May 2016

PwCMay 2016Symbiosis Institute of Health Sciences • Enterprise Performance Management for Healthcare

Management of a hospital has undergone sea change and so have thechallenges…

•Hospital management hasseen a paradigm shift overthe years.

•From doctor owners whomanaged all aspects of thehospitals to group ofstakeholders

• Strategic Investors

• Medical Team

• Admin Team

Distribution of Authoritiesand Responsibilities

Indicators like ROCE,EBITDA, IRR and PEmultiples are tracked tosee how healthy anorganization is.

Paradigm shift in the priorities ofmanaging a hospital

“Focusing not only on thegrowth story but also more onthe performance of thehospital”

Creates a win-win outcome forinvestors, doctors and patients.

Operational parameters like patientsatisfaction index, patient TAT andMIS are also tracked regularly.

Stakeholders have to constantly keep a tab on the endresult i.e. patient health outcome vis-à-vis thehospitals bottom-line

Changing perspectivesof investors

Healthcare industry,because of the way it hasevolved overtime hasbecome“one of the investmentdestinations forinvestors”


Organizations often face the challenge of “ Hand-Mind” barrier. A barrierthat creates a gap between strategic planning and operationalimplementation

MarketIntelligence

StrategyPlanning

Vision

Costs

HR

Marketing

Customerdynamics

Why is therea deviationbetweenbudget VsActuals ?

Why are my customersatisfaction levels lowand where am Iloosing market share ?

Information asymmetryamong the variousstakeholders preventsthem to take informeddecisions & achieve thetargets!

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The availability of information in time & information asymmetry amongthe stakeholders leaves the following challenges!

COO Challenges

How can I better predict therising costs ?

How can I optimise themanpower ?

How can I improve myutilization ?

How can I proactively sensethe delays ?

How can I proactively sensethe delays ?

Marketing Head challenges

How can I create a dynamicstrategic initiative ?

How to keep track of changingproduct/ case mix ?

How can I monitor changingcustomer requirements ?

How can I measure thecampaign effectiveness ?

How can I monitor every daycustomer satisfaction levels?

CFO challenges

How can I closely trackperformance ?

How can I monitor costs ?

How can I reprioritise mybudget allocations as permarket changes ?

How can I compare variousgroup units ?

How much can I rely thegenerated reports ?

CEO Challenges

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Such challenges leave scope for various pain points in the organization

Patient Care ServicesDifficult todesign &monitor KPIs

Administration

Require extensive clinicaland administrativeresources forperformance monitoring

Medical AdminUnable to replicatebest practices acrossthe organization

Difficult tobenchmark againsthealthcare industrystandards

InformaticsUnable to derivebusiness insightsfrom availabledata

Finance Quality Team

PatientSatisfaction

TreatmentQuality

ProductivityImproveFinancial Results

AccelerateGrowth

Pain Point

Uncertainty ofimpact on costingand profitability dueto strategic decisions

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The challenge is compounded by the fact that Healthcare Industry isundergoing changes

Proliferation of narrownetworks

Rising demand/cost inemerging markets

Rise of consumerism

Macro-trends

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Focus on value overvolume

Regulatory reform

Blurring lines between insurer andcare provider/ deliverer

Emphasis on big data (including nextgen analytics)

Government (& Private sector)changing role in funding

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Enterprise performance management (EPM)

CorporateGoalsStrategy

Analytics

TechnologyManagement

Processes

Daily tasksby all

employees

EPM consists of a set of managementand analytic processes supported bytechnology that enables businessesto define strategic goals and thenmeasure and manage theperformance against those goals.

It provides a closed-loop mechanismto understand whether end-to-endprocess flow improves theperformance and enables themanagement to take necessarymeasures to meet the target.

EPM solutions bridge the gapbetween high-level strategy and dailyexecution.

They align and connect the entireorganization so that every employeeknows how daily actions impactcorporate goals.

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Bridge the gap


Increasedcoordination withoperations

Insightsthrough dataanalysis

InformedPricing

ProcessKnowledgeLeakage &loss of talent

UnhappyCustomers

Non-utilisationof data forinsights

Effectivetalentutilisation

Disparate IT systems

Better billing/paymentprocesses

Working in Silos

Integrated ITsystems

Performance management needs to evolve…

EPM brings together and connect differentdepartments to develop a common asset tointegrate all problems and provide meaningfulsolutions

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Integrate business plans

An integrated sales, operational andfinancial planning process with driver-based planning and sensitivity testingcapabilities allows to optimise andallocate business assets and moreaccurately predict future earnings.

Set the right business targets

Alignment between businessstrategy and the KPIs used to set goals,coupled with an aligned andmotivational workforce reward modelcreates superior performance acrossorganization.

Improve business reporting

Management information and reportingis pervasive, providing the rightinformation at any point in time toreveal what’s really happening andproviding the insight to supportconfident decision making.

Predict outcomes with analytics

Testing strategic decisions anddiscovering patterns based upon thehuge sets of data available. Analyticsmoves to agile decision making based ona predicted view of future outcomes.

Enterprise performance management encompasses improvement acrossthe below four key activities

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PwCMay 2016

Kaiser Permanente’s focus on social “non-medical ” needs isimproving patient outcomes greatly

23What's transforming global healthcare? •

Source: Kaiser Permanente

Congestive heartfailure patients

Oakland:high readmission

rates

Richmond:low readmission rates

Care deep-dive

With FamiliesNutritional

meals

Single

Frozen meals,high sodium,low nutrition

Intervention

Geo-spatial analysis

Contract with a privatevendor to deliver high-

quality, fresh meals at lowcost to these members

Section 4 – Healthcare in a perpetual crisis

PwCMay 2016

• Cascades enterprise vision into

financial and non-financial

metrics

• Creates accountability to

enhance business performance

across the organisation

Symbiosis Institute of Health Sciences • Enterprise Performance Management for Healthcare

EPM Framework to guide Implementation of an integratedstrategy

EPM Frameworkhas 3 components

Planning andBudgeting

Reporting andperformance

reward

• Agile day-to-day analysis, weekly

and monthly reporting, modelling

and decision support activities

• Required to adjust business

objectives and forecast

• Chalks out individual behaviours, delivery metrics and

reward models to align people’s performance to business

performance

• Reporting and review can be at multiple levels:

Operational Reporting: What happened

Analytical Reporting: Why it happened

Real-time Reporting: What is happening now

Proactive notification: What might happen

Costing andanalysis of

performance

Either Budgeting or Costing can bestarted first depending on maturitylevels of organization. It is prudent fora new entrant to begin with budgetingand move onto costing. Conversely, amature player should begin withcosting

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PwCMay 2016

Section 6 – Solutions to unlock value

Symbiosis Institute of Health Sciences • Enterprise Performance Management for Healthcare

Solutions offered by EPM..

Effectively resolve issuesby drilling down into andeliminating root causes

Course-correctquickly throughmanagement alertsfor deviations

Replicate bestpractices acrossfacilities and units

Facilitate tracking ofquality monitors againstthe benchmarks on a day-day basis

PatientSatisfaction

TreatmentQuality

Productivity

ImproveFinancialResults

Uncover and prioritize need foraction through benchmarkingagainst healthcare industrystandards and internal goals

Facilitate substantiateddecisions by providingvisibility into hospital-wideinformation

Increase planning reliabilityby simulating how actionswill affect hospital-wideperformance

AccelerateGrowth

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EPM as way out – Business Intelligence tools under EPM would help improveoverall hospitals performance

• Providing timely anddependable revenue and cashflow management

• Improving budgetingperformance and forecastaccuracy

• Improving cost and revenuemodelling.

• Linking financial and clinicalplanning

• Capacity management:tracking indicators like criticalincidents, discharge times,and patient transfers

• Enabling easier complianceand accreditation reporting

• Resource allocation: such asplanning staff levels, workload

• Predictability: viewing andanalyzing all factors thatimpact a patient’s length ofstay

• Tracking epidemics,incidents of hospital-borne illness

• Profiling and identifyingat-risk patients toimprove interventionstrategies

• Comparing the results oftreatments andmedicines to improveclinical outcomesthrough evidence-basedanalysis.

Business Intelligence Tools

• Integrated StrategicMeasurement

• Activity Based Costing (ABC)

• Balance Score card• Six Sigma• Total Quality Management

• Total Quality Management

Financial Performance Operational performance Clinical Issues

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Healthcare professionals can effectivelycollaborate and make informed decisions.They can analyze resources, operations,and finances, measure againstbenchmarks, and plan for upcomingbusiness cycles.

They can be accountable to thepublic and regulatory agencies,and share information withpatients and their families inkeeping with patient-centeredcare.

With a performance managementapproach, organizations are gaining aperspective of their entire businesslike they have never seen before.

Vast amounts of disparate healthand patient data are transformedinto information assets.

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Conclusion

© 2015 PricewaterhouseCoopers Private Ltd. All rights reserved. “PwC”, a registered trademark, refers to PricewaterhouseCoopers Private Limited (a limitedcompany in India) or, as the context requires, other member firms of PwC International Limited, each of which is a separate and independent legal entity.

Dr. Abhishek Pratap Singh

Director, Healthcare

PricewaterhouseCoopers, India

Tel: +91 9312623981

Email: [email protected]

Thank You!

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