Why Wipfli?
Wipfli’s healthcare consulting services take a comprehensive approach to your organizational needs, looking not just at processes and procedures but also at how you can develop and support your people. With our tailored solutions, you can help ensure accurate reporting, maintain compliance and thrive financially while meeting the healthcare needs of your community.
Reimbursement is the lifeline of your financial health. Wipfli can help you navigate Medicare and Medicaid reporting rules so that you can file for the appropriate rate and stay in compliance. Our experienced team supports a variety of healthcare entities with services, including:
- Annual Medicare/Medicaid cost report preparation
- Coding and compliance
- Disproportionate share reimbursement
- Licensing and Medicare/Medicaid certification/enrollment
- Medicare/Medicaid appeals
- Medicare/Medi-Cal preparation, review, appeals and rate-setting
- On-site reimbursement staffing
- Payment projections for regulatory changes
- Payor contract audits and compliance
- Provider-based applications
- Rural health clinic/FQHC rate-setting and change-in-scope rate change reports
Wipfli’s revenue cycle management services can help you understand your cash flow and improve your processes so that you achieve greater financial stability. Our team has experience serving a wide range of healthcare organizations, including rural healthcare providers, FQHCs, hospitals, health systems, home health and hospice providers and senior living providers. We can support your organization with:
- Revenue cycle process assessment
- Coding audits
- Outpatient coding
- Compliance
- Strategic pricing reviews
- Third-party payor contracting
- Denials management
Wipfli can help you be strategic in the way you analyze, optimize and implement capital and facility planning. We support your organization with:
- Feasibility studies
- Functional and space program design
- Market assessment and demand forecasting
- Physician demand planning
- Valuations and transactions
Wipfli brings a wide range of experience in helping FQHCs and other healthcare organizations meet regulatory requirements for strategic planning and stay future-ready.
Our strategy services are data-based, performing gap analysis to help you understand how you can get from your current state to your desired future state. They’re also actionable, providing you with clear next steps and support to help you navigate the risks and challenges you may face with implementation.
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UDS reporting: Turn compliance into strategic value
For federally qualified health centers (FQHCs), the Uniform Data System (UDS) can be a cumbersome burden — a backward-facing, compliance-driven reporting task that ties up critical assets every year between New Year’s and Valentine’s Day, costing personnel hours and operational efficiency. But for health centers interested in a data-driven future, UDS reporting can present a unique opportunity to modernize and even gain critical insights. A smarter approach to UDS reporting leads to enhanced federal compliance for FQHCs, plus improved behind-the-scenes efficiency and improved patient outcomes. What is UDS reporting in healthcare and how is it used? UDS is an annual reporting system through which FQHCs report their clinical and financial data to federal regulators, enabling authorities to monitor healthcare trends, allocate resources effectively and further data-driven decision-making about community needs. Federal UDS reporting is often contemporaneous with analogous reporting to state agencies, on similar or complimentary benchmarks. UDS data is also used to evaluate the performance of health centers, improve standards of care and identify centers of excellence. By providing insights into disease patterns, treatment costs and patient demographics, UDS serves as a vital tool for managing and tracking critical data from healthcare access points nationwide. Traditionally, UDS data has been used primarily for monitoring purposes, with limited direct consequences for inaccuracies or deviations from the norm. However, the landscape is shifting, and there are now more reasons than ever for FQHCs to insist on accurate data, both from an accountability perspective and because of the potential high value of the insights offered through the data. During the COVID-19 crisis, certain grant awards were directly tied to the total number of patients served, as reported through UDS. This allocation method may continue into the future, underscoring the importance of accurate and comprehensive data reporting for FQHCs seeking to secure vital funding and resources. Today, UDS is commonly used to compare and contrast health centers, particularly along the lines of staffing ratios, quality scores, and financial efficiency. It’s become more common for lenders, funders, and regulators to consult UDS data as a way to benchmark FQHCs against one another. Additionally, savvy Boards of Directors often consult their health center’s public data, monitor year-to-date reporting, and seek to engage executives to understand how (and why) data is trending. The challenges behind meeting the data reporting requirements With a strict reporting deadline of February 15, many FQHCs rush at the beginning of the year to allocate resources to collect the necessary data and organize the reporting. If centers haven’t been checking data quality and outcomes throughout the year, it can make for a stressful Valentine’s Day. To effectively address the challenges associated with UDS reporting, it is crucial to first identify the specific pain points within an FQHC’s data collection and management operations. Common hurdles include: Lack of dedicated resources: Many FQHCs don’t have the resources to dedicate personnel to the UDS reporting process. Often, data entry and reporting responsibilities are assigned to staff members whose training is in other areas, leading to potential oversights or inaccuracies. Data silos and fragmentation: In some cases, data may be scattered across multiple systems or departments within an FQHC, preventing a comprehensive view of the organization’s operations and patient population. Technical complexities: Navigating the intricacies of EHR systems, financial software and the UDS reporting platform itself can pose significant technical challenges in getting systems to generate the correct data sets, particularly for organizations with limited IT resources or expertise. Manual data entry and error-prone processes: Reliance on manual data entry and lack of automated processes is a time-consuming process, tying up valuable resources on tedious work that can also introduce human error, compromising the accuracy and integrity of the reported data. Lack of staff training and engagement: Inadequate training and limited staff engagement can lead to misunderstandings or misinterpretations of data collection and reporting requirements, resulting in inaccurate submissions that don’t capture the full quality of an FQHC’s services. Changing requirements: UDS regulations change every year, meaning FQHCs need to annually invest additional resources into keeping up with the latest updates. Identifying these pain points can help FQHCs develop targeted strategies and leverage available resources to address the specific challenges they face, paving the way for more efficient and accurate UDS reporting and a greater benefit for the FQHCs themselves. Building a more effective UDS reporting process How can FQHCs ease the burden of UDS reporting? And what modifications can be put into place to turn the onerous process of data collection and management into a source of added value for the organization? FQHCs can simplify the UDS reporting process and position themselves for success in an increasingly data-driven marketplace by focusing on five critical areas for improvement: Creating a data governance committee: Establish a cross-functional data governance committee that brings together stakeholders from various departments, including clinical, operational, financial and quality teams. This committee should be responsible for overseeing how data is coded, collected and managed, identifying areas for improvement and driving organizational alignment. Technical enhancementsto the system: Conduct a comprehensive analysis of data workflows and map the journey of data from its point of capture to its ultimate destination within the reporting systems. This exercise can help identify system limitations, bottlenecks, redundancies and opportunities to streamline processes. Monthly data analysis: Pull and discuss data every month in order to identify issues and squash them early. Data can be compared against prior-year trends and, in the case of variance, can be tracked and analyzed to determine why the variance is occurring. It’s much easier to proactively address issues than to try troubleshooting late in the year with the February 15 deadline fast approaching. Data quality audits: Implement regular data quality audits to validate the accuracy and completeness of the data being collected and reported. These audits can involve sampling techniques, cross-referencing multiple data sources and leveraging data analytics tools to identify discrepancies or anomalies. Staff training and engagement: Invest in ongoing staff training and engagement initiatives to ensure that all stakeholders understand the importance of accurate data collection and reporting. Additionally, by identifying early in the process who is responsible for what, more tasks can be managed in a timely fashion, and everyone will be working from the same playbook from the start. By addressing these key issues, organizations can begin to transform their once-dreaded UDS workload into a valuable chance for growth and operational improvement. Use UDS data reporting to spark growth Follow these steps so your FQHC can successfully harness data to its strategic advantage. Make UDS a monthly priority by reviewing it regularly with leadership and the board. Include UDS in routine reporting alongside financial and clinical metrics. Benchmark against peers to identify unusual trends or potential issues. Compare UDS data to internal reports and clinician insights to uncover discrepancies. Establish clear data governance by defining a source of truth for different needs across competing systems such as UDS, EHR, payroll, accounting and Population Health System. Treat UDS as an ongoing process rather than a once-a-year burden to drive operational improvements, efficiency and growth opportunities. Turning UDS reporting into value UDS can provide more than just peace of mind for your organization. By shifting to a value-producing approach rather than a compliance-only focus, your organization can derive significant benefits from the annual exercise. Automating and integrating data to improve operational efficiency Manually pulling data together is a time-intensive process that ties up key resources just to meet regulatory deadlines. But shifting to an automated data collection system and implementing integration tools that can pull data from all of your systems can minimize data handling while improving accuracy. This provides value by reducing preparation time and staff costs , while also freeing up resources to focus on patient care or operational improvements. Additionally, real-time access to your data can be used to monitor performance on an ongoing basis, not just during UDS prep time. Turning UDS preparation into a continuous quality improvement cycle UDS preparation at many health centers is reactive, with efforts focused merely on submitting a complete product or on avoiding UDS quality-control questions in a rush to get the process done. But by using the process as a catalyst for ongoing quality improvement, you can have regular visibility into actionable data to monitor improvement in clinical care, financial reporting and operational processes, leading to better outcomes for your organization. Using UDS data to enhance patient care with higher-quality reporting Your data can help create actionable insights that can improve the quality of the care you provide. Your preparations already include reporting on standard clinical quality measures, which matter to funders, your community and — most of all — your patients. UDS provides a valuable opportunity for leadership to monitor these quality measures on an ongoing basis and take steps to improve them before undesirable trends become entrenched. Don’t just consider these isolated reporting activities — this data can be used to make real-time decisions. Improving quality metrics is often tied to reimbursement under value-based care models, and may generate quality incentive payments from payers, so your bottom line benefits as well. Improving staff efficiency and engagement through process standardization UDS preparation can overburden staff, leading to burnout, inefficiency and potential reporting errors. But a standardized process with streamlined workflows for data collection, review and submission can help ensure smoother operations, reduced redundancy and less stressed-out staff. Involve clinical staff in audit readiness programs so they can grasp the link between checking boxes in the EHR, day-to-day care delivery and quality metrics that are ultimately reported publicly. This also leads to a more proactive quality-first culture, decreasing the need for a last-minute scramble to gather and process relevant data come February. Ultimately, UDS offers your health center a wealth of opportunities. It’s up to your organization to determine what that might mean for your operations. How much of a role UDS plays in your day-to-day may differ among organizations, but whatever your desired level of involvement is, it’s important to choose a vision, document it and work toward implementation. Read more 4 workforce strategies for FQHC financial health Improving rural healthcare RCM with data analytics The tech infrastructure that can drive your rural health transformation
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Six benefits of data and analytics for senior living facilities
In the current market, the senior living industry is grappling with a variety of competing challenges. Critical financial, operational and strategic issues demand significant attention and resources. Additionally, while technology solutions have produced an abundance of data, actionable insights are still lacking. Data and analytics are possible solutions that can help senior living facilities overcome these challenges. Organizations can use data analysis to turn financial, organizational and residential data into actionable insights that lead to more confident decisions about investments, growth and resident care. But where to start? The potential use cases for data are vast, so it’s helpful to focus on scenarios that can quickly generate large value. Below are six instances where senior living facilities can see benefits from leveraging data and analytics: 1. Financial and operational transparency The majority of senior living organizations have reporting in the areas of finance and operations, but often these reporting processes are highly manual, Excel-based and time-consuming. Modern data and analytics solutions allow for automation and optimization of these processes, which provides more time for analyzing and acting on the insights as opposed to manipulating the data. The result is higher quality and better capabilities for the facility. Intuitive dashboards can make key financial and operational metrics more readily available across an organization. They allow leaders to dynamically drill into their respective areas in near real time and directly impact metrics in a valuable way, rather than relying on the rearview mirror. Accessibility to core financial and operational metrics allows organizations to be nimble and is critical to remaining resilient in the current market. This helps diminish the risk of turnover within an organization, as well as provide information readily for quick and educated decision-making. 2. Expansion decisions Growth decisions in senior living carry significant financial and operational risk. Whether considering a new location, adding a service line or increasing capacity at an existing site, leaders need to make data-driven decisions. Data and analytics give organizations a structured framework for evaluating expansion opportunities before capital is committed. By analyzing performance across locations and service lines, leadership can quickly identify which areas are generating strong returns and which are underperforming. This prevents organizations from scaling what isn’t working and enables focused investment where the greatest opportunity exists. Key capabilities that can drive smarter expansion decisions include: Performance benchmarking across services and locations: Compare revenue, occupancy and margin across sites to identify which models are most scalable and replicable. ROI measurement: Quantify the financial return of existing investments to build a defensible business case for future expansion and prioritize the highest-value opportunities. Capacity utilization analysis: Understand how effectively current space and resources are being used, revealing whether demand exists to justify growth or whether optimization is needed first. Identifying operational bottlenecks: Uncover workflow, staffing or care delivery constraints that could be magnified at scale, allowing organizations to resolve inefficiencies before they impact a new or expanded operation. When expansion decisions are grounded in data rather than assumptions, organizations reduce downside risk, improve stakeholder alignment and increase the likelihood that growth translates into sustainable, long-term value. 3. Quality of care Use of data analytics tools enables senior living facilities to monitor their standards of care. These tools allow analysis of valuable information such as: The percentage of short-stay residents who showed improved mobility over a specific time period. Year-over-year changes in the number of long-stay residents who have fallen. Change in the number of short-term patients requiring outpatient emergency department visits. Annual reporting metrics. These data and analytics tools also allow easier access to data that is helpful when meeting government regulations or applying for federal or state grants. Having this information on demand enables organizations to constantly assess performance and identify areas for improvement, enhancing the safety and experience for residents. 4. Staffing and retention With current staffing challenges throughout the healthcare industry, finding talent is extremely difficult, which makes retention a higher priority than ever. Predictive analytics can play a key role in retaining staff as well as optimizing staff scheduling. Regarding retention, predictive models can be deployed to help determine a flight risk for staff. This type of proactive identification can help managers implement retention strategies and diminish overall risk. Improved transparency, real-time data and predictive analytics can also support enhanced forecasting and planning for staffing. Enhancing existing staffing processes with these data and analytics capabilities can help improve accuracy, support growing resident volumes and decrease costs for supplemental labor and overtime. 5. Marketing and growth: Attracting new residents Effective marketing is a great way to maximize the inflow of new residents into your facility. Understanding your resident profile will provide you with valuable insights to pinpoint where your current residents are coming from and where you should target your marketing efforts. By tracking and creating visualizations of your current marketing endeavors, you can: See exact ROI by specific campaigns and trends across locations or campaign type. Determine location voids in previous campaigns. Better understand correlations between new residents and campaign successes. Identify previously untapped opportunities. Both aggregate-level and detailed-level information are beneficial for understanding and attracting residents to your organization. Common data analytics tools allow users to easily navigate between these high and low levels of detail for powerful business discovery. Additionally, geoanalytics (enhanced mapping) capabilities in data and analytics offerings can maximize insights for organizations in this area. 6. Experience, surveys and feedback While employee, patient and family satisfaction surveys and feedback platforms are commonly used, organizations can find it difficult to aggregate and process the data these platforms produce. Data and analytics tools allow this data to be organized effectively, demonstrating value by delivering actionable insights. Understanding these insights, both positive and negative, allows organizations to market to strengths and improve deficiencies. Data and analytics solutions help improve the timeliness and accessibility of feedback, which supports quick and impactful changes for an organization. Read more AI in senior living: How organizations can use AI to scale smarter How independent life plan communities can thrive while maintaining their independence Senior living providers are missing out on valuable revenue opportunities. Here’s how to change that.
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AI in senior living: How organizations can use AI to scale smarter
AI is changing how businesses and organizations operate across sectors — and healthcare is no different. But while senior living leaders are curious about AI’s potential, many are unsure of how to convert that promise into meaningful results in areas like medication management, EHR analytics, personalized care and an all-around better experience for residents. However, the biggest roadblock here is often not technology, but mindset. Keep reading to learn more about how to solve that, plus more effectively implement AI within your senior living organization. What’s stopping senior living organizations from embracing AI? Faced with challenges like rising costs and Medicaid cuts that are already taking effect, many senior living organizations could benefit from finding efficiencies through AI. But this has proven easier said than done, in part because embracing AI demands a mindset shift. AI is a change management problem While integrating AI into your senior living organization does require implementing new tools and upskilling your team, it’s also largely an exercise in change management. Your team is used to operating one way, which can make building and sustaining the momentum you need to rebuild your systems or processes to take advantage of AI or automation tools feel a little bit like pushing a boulder up a hill. According to a survey of Wipfli clients, 91% of businesses or organizations report that non-technical obstacles are the biggest blockers to better leveraging new technologies like AI. Meanwhile, only 19% of executives actually feel comfortable leading an AI-transformation effort. In other words, because AI is still such a new and rapidly developing technology, organizations and leaders don’t feel comfortable with it. And that discomfort can make it harder to create results. Haphazard AI use can actually slow adoption and create chaos Is your senior living organization currently using AI? If your first instinct is to answer no, there’s a very good chance you’re wrong, because some of your individual team members are almost certainly using AI tools, regardless of whether they have buy-in from leadership. However, this risks creating a wild west scenario, where AI gets implemented piecemeal or haphazardly and without any overarching AI strategy. In this situation, you won’t have any governance standards, policies or processes to help ensure consistency, and can even risk HIPAA violations by exposing PHI to AI tools that don’t meet compliance requirements. Plus, such haphazard efforts will often flounder, blunting momentum for a more organized AI implementation plan. How should senior living organizations more effectively leverage AI? For senior living leaders looking to develop an effective, organization-wide approach to AI, the process matters. Specifically, you want to determine where you want to go, how you’re going to get there and what tools you’ll need to succeed. 1. Establish direction by identifying specific problems you want to solve A good AI strategy doesn’t mean buying your team a ChatGPT Pro subscription. Instead, identify specific problems within your organization where AI could make a difference. For example, if your organization is struggling to find skilled healthcare workers to fill key roles, consider whether AI could allow you to deploy your existing team more effectively by automating certain lower-level tasks so your staff can focus on more patient-centric work. Or can AI analyze data from your EHR to identify patient health trends you can use to improve care? Here, it can be good to lean on an advisory firm to help assess your current systems and processes and find gaps that AI could fill. You can also do this entirely in-house, so long as you keep the focus on looking for problems to solve. 2. Design your AI implementation strategy Once you’ve found problems that AI could help solve, you need to build a framework for implementation. This means designing an organization-wide AI strategy to help put new solutions into place. This includes laying out specific steps in the implementation process, identifying leaders or change champions to actually spearhead the rollout and establishing KPIs. It’s also essential to evaluate your existing data sources and prepare them for use by AI tools, a process that can include establishing a centralized data repository or warehouse. During this effort, you’ll need to consistently communicate with your whole team about why change is happening here and how they can help, as well as consider what training or upskilling opportunities you’ll need to provide. 3. Deliver by implementing specific tools that fit your strategy At this point, you can start implementing AI tools to solve the specific organizational problems you’ve chosen to target. However, this isn’t just a one-and-done event, but an ongoing process that involves both choosing the right tools and embracing the human, change management side of the equation. Your advisor can help you decide which AI solutions make sense for your needs, as the market has brought forth a dizzying array of options. Within your organization, communication remains essential, as you need to not just establish momentum, but maintain it. How can leaders prepare to oversee an organizational AI strategy? An effective AI strategy typically starts at the top, with commitment from leadership. So how should leaders prepare to oversee this effort with an eye towards more effective change management? Here are key leadership pillars to consider: Self-awareness: Before you ask your team to change by implementing AI, are you prepared to do the same? AI literacy: Your leadership team and organization need a shared understanding of what AI actually is and how you’ll be using it. Change leadership: Don’t just throw change at your team, but implement thoughtfully through planning, clear communication and celebrating wins or milestones. Effective use of resources: Throughout your AI implementation process, consider what work is being done, who will perform it, when it should happen and why it matters. Coaching and upskilling: Create training or coaching opportunities for your whole team to adapt to the changes within your organization. Read more Maximize new tax strategies for senior living providers 5 strategic planning imperatives for senior living organizations Embracing change in senior living: The path to innovation and growth
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