From clinical and technological advances to changing reimbursement models and expanding regulations, healthcare’s complexities continue to multiply. Making thoughtful, forward-looking decisions in this environment can be enormously difficult, particularly for organizations that lack specific domain expertise or don’t have the time or resources to monitor and incorporate industry trends and best practices. That’s why healthcare consultants have never been more essential for every stakeholder across the healthcare continuum.
What is healthcare consulting, and why is it important?
Ideally, a healthcare consulting partner provides fresh, impartial insight into a specific problem, challenge, or opportunity, and expert guidance for addressing it. Healthcare consulting solutions can be strategic, tactical, or a combination of both.
Depending on the issue, the consultant may or may not play a role in implementing the recommendations. Healthcare consulting firms may employ many experts with broad and deep subject matter knowledge—contributing different perspectives under one roof—to bring an outside-in and inside-out point of view to every project.
What do consultants do in healthcare?
Healthcare’s ongoing transformation from the predominant fee-for-service reimbursement model to value-based care is triggering fundamental changes in medical insurance coverage, clinical care, quality monitoring, patient engagement, and reporting and reimbursement.
Healthcare consultants can help organizations anticipate and adapt to these changes by delivering targeted interventions that lead to higher quality care and reduced cost. Related trends that are fueling the need for the external expertise of healthcare consultants include:
- Regulatory mandates to improve care quality
- An aging, high-acuity population requiring greater utilization of services across the care continuum
- IT interoperability and analytic capabilities to support population health
- An industrywide commitment to improve health equity
What kinds of services do healthcare consultants provide?
Broadly speaking, strategic healthcare consultants focus on the clinical, operational, or financial domains and typically work to improve revenue, enhance efficiency, and reduce costs. More tactically oriented healthcare consulting categories are as diverse as the industry itself: IT, revenue cycle management, the patient journey, regulation and policy, human resources, health equity, market access, reimbursement, partnership agreements, mergers and acquisitions, and network contracting, to name just a few.
How should provider and payer organizations evaluate and choose healthcare consultants?
As with any partner, due diligence should be conducted to validate the consultant’s credentials, expertise, and experience, and to confirm alignment with the task at hand. Reviewing case studies and understanding use cases can provide a real-world sense of the consultant’s track record, approach, and areas of expertise.
What else is important to consider when selecting a healthcare consultant?
Because consultants often work side-by-side with an organization for an extended period, mutual trust is a prerequisite for a sustainable relationship. Central to that trust is a guarantee of impartiality on the part of the healthcare consultant. While not applicable in all engagements, ensuring that the consultant is not predisposed to a particular technology or solution is essential. This can include obtaining written assurances that the consultant does not have existing financial arrangements with third parties, agreements that could bias their guidance.
What about cultural alignment?
Compatibility between the healthcare consultant and the client’s organizational culture is nearly as important as trust when it comes to fostering a solid working relationship. While the consultant necessarily must play the role of outsider, it’s important to identify one that will work within the existing leadership structure, value opinions of diverse stakeholders, and maintain an understanding of, and respect for, the organization’s mission and internal operations.
What responsibilities do clients have in a healthcare consulting engagement?
Clients should clearly define the task they seek assistance with and the goals they hope to achieve. Hazy or ever-expanding engagement parameters can lead to misunderstandings, higher costs, and ultimately less-than-satisfactory outcomes.
Clients also must be willing to listen to, and consider, the consultant’s recommendations, however unexpected they may seem. No one likes to be told they’ve been doing something the wrong way and change is difficult under the best of circumstances. But ultimately, you’re paying the consultant to identify solutions you’ve missed and to push decisions that may otherwise be difficult to make.
So be sure to get your money’s worth while staying within the specified scope of work. If you are hiring a new healthcare consultant, it’s reasonable to start with a scalable, phased project that can evolve and expand over time by identifying explicit deliverables along the way, based on previous findings.
Why choose RTI Health Advance healthcare consultants?
RTI Health Advance healthcare consultants are steeped in the industry. We know healthcare because we have worked for providers and payers as clinicians and business operators.
Anchored within a 60-year-old research institute, RTI Health Advance is backed by leading scientists and experts in over 250 scientific, technical, and professional disciplines. With RTI Heath Advance, we’re continuing to deliver on the promise of science to improve the human condition by tackling the intricate details surrounding value-based care. We’ll get you there, no matter where you are in the process, one step at a time.