Payor Contracting

What Does a Healthcare Consultant Do?

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Consulting is a somewhat enigmatic field. Everyone has heard of it, but most people only have a rough idea what professional consultants actually do. This couldn’t be more true for those in the healthcare industry—where most providers are unsure about the value healthcare consultants can provide their practice.

If you are wondering what a healthcare consultant is, you’ve come to the right place. The healthcare consulting field will only see greater demand over the next decade, meaning it’s important to understand why. Read on for a quick rundown, including an overview of the field and the responsibilities and benefits of healthcare consultants.

Healthcare Consulting: The Basics

In basic terms, a consultant is someone who provides professional advisory services to companies on a self-employed basis. They are either experts in an industry (such as healthcare) or generalists that offer solutions and advice on best practices across sectors.

What is healthcare consulting and what does a consultant do? Healthcare consulting can help healthcare organizations like hospitals, physician groups, pharmaceutical companies, or public health entities to optimize, generate revenue, and make structural improvements. A consultant typically has deep industry knowledge of the healthcare sector and public health policies coupled with a solid understanding of healthcare business development and growth (typically a bachelor’s degree or master’s degree with a career in healthcare or other appropriate field). They also have a strong professional network, interpersonal skills, and communication skills to help organizations growth their presence and negotiate better contracts. Finally, they can provide analytical skills to help sift through data and recommend solutions.

What Do Healthcare Consultants Do?

Some of the typical steps of a healthcare consulting role are:

  • Provide advice on best practices
  • Guide organizations toward growth
  • Advise on regulatory issues and policies
  • Negotiate better contracts for clients
  • Maximize efficiency for improved patient outcomes
  • Create a strategic vision
  • Offer financial knowledge and business administration experience
  • Provide insights and innovative solutions
  • Analyze data and make recommendations based on industry trends

Of course, the day-to-day tasks for a healthcare consultant will vary based on the client’s requirements. Most healthcare consultants will work on a myriad of projects over the course of their career, moving from client to client on short-term contracts. A healthcare facility will hire a consultant to provide solutions for specific challenges that require the unique knowledge, skills, and expertise that healthcare consultants can provide.

Main Responsibilities of Healthcare Consultants

Because healthcare consultants work for various players within the healthcare industry, their responsibilities vary greatly. However, there are several sector-wide value propositions that healthcare consultants offer clients.

What do healthcare consultants do and why is healthcare consulting important? Let’s take a look at six of the most important responsibilities and solutions they can offer.

1. Add Value

The most important responsibility of a healthcare consultant is to add value to the client’s practice. What are some specific ways healthcare consultants add value? The fact is that value generation varies significantly depending on a specific provider’s needs. The best healthcare consultants will work with you to an advanced degree to add value where you need it most.

There are some general avenues that most top healthcare consulting firms target, including the following:

  • Formulate a clear strategic vision for healthcare organizations and frame achievable goals to create a pathway forward
  • Analyze the revenue cycle of a healthcare entity and generate solutions to improve reimbursement levels
  • Develop healthcare marketing initiatives (that may be ignored by providers without the help of a consultant)
  • Reassess the operational efficiency and clinical capacity of a provider by conducting a top-down assessment of management and staff
  • Integrate technology and healthcare systems into the provider’s day-to-day clinical setting to increase efficiency and modernize activities
  • Provide insights and expertise on solutions to increase patient satisfaction

These mechanisms are always aimed at increasing the viability and competitiveness of a provider and, in effect, increasing profits over time.

2. Improve Decision-Making Processes

Another important responsibility of a healthcare consultant is to improve the managerial processes of the healthcare organization as a whole. This entails an assessment of the practice to identify any areas of improvement.

Depending on the healthcare provider in question, process improvement will focus on several different types of administration:

  • Management
  • Marketing
  • Technology
  • Operations
  • Human Resources

Consultants will come into a practice and complete a full assessment of how decisions are made at each level, and then provide advice to employers on how to improve those processes.

3. Sign Better Contracts

One of the most complex and difficult activities for a healthcare provider is managing contracts between the practice and payors (insurance companies and government entities). Not only are healthcare providers not trained to negotiate contracts, they are also dealing with various payors at once and must assess each contract regularly. Due to this complexity, healthcare organizations tend to have issues getting beneficial contract terms which can limit profits.

Healthcare consultants can provide the expertise necessary to negotiate better contracts for providers and effectively increase revenues. They also can train staff with the right skills on how to monitor contracts and create a system that maximizes value from each contract overtime.

4. Manage Growth and Development

Because healthcare organizations are typically focused on patient care, the growth and development of the business as a whole can suffer. Healthcare consultants can help a provider manage this growth and make sound financial and strategic decisions in the process.

5. HR Considerations and Team Growth

Healthcare consultants also help providers manage their team and HR considerations. They provide insight on the most important operational challenges for an organization and can work with each member of the team to frame roles and responsibilities more clearly.

6. Avoid Pitfalls and Risk

Lastly, healthcare consultants are risk experts. They help providers anticipate problems and avoid pitfalls in the future by implementing solutions to reduce risk to the overall business and create a sustainable pathway forward.

Partner with PayrHealth to Add Value to Your Practice

If you are looking for healthcare consultants that embody all of the qualities listed in this article, consider partnering with PayrHealth. At PayrHealth, we work directly with providers to improve their contract management efforts. Our clients sign better contracts, make more revenue, and improve the efficiency of staff by alleviating tertiary pain points associated with poor payor contracts.

If you’re looking for innovative solutions that can transform your healthcare business, get in touch today.

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