What Does a Healthcare Consultant Do?

What Does a Healthcare Consultant Do?

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

If you are wondering what a healthcare consultant is, you’ve come to the right place. Read on for a quick rundown, including a basic overview of the field and the main responsibilities of healthcare consultants. 

Provider credentialing

HEALTHCARE CONSULTING: THE BASICS

In the most basic terms, a consultant is someone that provides professional advisory services to companies. They are either experts in a given industry or generalists that offer advice on best business practices across sectors. 

What is healthcare consulting and what role does the healthcare consultant play? Healthcare consulting can support practices to optimize efficiently, generate revenue, and make structural improvements. A healthcare consultant would typically have deep industry knowledge of the healthcare sector coupled with a solid understanding of business development and growth. 

Some of the main characteristics of healthcare consulting include the following:

  • Providing advice on best practices
  • Offering guidance on growth
  • Advising on regulatory issues and policies
  • Negotiating contracts on behalf of clients
  • Maximizing efficiency
  • Creating a strategic vision for clients
  • Helping to solve problems and approach challenges

Of course, the actual day-to-day job for a healthcare consultant will vary based on a given 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 provider will hire a healthcare consultant to address specific challenges in their business that require the unique knowledge and know-how that healthcare consultants can provide. 

MAIN RESPONSIBILITIES OF HEALTHCARE CONSULTANTS

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

What does a healthcare consultant do and why is healthcare consulting important? Let’s take a look at six of the most important responsibilities: 

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

  • Formulate a clear strategic vision for the healthcare provider and frame achievable goals to create a pathway forward
  • Analyze the revenue cycle of a provider and generate a strategy to improve reimbursement levels
  • Develop marketing initiatives that tend to be ignored by providers without the help of a consultant
  • Reassess the operational efficiency of a provider by conducting a top-down assessment of management and staff
  • Integrate technology into the provider’s day-to-day operations to increase efficiency and modernize activities

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 decision-making processes of the firm 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 decision-making:

  • 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 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 providers 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 on how to monitor contracts and create a system that maximizes value from each contract overtime. 

4. Manage Growth and Development

Because healthcare providers 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 strategies to reduce risk to the overall business and create a sustainable pathway forward. 

PARTNER WITH HEALTHCENTS TO ADD VALUE FOR 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 an innovative healthcare consultancy that can transform your business, get in touch today.

Sources: 

Baker, Kristen. Healthcare Consulting: What It Is & How to Succeed in It. https://blog.hubspot.com/sales/healthcare-consulting

Rappleye, Emily. 5 things to know before becoming a healthcare consultant. https://www.beckershospitalreview.com/hospital-management-administration/5-things-to-know-before-becoming-a-healthcare-consultant.html

Warner, Jon. How External Management Consultants Can Help Healthcare Organizations. http://rx4group.com/how-external-management-consultants-can-help-healthcare-organizations/