What is Healthcare Consulting?

Healthcare consulting helps organizations navigate the common challenges facing the industry. These consulting bodies can come in the form of major consulting firms with a specific healthcare branch, or they can be highly specialized companies that address one area of healthcare challenges – like the difficulty of managing payor contracts.

Many players within the healthcare industry, especially providers, have a limited understanding of the benefits healthcare consulting firms offer and why healthcare consulting is important. As a matter of fact, healthcare consulting is especially important for providers because of the challenges associated with balancing patient care and patient experience with normal healthcare business operations.  

To equip providers with a full overview of the healthcare consulting sector, here is a quick guide to what is healthcare consulting, along with its most important characteristics.

What is A Healthcare Consultant?

A healthcare consulting firm acts as a contracted third-party advisor to clients in the healthcare sector. Every healthcare organization or healthcare practice could potentially contract an advisory firm to assist in improving organizational competency. These healthcare organizations typically include:

• Healthcare providers such as hospitals, doctor’s offices, and other facilities
• Managed care organizations and payors such as insurance companies and government entities
• Pharmaceutical companies
• Pharmacies
• Medical equipment and biotech companies

The role of a healthcare consulting firm is to reduce costs and optimize efficiency, revenue generation, and structural improvements for its clients. This can take a broad range of forms, with various specializations and consulting services emerging within the healthcare consulting sector:

• Business strategy consulting
• Technology implementation
• HR and people management
• Legal and regulatory affairs
• Marketing
• Contract specialists
• Revenue and reimbursement experts

The main goal of all of these segments within the wider healthcare consulting space is guiding management to make better decisions and, in effect, improve the organization’s profit potential.

Most healthcare consultants work on a short-term project basis, meaning that a healthcare organization will contract a consultant or a team of consultants for specific consulting services. However, some larger healthcare organizations could potentially have a consulting firm on retainer and continuously receive evaluation and advisory services to improve business performance over a longer period of time. This is especially the case with large healthcare organizations with the financial power to employ a vast supply of consulting services.

The Different Types of Healthcare Consulting Services Explained

In many ways, the healthcare consulting sector mirrors the high level of role variation that defines the healthcare industry. There are various types of healthcare consultants with specific specializations. Let’s take a look at each in a bit more detail.

Strategy Consulting

Strategy consulting is one of the most dominant fields in any consulting industry. These advisors are typically generalists who have strong business acumen mixed with deep experience in the healthcare sector. The goal of strategy consulting within healthcare is two-fold:

• To develop a business strategy for a client in accordance with its main goals, vision, and mission
• To deter the company from making business mistakes or to remedy past issues

In most cases, strategy consulting is focused on the growth and development of an organization or business. Some of the top healthcare consulting firms have strategy consultants that will assess all parts of the organization, including the following:

• Finances
• External and internal relationships
• Management and staff
• Business model
• Past performance
• Future projections
• Organizational mission, vision, and values

Because strategic consultants provide the most well-rounded assessment of a healthcare organization, they are typically considered a one-stop shop in the sector and can provide the basis for contracting more specialized consulting services.

Technology Consulting

Technology continues to have a major effect on how every business operates, including healthcare organizations. Unfortunately, navigating through technological implementation represents a challenge for most healthcare players. The solution? Technology consultants.

Over the past decade, technology consulting has emerged as another dominant field in the industry. As more and more businesses require specialized know-how on implementing technology into day-to-day operations, technology consulting has deepened its hold on the healthcare sector. Technology consultants have various roles within the industry:

• Evaluating an organization’s technological applications
• Advising on IT implementation and selection of systems
• Implementing a digital transformation strategy
• Installing new healthcare systems and providing guidance on utility and digital health
• Monitoring this implementation and providing support services to team members

There have been various technological innovations and digital technologies in recent years that have transformed the healthcare sector and created a solid market need for technology consultants, including:

• Automated medical record data applications
• Device integration technology
• Machine learning and artificial intelligence platforms
• Data-driven insights

Healthcare providers need to understand and learn how to use these data systems, so they contract technology consultants to facilitate this process.

HR & Operations Consulting

Just like any business, healthcare organizations must responsibly manage their human resources and operations departments. People management has become increasingly important in an era when performance is continuously linked to job satisfaction and professional development opportunities within the industry.

A management consulting firm is a specialist in stimulating a positive work atmosphere and managing people and hiring efforts effectively. Some of the most important roles of HR and operations consultants include the following:

• Developing hiring standards and techniques
• Providing guidance on professional development
• Retainment efforts
• Improving customer experience
• Promotions
• Diversity
• Management training
• Best practices for employee and company policies

Because effective people management can have such a major effect on the overall performance of a business, healthcare organizations are contracting these consultants and consulting services to focus on overhauling their HR team and operations departments.

Legal and Regulatory Consulting

The regulatory environment in which healthcare organizations operate is in a constant state of flux (especially when it comes to US-based companies). Every organization must adhere to shifting legal regulations within a given locality or state, as well as with federal law. This can have a major effect on how the organization approaches day-to-day operations, planning, patient care, and much more.

To offset any potential regulatory or legal issues, healthcare companies work with legal and regulatory affairs consultants, typically lawyers or legal experts, to manage and implement necessary changes. At times, a healthcare organization will keep a legal consultant on retainer to continuously monitor the changing regulatory landscape.

Marketing Consulting

The days when healthcare organizations required little to no marketing efforts are over. The industry has become increasingly competitive across segments, forcing every healthcare organization to consider marketing initiatives to remain competitive and maintain patient growth.

Unfortunately, most healthcare organizations retain limited knowledge and capability when it comes to marketing. For this reason, healthcare marketing consulting has emerged as a useful mechanism to implement marketing strategies among healthcare organizations. Marketing consultants provide several consulting services to healthcare organizations, including:

• Determination of marketing requirements, if any
• Formulation of a marketing strategy
• Implementation and monitoring of advanced analytics
• Continued assessment of the efficacy of marketing initiatives

The length and scope of marketing consulting services vary depending on the time requirements associated with these activities. Larger organizations typically work with marketing consultants on a long-term basis and smaller ones contract them for specific campaigns.

Revenue-Specific and Contract Consulting

Revenue and contract management might be one of the most blatant complexities within the healthcare space. While large hospitals and insurance companies will employ a team responsible for managing the various elements of financial management and profit generation, most healthcare companies require short-term assistance to negotiate and manage financial systems.

There are two consulting fields worth noting here:

• Contract management
• Revenue cycle management

Contract management consultants will assist healthcare providers in managing the full life cycle of contracts with payors, including the following tasks:

• Analyzing each payor contract
• Understanding billing codes
• Determining which contracts provide benefits and drawbacks
• Standardizing contracts across payors
• Re-negotiating better terms for providers
• Training staff on how to work with each contract
• Automating the contract management process

Revenue cycle management is intricately linked and requires a deep dive into reimbursement policies to determine whether they are fair and how they can be improved.  

Healthcare Consulting: The Bottom Line

While healthcare consulting has cultivated a major market presence in every segment of the healthcare industry, consulting services are especially attractive to providers. Why? Because providers usually do not retain the competencies necessary to meet the ranging business challenges that continuously plague the healthcare sector. Providers must balance patient care with business operations, which is a uniquely difficult undertaking.

Typically, healthcare providers (especially smaller ones) have been at a disadvantage due to their counterparts’ size and financial power. Healthcare consulting has effectively closed the gap and equipped smaller providers with the tools necessary to compete and remain profitable in the sector. This is a direct result of the emergence of various healthcare consulting firms that focus on smaller organizations, offering services that are affordable and tailored to the needs of any provider or healthcare business.

Premier Healthcare Consulting with PayrHealth

If you are a healthcare provider looking to improve your revenue generation, sign better contracts, and manage your team more effectively, partnering with PayrHealth is your solution. PayrHealth is a healthcare-specific consultant that helps its clients transform their healthcare business and deliver results. If you want to grow your practice and improve your business relationships with payors, then we’re here to help.

By employing the best technological solutions and the smartest consultants with healthcare experience, PayrHealth is a healthcare consultant that can reinvent your practice and help your business generate profits fast. Get in touch today to discuss your organizational challenges and start reaping the benefits immediately!