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Common challenges

Health fund negotiations
Negotiations with health funds can make or break the financial sustainability of a healthcare company. Get the data you need to have the upper hand in these negotiations.
- Lack of granular data
  The core foundation of negotiations with health funds is to understand the prevalence and related cost of various diagnostic-related groups. A healthcare company must understand predicted patient volumes and expected costs with a high level of granularity in order to generate the revenue required for sustainability. Without that understanding, you’re operating in the dark.
- Mismatched revenue
  When you don’t have the data transparency you need, you risk negotiating from a place of incomplete information – and having revenue and cost mismatches. This can eat away at margins and place significant pressure on your organisation’s operations.
- Scenario modelling
  Cubewise and IBM Planning Analytics / TM1 offer a solution for sophisticated scenario modelling and planning that can be invaluable for your negotiations. It can ingest data from a variety of sources and give you drill-down analysis capabilities to get to any level of granularity you require. With a robust understanding of impacts on your business, you can negotiate from a position of strength.
Labour planning
- Measuring labour KPIs
  In order to make strategic decisions about your workforce, you need to have performance data that analyses key metrics like daily work hours, billable splits, patient volume, admissions and more. These need to be accurately calculated and relied upon to drive the right incentives regarding labour planning and compensation. When done poorly, they can be a significant drag on staff morale and your company’s bottom line.
- Suboptimal resource allocation
  Without the right data backing up decisions, human resources can be allocated in a suboptimal way – either asking too much of people or creating too much idle time. This allocation needs to be dynamic, responding to changes in demand and adapting to patient needs as they evolve.
- Workforce planning
  Cubewise and IBM Planning Analytics / TM1 offer a comprehensive Financial Planning & Analysis (FP&A) solution that can manage your workforce planning in a holistic way, informed by your financial and operational data. Plan ahead for expected patient volumes and use the functional database methodology to assess how changes in hiring strategy affect the key metrics you care about.
Contractor management
- Measuring contractor effectiveness
  Healthcare providers will often outsource catering, laundry, waste management, security and the like to external parties who are responsible for managing those non-core aspects of the customer experience. However, if you don’t monitor and measure their effectiveness, you can find they reduce value, not create it.
- Overpaying for services
  Without keeping any eye on how contractors are performing and what they are charging, you can easily overpay for services, thus hurting margins and reducing operational flexibility. What’s needed is careful management of ongoing contracts and a finger on the pulse of costs so you can make smart and informed decisions.
- Transparent cost management
  Cubewise and IBM Planning Analytics / TM1 provide a unified planning framework that allows you to drill down into specific contractor costs easily and efficiently, while also tying them to business KPIs. This transparency allows you to identify when you’re overpaying and when you need to look for alternative service providers.

Lack of granular data
The core foundation of negotiations with health funds is to understand the prevalence and related cost of various diagnostic-related groups. A healthcare company must understand predicted patient volumes and expected costs with a high level of granularity in order to generate the revenue required for sustainability. Without that understanding, you’re operating in the dark.
Mismatched revenue
When you don’t have the data transparency you need, you risk negotiating from a place of incomplete information – and having revenue and cost mismatches. This can eat away at margins and place significant pressure on your organisation’s operations.
Scenario modelling
Cubewise and IBM Planning Analytics / TM1 offer a solution for sophisticated scenario modelling and planning that can be invaluable for your negotiations. It can ingest data from a variety of sources and give you drill-down analysis capabilities to get to any level of granularity you require. With a robust understanding of impacts on your business, you can negotiate from a position of strength.

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