Health system CFOs and their executive colleagues are faced with daunting market forces, exacting downward pressure on operating margin performance.
Market Forces Challenging Growth
Custom Impact Analysis
*Estimated results are informed by national cohort analysis 2022, staffing analysis 2022 and customer case studies
CDI & UM Annual
Revenue Impact
Hours Saved for UM
Team Annually
Increase in
CDI Query Rates
Escalating Denial Rates
Constraints to Top Line Growth
Unsustainable Labor Costs
Many health systems experiencing growing revenue leakage are grappling with rising costs of chasing payment. Average denial rates have grown 33% since 2016 to 12% in 2022, resulting in $5M of average lost revenue per hospital. 82% of these denials are potentially avoidable, and up to 60% of denied claims are not resubmitted.
Should we aspire to pre-pandemic margins, we quickly find we can’t increase rates or volumes adequately to make up the difference. 16-20% increases in commercial reimbursement rates, or 11-15% increases in commercial case volume, would be required to achieve pre-pandemic margin performance; both outcomes are unlikely.
The labor cost growth curve has become entirely untenable, a fact widely recognized across the C-Suite, as 68% of operating budgets are projected to be spent on labor in 2023 (typically closer to 55%). In just one year, from 2021 to 2022, 46-50% of this % net increase in OpEx was attributed to growth in
labor costs.
A Clarion Call for New Thinking, New Strategies,
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How healthcare providers are paid, penalized, AR days, and quality rankings - all are driven by capturing the complete value of care.
How to increase financial resilience despite these seismic market constraints?
How to increase yield while duly optimizing workforce costs?
Median lift in top
risk-adjustment
variables
23
Median lift in team productivity
(queries per CDIS)
136
Additional reimbursement recognized annually across client cohort
Iodine’s Aware Suite is a unified platform to fortify documentation accuracy, drive workflow efficiencies and ultimately strengthen revenue integrity. In the face of labor and cost volatility, Iodine is an essential component to establishing a foundation of revenue capture and growth.
U.S. Hospitals
leveraging Iodine
to manage CDI/UM
900
4
6
Iodine Makes a National Impact
What Iodine Does
Interested in learning more about how Iodine can unlock your complete value of care and receive a full custom impact analysis?
Quality
Contacting
Reputation
Lab results
Vital signs
Orders
Medications
Patient history
Radiology results
Cardiology results
Documentation
Demographic Info
Working, target,
and final codes
DNFB & AR
Reimbursement
Necessity to account for the full scope of a patient’s medical record
Denials
Documentation Accuracy & Medical Necessity
Receive Your Custom Impact Analysis
Unlock the Complete Value of Care
Impact estimate based on Iodine cohort results.*
Both functions necessitate taking account of the full scope of a patient’s medical record.
• Lab results
• Vital signs
• Orders
• Medications
• Patient history
• Radiology results
• Cardiology results
• Documentation
• Demographic info
• Working, target,
and final codes
• LOS prediction
5
Hospital Name
1. November 2023 Kaufman Hall Flash Report
2. Source, The Academy, The Health Management Academy, CFO Forum Debrief, December 6, 2022.
3. Sources: McKinsey; Academy research and analysis / Change Healthcare Denials Study 2022 / Becker’s Hospital Review / Journal of AHIMA
4. 2021 Iodine Cohort Study, across client cohort
5. 2022 Iodine Cohort Study
6. 2023 Iodine Cohort analysis, within facilities' first year with Iodine
2
3
2
3
XX,XXX+
66%
$XX.XXM
Iodine Software builds transformative technologies that make the healthcare revenue cycle work. Our proprietary AI engine, CognitiveML, automates clinical and administrative work, thereby improving reimbursement and enabling clinicians to focus on the delivery of high quality, patient-centric care.
Our technology analyzes the entire patient record, predicting patient acuity, likelihood of medical conditions, whether those conditions are accurately documented, and the appropriate level of care necessary to achieve positive outcomes. These predictions prioritize cases for CDI and UM review, enhancing health systems’ ability to achieve accurate documentation and patient status.
Iodine offers seamless workflow to support chart review, query development, submission, and response by physicians using the EMR, text/email, or a mobile application.
1.5
+
%
%
B
$
Grim Margin Projections
Iodine is transforming the mid-revenue cycle, normally constrained by manual work and inefficient human clinical reviews, with augmented intelligence and novel Machine Learning / AI tech.
We seek to maximize appropriate reimbursement, clinician productivity, and organizational quality / reputational scores.
Unsustainable Labor Costs
Constraints to Top Line Growth
Escalating Denial Rates
1
Leading health systems may have enjoyed pre-pandemic operating margins around 3.5%, but those have plummeted back to earth with 2023 EOY projections hovering around 1% margins. Uncertainty persists as to whether this is simply a ‘market cycle’ event or if this will remain our fiscal reality.
Grim Margin Projections