Creating Lasting Impact in Healthcare

Creating Lasting Impact in Healthcare

On the first day of Spring Quarter, Professor Dan Adelman welcomed his students to Booth’s Healthcare Analytics Lab exclaiming, “Over the next 11 weeks, you will embark on a journey that is going to push you, and make you learn skills that you will use through the rest of your career.”

Healthcare Analytics Lab is an opportunity that is unique to Chicago Booth. And Professor Adelman’s advice was prophetic.

The accountant in me learnt to code, read lines of R, Stata, and understand Python. Now, I find myself equipped with a whole new skill set:

1.) I can carry a longer-than-two-minute conversation with software engineers (!), and

2.) I learnt the nuances of provider administration, delved into hospital accounting, applied financial analytics to understand hospital financing, and learnt clinical coding. Several of these learnings enhanced my understanding of the US Healthcare system.

An experiential learning opportunity that delves into intricacies of healthcare and goes far beyond classroom credit.

As mentioned previously, Healthcare Analytics Lab is an opportunity that is unique to Chicago Booth. Every spring, students work with a leading healthcare provider organization on an 11-week project, which is usually a critical strategic priority for the organization. Students are required to go through a rigorous application process to get accepted, and the class is a diverse, multi-disciplinary group. As Professor Adelman says, “Each project calls for a somewhat different mix, and we draw from students all around campus.”

I worked on a project to transform profitability in the Neonatal Intensive Care Unit (NICU) at the University of Chicago Hospital Network. I worked with a talented team that included a medical student, a public policy major, a global healthcare specialist, and a data expert.

The project was nuanced because of the multi-stakeholder environment in which we operated. We engaged with the head of Neonatology, senior stakeholders in finance, chief of nursing staff—and presented our findings to a senior audience consisting of the Chief Medical Officer, Chief Operating Officer, and heads of several departments.

Beginning with a detailed analysis of the data, we leveraged advanced data science to derive trends from several thousands of lines of data. The patient group was divided into cohorts based on specific medical procedures, and business impact was studied for common procedures. Medical conditions were studied for specific financial trends. We delved into the world of insurance reimbursement and decoded policy change, reimbursement policy, and hospital accounting.

This project takes months of effort from Professor Dan Adelman, Director of Experiential Learning Nathaniel Grotte, the Booth IT Security & UCM Legal teams, and Project Mentors.

“I start scoping projects with sponsors in July, and by the start of Fall Quarter the instructional team will start meeting on a weekly basis to prepare the projects,” Professor Adelman says. “The biggest challenge is having the data available at Booth by February 1. Because we are dealing with healthcare data, which is protected under HIPAA law, obtaining the data for students to use is quite arduous and must be organized well in advance.”

The Outcome

After several weeks of dedicated effort (we lost track of the hours that we spent!) and conversations with stakeholders, our analysis was an actionable roadmap to improved NICU profitability, as well as a clear identification of highest cost drivers, and trends for operational improvements. The Board of the Hospital and the physician community were highly appreciative. The Healthcare lab was an opportunity to leverage business to create tangible impact in healthcare.

What does this mean when we understand the larger context of the US Healthcare ecosystem?

An incredible part of the Booth curriculum is the emphasis on “zooming in” and “zooming out”—the flexible curriculum and inter-disciplinary learning makes us reflect on what this experience means for a larger ecosystem. So, what did this class teach me about the larger context?

1.) The cost of healthcare is higher than it has to be. (By “cost,” I mean cost to all stakeholders—patients, providers, and payers.) Currently, insurance reimbursement (for instance, government plans such as Medicaid) reimburse a specific percentage of what hospitals report as cost. In the past, providers were believed to have inflated costs reported in reimbursement reporting, as a result of which insurers now reimburse a specific percentage of costs. A simple solution could be to even out costs across the value chain. Hospitals account for costs at actuals and report the same while claiming insurance reimbursements. This lowers overall costs of the system. A little too simplistic wishful thinking? Perhaps.

2.) Insurance is more complex than it has to be. Providers across the country invest heavily in insurance reimbursement processing systems and hire specialists to provide the best advice to maximize reimbursements. Insurance has now evolved to become as complex as Tax. Does this complexity need to exist? Do we need to have clause “3.4.1” in a student insurance plan that tells us that “falling off a ladder” will be reimbursed, but a common cold will not?

3.) Insurance reimbursement is highest for high acuity conditions, as it should be. This follows the tenet that healthcare reimbursements follow costs, which are likely to be high for acute care.

4.) Is the high enforceability of outcomes incentivizing physicians to be overly cautious at the cost of efficacy? The shift from an incident-based to outcomes-based reimbursement was a step in the right direction, as it should be. However, are the rules around outcomes fluid enough to allow physicians to utilize their technical expertise without the cloud of liability influencing their judgment?

The US healthcare system is a trendsetter in several ways—stellar physician talent, a culture of research, and home to the most influential medical advances—which are distinguishing factors vis-à-vis emerging economies with lower healthcare access/infrastructure. However, there is scope for improvement in a system that is home to the world’s best talent and acute care. The Healthcare Lab provided a stellar opportunity for discovering nuances of the healthcare system to make us valuable thought leaders in the future.

Pictured in Photo (from left): Matt Green (Harris School), Jim Isaacs (UChicago Medicine), Richard Tran (Harris), Priyanka Prakash (Booth), Matt Mennel (Booth), Christine Cook (Project Mentor), Patrick Burke (Booth)

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