Slide 1: Redefining Value: How Analytics and AI can Transform the Payor–Hospital Relationship in Asia Pacific
Redefining Value: How Analytics and AI can Transform the Payor–Hospital Relationship in Asia Pacific © Health Catalyst. Confidential and Proprietary.
Slide 2: Health Catalyst Speakers
Health Catalyst Speakers Farhana Nakhooda Robert DeMichiei Pat Rocap Bob Alexander SVP, Healthcare and Strategic Advisor VP, Financial Services Principal, Cost Life Sciences, Asia Management Pacific Consultant © Health Catalyst. Confidential and Proprietary.
Slide 3: Agenda
Agenda Asia Pacific Healthcare Challenges How to Identify Waste with Activity-Based Costing Reducing Clinical Variation Scaling and Transforming Actionable Insights in Activity-Based Costing with AI Q&A © Health Catalyst. Confidential and Proprietary.
Slide 4: Audience Poll
Audience Poll 1 Does your current costing solution have organizational buy-in from clinicians in your hospital? A Yes B No C Uncertain © Health Catalyst. Confidential and Proprietary.
Slide 5: Quadruple Aim Focus
Quadruple Aim Focus Healthcare Framework Focusing on Four Key Goals Improving the patient experience: Improving the health of populations: Enhancing the overall experience Promoting the health and well-being of patients receiving healthcare of entire communities. services. Improving workforce well-b
Slide 6: Health Care Financial Pressure Is Real in Asia Pacific
Health Care Financial Pressure Is Real in Asia Pacific Increasing financial scrutiny Struggle to identify and by payors and move to DRGs prioritize opportunities Legacy Costing Systems do not Clinician distrust in financial uncover the true opportunity data Government move to Capitation and Value Ba
Slide 7: Why Traditional Tools Fail Service Line Leaders
Why Traditional Tools Fail Service Line Leaders You get data, but not the tools to act on it. © Health Catalyst. Confidential and Proprietary.
Slide 8: How to Identify Waste with Activity-Based Costing
How to Identify Waste with Activity-Based Costing © Health Catalyst. Confidential and Proprietary.
Slide 9: Audience Poll
Audience Poll 2 What methodology is your current costing system based on? A Cost-to-Charge ratios (CCR) B Relative Values Units (RVU development for procedures) C Activity-Based Cost (ABC based upon actual patient data at provider level) D Hybrid of methods E N/A - No costing system © Health Catalys
Slide 10: Patient and Physician-Level Costing
Patient and Physician-Level Costing Catalyst for Change Organization Level Health System Team Level Hospital 1 Hospital 2 Hospital 3 Service Lines Orthopedics Cardiology Neurosurgery Primary Care Oncology Pediatrics Behavioral Health Leader or Physician Level The Quadruple Aim requires individual vi
Slide 11: Activity-Based Costing: A Collision of Financial and Clinical Data
Activity-Based Costing: A Collision of Financial and Clinical Data Activity-Based Costing Analytics © Health Catalyst. Confidential and Proprietary.
Slide 12: Activity-based costing connects the actions and decisions of clinicians
Activity-based costing connects the actions and decisions of clinicians…relating to the consumption of finite resources…to the actual cost of each action and decision. Actions have (cost) consequences. © Health Catalyst. Confidential and Proprietary.
Slide 13: Managing Costs by Patient Pathway
Managing Costs by Patient Pathway 3 patients having the same procedure Patient 1 Patient 2 Patient 3 1 2 3 © Health Catalyst. Confidential and Proprietary.
Slide 14: Activity-Based Costing
Activity-Based Costing A paradigm shift affording greater visibility into the true costs of service delivery © Health Catalyst. Confidential and Proprietary.
Slide 15: Example: Empower Change with Trustworthy Data
Example: Empower Change with Trustworthy Data Full Consumption Costing and Clinical Variation © Health Catalyst. Confidential and Proprietary.
Slide 16: Example: Strengthen Strategic Decision Support
Example: Strengthen Strategic Decision Support Data showing that more expensive procedures to not always yield better outcomes © Health Catalyst. Confidential and Proprietary.
Slide 17: Supply Variation by Provider – Hip & Femur
Supply Variation by Provider – Hip & Femur Supplies Expense for DRGs 480-482 - Surgeons with at least 5 cases $10,000 $9,000 $8,000 $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 Phys A Phys B Phys C Phys D Phys E Phys F Phys A Phys G Phys H Average per Case Phys A Phys B Phys C Phys D Phys E I
Slide 18: Example: Service Line Reporting – Links Service Line with Service Center
Example: Service Line Reporting – Links Service Line with Service Center E UT Y ER IT ST RG Patient Service Line IN TH SU L AL Components A C IC DI HE OG AE 'S OP OL EN TH UR M ($ in millions) I O OR HV NE W Patient Revenue $227 $178 $140 $134 Direct Expense 2 $57 $46 $34 $10 Service Expense 3 $73 $
Slide 19: Other Strategic Cost Management Examples
OTHER STRATEGIC COST MANAGEMENT EXAMPLES Payor Negotiation Proactive Pricing Strategy Service Line Management o Vendor consolidation/supply cost “activation” – “credit” to physicians. o New integration opportunities. o Closure/consolidation strategic growth. o Horizontal cost reduction. Cl
Slide 20: Demo
Demo © Health Catalyst. Confidential and Proprietary.
Slide 21: Activity-Based Costing Data A Clinical Perspective
Activity-Based Costing Data A Clinical Perspective Reveals true cost drivers Identifies waste and variation Supports prioritization and strategic decision making Enables clinician and service line engagement Drives continuous improvement © Health Catalyst. Confidential and Proprietary.
Slide 22: Heart Failure Cardiologists Comparisons
Heart Failure Cardiologists Comparisons © Health Catalyst. Confidential and Proprietary.
Slide 23: A Heart Failure Story
A Heart Failure Story Process Metrics Analysis Large Health System Data Queries / Clinical Cost Intelligence Prolonged LOS and high average Echocardiogram analysis variable cost for HF patients Daily weights revealed in a Power Costing Guideline directed medical therapy not added analysis du
Slide 24: Variation Analysis
Variation Analysis Clinically Indicated Guideline Directed Daily Weights Diuretic Dosing Medical Therapy LOS decreased by LOS decreased by LOS decreased by X X days X days days Variable cost Variable cost Variable cost decreased by X$ decreased by X$ decreased by X$ © Health Catalyst. Co
Slide 25: Relation of Goals, Metrics, and Interventions
Relation of Goals, Metrics, and Interventions THE “WHY” THE “WHAT” Intervention #1 Outcome Goal Process Metric Educate physicians on current guidelines and their associated outcomes by 9-30-25. Decrease the Increase the mortality of patients percentage of HF Intervention #2 with heart failure patien
Slide 26: Scaling and Transforming Actionable Insights in Activity-Based Costing with AI
Scaling and Transforming Actionable Insights in Activity-Based Costing with AI © Health Catalyst. Confidential and Proprietary.
Slide 27: Introducing Clinical Cost Intelligence
Introducing Clinical Cost Intelligence WHAT IT IS A precision cost intelligence solution purpose-built for service line leaders to eliminate unwanted variation, improve outcomes, and drive performance across sites. WHAT IT DOES It delivers trusted, case-level insights that help leaders: • Identify h
Slide 28: AI Enabled Activity-Based Costing
AI Enabled Activity-Based Costing Hundreds of thousands of combinations of Multistep/Multi-Agent Framework providers, procedures, supplies, etc. Our goal is to identify cost and reimbursement Statistical/machine learning models variations/irregularities adapted to the complexity and nuances of
Slide 29: © Health Catalyst. Confidential and Proprietary.
© Health Catalyst. Confidential and Proprietary.
Slide 30: Why Clinical Cost Intelligence Works
Why Clinical Cost Intelligence Works Start Where It Matters Most Focus on high-impact service lines under financial pressure. Uncover What Averages Miss This isn’t a Reveal hidden cost variation at the case, provider, and procedure level. costing tool. Engage Physicians with Trusted Data It’s a Give
Slide 31: Example of Clinical Cost Variation - Knee TJR
Example of Clinical Cost Variation - Knee TJR © Health Catalyst. Confidential and Proprietary.
Slide 32: Proof & ROI
PROOF & ROI Client Focus Area Key Results Surgical Services, • $3M saved via ERAS (2 yrs) UPMC Orthopedics, Women’s • Reduced LOS, labor, supply variation across service lines Health Inpatient Care, Surgical • Revenue increase via payer renegotiation Temple Health Populations • Identified variation
Slide 33: Questions?
Questions? Farhana Nakhooda| SVP of Professional Services Rob DeMichiei | Strategic Advisor, Previously CFO at UPMC Pat Rocap | VP of Financial Services Bob Alexander | Principal, Cost Management Consultant Alora Martin | Webinar Program Manager hcwebinars@healthcatalyst.com © Health Catalyst. Confi