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Revenue flows in a value-based payment world

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He says:

“Start by making a list of all your current revenue streams. A revenue stream is anything that you can separate out as a business. For instance, “in-patient room charges” is not a revenue stream, since it lumps together people in beds recovering from surgery, women recovering from giving birth, and people into the cancer center for tests.”


“Now make a big grid. List your revenue streams down the left side. Across the top, list where you get the customers to fill that revenue stream. Do they come in through the emergency department? Are they brought in by local specialists? Did they come to you through a medical tourism program? Did they choose your birthing center because of your ads? Or because you are covered in a particular network?”


“What you have up on the board now represents your present state. Start over with a new set of white boards. Duplicate the basic grid, but add possible future revenue streams, such as taking on a risk-based contract for an employer, opening on-site clinics, joining a captive accountable care organization, taking a risk-based Medicaid role, or beginning a medical tourism program.”


“This dimension will not fit on the white boards, because we need a whole discussion about each possible future revenue or customer source. For each one, we are going to ask: How much time, capital, human resources, executive attention and luck is needed to effect the change? How likely is it that we can garner all of that? How long will it take? So, how likely is it that the change can happen, and in what time frame? These questions require serious study and data gathering.”

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