Achieving financial sustainability in Canadian healthcare

Hospitals continue to face large, growing structural deficits due to the increasing impact of emerging cost pressures. In the face of growing financial challenges, Canadian hospitals must adopt innovative strategies to secure long-term financial sustainability. In this report we outline key insights and approaches to achieve financial sustainability in Canadian healthcare institutions.

Cost pressures have intensified

In addition to traditional cost pressures (e.g. growing/aging population, diverse patient needs, increased prevalence of chronic diseases, rising healthcare delivery costs), pandemic-related events have exacerbated fiscal challenges:

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Health workforce shortage

Escalating costs of overtime, absenteeism, and expensive recruitment and retention efforts.

Surgical backlog

Empower and inform your teams and stakeholders with full access to data visualization tools and insights

Aging infrastructure

Old facilities require more maintenance, consume more energy, and need frequent updates to meet modern standards.

Increasing sub-specializations

Increased coordination costs due to proliferation of sub-specialties to treat complex conditions.

Digital and technological adoption

Required investments in new systems and innovations (e.g. genetic sequencing) to support new models of care.

Capital constraints

Greater reliance on debt financing for site modernization, alongside increased operational costs from shifts to subscription-based models.

Alternative revenue sources

Reduced margins from ancillary businesses (e.g. retail, research, parking, etc.) due to behavioural changes.

Social Determinants of Health (SDH)

Increased healthcare access issues and costs due to SDH (e.g. income, education, housing) and an aging population.

What is a structural deficit?

A situation where a hospital's recurring expenses required to cover efficient operations consistently exceed its revenue, indicating a fundamental imbalance between ongoing costs and incoming funds.

What can you do?

While health authorities seek to implement remedies at the system level (e.g. funding, policy amendments, etc.), hospitals need to do their part to secure long-term financial sustainability by:

Thinking differently: Shifting reliance from traditional ways of working to innovative models of care, leveraging technology (e.g. Artificial Intelligence, Machine Learning) to realize sustainable savings.
Focusing on execution: Rapidly mobilizing the required changes in short-order – have a bias to action.
Leveraging partnerships: Understanding your ecosystem and working with both traditional and non-traditional partners

Enhance efficiency without compromising the excellence of care.

Six levers to achieve financial sustainability

When looking to unlock savings our team recommends an approach focused on six levers.

Key goals	Hospital/Local solution
Clinical operations Drive efficient and effective care delivery	LOS/Flow optimization: Care pathway redesign, discharge planning, OR productivity Program-level CPWC: Resource utilization, capacity management
Back-office and service optimization Optimize back-office services across hospital sites	Centralization / shared service optimization Outsourcing non-core services
Workforce Better forecast healthcare staffing needs	Leveraging alternative roles and team-based models Scope of practice optimization Scheduling optimization
Automation and digital adoption Streamline manual processes and boost digital usage	Application consolidation, legacy system replacement, cloud adoption, workflow automation Data standardization and analytics integration
Capital Effectively budget and finance the increasing costs of property, plant, and equipment	Debt and financing strategy optimization Monetization of assets Alternative/supplementary revenue sources
Integration of care Reduce system costs, maintain clinical outcomes, and ensure complete integration of all data and information	Repatriation of services to lower cost providers Development of partnerships across care continuum Leveraging public-private partnerships

How our team can help

Advanced data-driven diagnostics

Identify local and systemic pressures to understand structural deficits' root causes
Assess population health service needs and their funding implications
Work with stakeholders to understand data quality, anomalies, and financial results interpretation

Practical application

Realize and re-invest immediate savings and plan for future needs with viable short and long-term gains
Identify tried-and-true innovations to implement and scale based on your unique circumstances
Facilitate change management from leadership to your frontline to ensure successful adoption

Sustainable by design

Utilize innovations like predictive analytics and AI for sustained financial performance
Design and implement governance structures and incentives to foster accountability and transparency
Build internal capacity and capability for long-term financial improvement

Call to action

To learn more about how your hospital can implement these strategies for financial sustainability, download the document "Achieving financial sustainability in Canadian healthcare."