Shifting from a volume-based business model to a value-based model can require exhaustive research, meticulous planning, steadfast implementation and careful monitoring going forward. But the rewards can be a transformation that allows an organization to survive and thrive in the ever-changing world of healthcare.
According to a report by McKesson, based upon the pharmaceutical corporation’s survey of payers and providers and an Accountable Care Organization (ACO) readiness study, executives at top performing ACOs – where doctors, hospitals, and other healthcare providers team to give coordinated care to Medicare patients – strategies in four areas in particular are allowing them to reduce spending and deliver services more effectively.
1. Strategic Management and Leveraging Analytics
The foundation for any successful organization is intelligent management, from establishing a clear vision to developing and following a strategic roadmap that considers the provider and payer landscape in play and how to successfully navigate it to achieve the desired goals. This process involves issues including governance, technological infrastructure, ﬁnancial strategy, staffing and patient care.
Peter Goldbach, M.D., chief medical officer of RediClinic and Health Dialog, states in an article for HHN magazine that population management is key to controlling costs and improving care with reduced use of emergency departments and fewer hospitalizations. Taking advantage of the latest analytic and reporting capabilities that provide insight into costs, utilization patterns and disease progression can be particularly valuable.
2. Developing a Tailored Network
No healthcare organization can operate effectively as an island. Healthcare executives and hospital board members should be focused on developing a clinically integrated, living and breathing network for patient care.
A successful network incorporates not just the right complement of primary care and specialty physicians but also low-cost facilities that can offer high-quality services. This multifaceted approach allows delivery of improved, streamlined care that can cover a wide range of patient situations.
3. Practice-free Transformation
Make the transition as smooth as possible. Managing change – from patient ﬂow to service delivery to addressing compliance and more – is a steep obstacle to overcome. But understanding the best way to make specific changes – and when – can reduce the amount of disruption, ensuring a better experience for both patients and staff.
Use your healthcare leadership style to enlist the help of doctors and staﬀ to successfully manage a new reimbursement environment mixing fee-for-service and value-based payments.
4. Patient Care Coordination and Communication
Patient care must be diligently tracked across the care continuum. To achieve better outcomes, healthcare executives need to recognize the importance of having a sufficient number of managers, registered nurses and nursing assistants for oversight and managing utilization as patients transition between hospitals, home care, and ACOs.
The McKesson report also stressed the value and necessity of managing, collecting and analyzing disparate data that is available. It can be vital to evaluating operations and considering modifications to established protocols or launching initiatives in new areas.
Moreover, the most successful healthcare organizations consider technology systems when optimizing any one of these four of critical areas. When patient data is accessible and communications are clear at every intersection of the patient's journey, healthcare providers can benefit from lower costs and patients can receive better care.
The Executive Master of Health Administration program through USC’s Sol Price School of Public Policy offers healthcare professionals a graduate-level education designed to prepare them to navigate the changing landscape of healthcare.
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