The reformation of our
healthcare system to one that is value-based, rather than volume-based, is
still an ongoing process with quite a way to go. Getting to value is not an
easy, or straightforward road. Healthcare organizations, including
providers, payers, and the government have all encountered numerous starts and
stops, dead-ends, and flat-out blockades. Some pioneering organizations
have made great progress, but navigating the journey to value-based care is no
small feat for any organization and requires a thoughtful plan of action
matched to exceptional leadership.
A well-thought out roadmap to
value-based care for a healthcare delivery system includes considerations of
organizational structure, integration of facilities, geographic expansion of services,
measurement of outcomes and costs of care, reimbursement reforms, and
integrated information technology (Porter
and Lee, HBR). All components of the roadmap are important and each
component presents its own unique challenges.
For instance, take the
measurement of outcomes of care and the costs to achieve that care. To
determine either one, you must first determine perspective. Clinicians,
patients, and other caregivers can each have their own set of criteria by which
they measure a successful outcome of care. The key for an organization is to
align those criteria to form a set of metrics which provide sufficient
clinical, but patient-focused information about the care being delivered and
the process through which it was delivered. When measuring costs,
perspective is again paramount. Is the organization interested in
measuring the costs associated with the delivery and provision of care only?
Are they also interested in measuring the cost to the patient of consuming that
care? Perhaps, they are interested in the costs to employers of care? Perhaps,
to the healthcare system as a whole? All are valid questions and
measurements that determine how organizations will report their unique value
proposition.
With unique experience in
designing and implementing value-based programs at leading healthcare
organizations InterOPERANT provides guidance and leadership to assist our
clients in determining their unique roadmap to value-based care.
For more information about our solutions, please contact me:
Heidi Wied Bunyan, MPH,
MHA, FHFMA
Don Lyons, FACHE, Managing Partner
