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