Five Strategies for Success
By Jeff Wood, Vice President, Product Management, Navicure
Twitter: Â @Navicure
The healthcare industry is in the midst of a major transformation. Traditional fee-for-service models are giving way to value-based ones that aim to better link healthcare costs with healthcare quality.
From patient-centered medical homes (PCMHs) to accountable care organizations (ACOs), providers across the country are joining forces in record numbers in pursuit of this common goal. In fact, the Medical Group Management Association (MGMA) estimates that more than half of U.S.-based physician practices are now owned by hospitals, representing a nearly 75 percent increase in the number of physicians employed by hospitals since 2000.
Unlike the hospital-practice consolidation that took place during in the 1990s, these efforts are singularly focused on alignment. Why? In order to make these relationships work, today’s hospitals and physician practices know they must synchronize their own needs and requirements with those of their partners.
As traditional organizational boundaries expand, there are a number of different strategies hospitals and physician practices can deploy to successfully achieve alignment across clinical, financial and technological lines. These include:
- Building a culture that embraces change. When moving toward a value-based model, it is critical that staff at all levels of the organization support new programs and initiatives. To ensure all voices are heard and all viewpoints are represented, it’s a good idea to appoint a diverse mix of affiliated and employed physicians to key leadership roles.
- Matching hospital objectives with practice incentives. Unless physicians and hospital executives are on the same page, it’s nearly impossible for meaningful transformation to take place. Hospitals can better advance their accountable care goals by employing financial incentives that encourage physicians to engage in specific behaviors and promote desired outcomes.
- Establishing interoperability between key IT systems. While hospitals and practices will continue to have different needs when it comes to HIT, it’s vital to enable secure, seamless access to patient and financial information across care settings. Having the ability to pull from a common, comprehensive set of data not only allows providers to better collaborate and coordinate care, but it also enables organizations to measure their progress and track results across the entire enterprise.
- Adjusting workflow processes. Once the right tools and technologies are in place, creating clear, coordinated processes for fundamental workflows is an important step. Denial management, for example, should be carefully monitored as workflows are integrated to prevent any potential disruptions to cash flow.
- Establishing and monitoring key performance indicators. Today’s focus on value-based reimbursement makes it imperative for provider organizations to track important metrics like denial rates, A/R days and productivity. With this data in hand, provider organizations can easily identify any challenges as well as areas for improvement.
By paving the way for greater collaboration, hospitals and physician practices can achieve a successful transition to value-based care, ultimately resulting in better outcomes and lower costs.
About the author: Â Jeff Wood currently serves as vice president, product management at Navicure, a leading healthcare billing and payment solutions provider for hospitals, physician practices and billing companies. He is a veteran of the healthcare industry and has experience helping hospitals and physician practices successfully implement and adopt HIT to improve workflow, reduce costs and drive efficiencies.