To arrive at sound answers, organizations must first ask the right questions.
The following questions stem from articles published by Becker's Hospital Review. They pertain to strategic planning, clinical integration, legal affairs and employee relationships. Each set of questions is linked to the original article, where readers can find more context and explanation around the questions.
Strategic Planning
8 Questions to Determine Whether a Hospital is Sustainable
Scott Becker, JD, CPA, partner with McGuireWoods in Chicago, says answers to the following questions are telling as to whether a hospital will end up going bankrupt or being sold.
1. Does the hospital have a clear strategy for physician alignment?
2. Does the hospital have high quality care?
3. Does the hospital have a great leadership team?
4. Does a hospital have a clear plan, or is it operating vaguely?
5. Does the system have a clear reason for being?
6. Is the hospital known for something?
7. What is the payor mix?
8. Is the hospital large enough to afford some chance investments?
10 Questions to Determine Path for Care Transformation
The following 10 questions can help hospitals determine which "path" they must take for care transformation. The available paths are:
- Redefine to a different care delivery system (such as more ambulatory or long-term care oriented).
- Partner with a care delivery system or health plan for greater horizontal or vertical reach, efficiency and resources for at-risk contracting.
- Integrate by developing a health insurance function or services across the continuum (such as behavioral health, home health, post-acute care, etc.)
- Experiment with new payment and care delivery models, such as bundled payments, accountable care organizations or patient-centered medical homes.
- Specialize to become a high-performing and essential provider.
1. What are the primary community health needs?
2. What are the long-term financial and clinical goals for this organization?
3. Would the organization be included in a health insurer's narrow/preferred network, based on cost and quality outcomes?
4. Is there a healthy physician-hospital organization (or business model that aligns physician in private practice with hospitals and hospital-employed physicians)?
5. How much financial risk is the organization willing or able to take on?
6. What sustainable factors differentiate the organization from current and future competitors?
7. Are the organization's data systems robust enough to provide actionable information for clinical decision making?
8. Does the organization have sufficient capital to test and implement new payment and care delivery models?
9. Does the organization have strong capabilities to deliver team-based, integrated care?
10. Is the organization proficient in program implementation and quality improvement?
22 Questions to Build a Healthcare Brand
The following 22 questions can help healthcare leaders assess their current brand and market competition.
1. How and when did your organization originate?
2. What does it offer to the community, your patients and care providers?
3. How has the brand been represented in the past?
4. What is its current positioning in the mind of the consumer?
5. What is its current market position?
6. How do the people behind your brand talk, act and think about the patients they treat?
7. What are consumers' current perceptions of your brand, your competitors and the category as a whole?
8. What do physicians and healthcare professionals think?
9. What interests consumers and physicians, makes them happy, keeps them up at night?
10. What do you offer that can improve their quality of life?
11. What would make consumers and physicians choose your brand again?
12. What are stakeholders willing to believe about your brand that is somehow different and more desirable than the competition?
13. What factors do patients, employees and physicians consider when choosing a healthcare organization?
14. What are the relationship-building attributes that resonate emotionally with your audiences?
15. Are the drivers tangible or intangible?
16. Which attributes do you need just to be considered?
17. Which attributes offer the highest return on investment and which aren't worth spending time or money on?
18. What's important to your community that you can do better than all your competitors?
19. Who are your direct and indirect competitors?
20. When you reverse-engineer their brands, how are they positioning their organizations?
21. Are their messages different or the same as yours?
22. Are the things your competitors are saying true?
5 Questions to Ask When Choosing a Retail Clinic Location
1. Will the location attract the desired patient demographic?
2. Is there an unmet primary care need in this location?
3. How are the local demographics and demand expected to change?
4. What are the traffic patterns like?
5. Where are the Starbucks, or another national chain, located?
19 Questions to Ask to Assess a Hospital's Capabilities for Accountable Care
1. Do we have engaged physician leaders with the vision and commitment to pursue clinical integration and accountable care?
2. Do our physicians understand and can they envision bridging the gap between fee-for-service and population-based care delivery?
3. Do we currently have a clinically or financially integrated network of providers, or will we have to form a new legal entity?
4. Do we have the governance structures with the status and credibility to make and enforce decisions about care management and providers' ongoing participation in the network?
5. How do we measure performance? Do we have tools and data to measure and identify variances?
6. Do our providers embrace and practice according to evidence-based guidelines?
7. Do we have the resources and staff to identify gaps in care, track and engage patients and coordinate their care?
8. Do we have the leverage to engage physicians and ensure alignment with clinical quality/value objectives?
9. Do we have the care coordination resources to engage patients, conduct outreach, measure feedback and improve patient experience?
10. Do we have scope or affiliations to facilitate integrated care delivery across the continuum?
11. Are systems and incentives designed and aligned to deliver the desired outcomes?
12. If not, do we have or can we develop plans, strategies and resources to address these areas effectively and in a timely manner?
13. Do we have baseline data to measure physician performance?
14. How will we obtain physician practice-level data? How will we expand or create those data sets?
15. How will we provide timely, actionable information to providers to support clinical decision making?
16. Do we have experience with risk and/or pay-for-performance programs? With bundled payments and episodic payments?
17. Do we have data to estimate performance under alternative payment arrangements?
18. Do we have actuarial support to validate targets?
19. Do we have financial stability to weather new risk/financial arrangements?
Clinical Integration or Hospital-Physician Relationships
5 Questions to Ask Before Acquiring a Physician Practice
1. Is the acquisition part of a larger strategy?
2. Is this acquisition really needed?
3. Did we assess the practice?
4. What are the acquisition's potential side effects?
5. Will the physician enterprise be adequately supported?
9 Questions to Assess Whether Physicians are Strategic Partners in a Hospital
1. Does your organization struggle to recruit or retain physician leaders?
2. Do executives or physicians ever describe each other as "us" and "them"?
3. Are you unable to identify three recent key decisions where your executive team deferred to physicians on matters beyond clinical practice or issues directly affecting physicians?
4. Does most of the feedback your administration receives come from a handful of vocal physicians?
5. Does your organization have a number of low-traffic or abandoned physician communication channels?
6. Is physician governance still focused on clinical and practice management issues?
7. Do physicians routinely fail to show up to meetings or respond to communication from hospital leadership?
8. Do key decision makers rarely participate in or respond to feedback from existing physician forums?
9. Does your executive team primarily rely on in-person meetings to ask for input from physicians?
Legal Affairs
16 Questions to Assess Hospital Legal Compliance
1. Is everyone at the organization challenged to do the right thing for compliance? Does the board hold everyone accountable for conforming to the organization's compliance policies and procedures?
2. Are performance incentives tied to satisfying compliance goals?
3. Does the chief compliance officer report directly to the CEO and a compliance committee of the board? Are the CCO and CEO reporting periodically to the board on compliance efforts, findings and issue resolution?
4. Is the CCO at the table when business decisions are made?
5. Does the organization have clear procedures in place so employees can safely report concerns of potential fraud and abuse? Does the organization ensure any reported issues are promptly and effectively investigated?
6. Are there appropriate procedures in place to ensure self-reported items follow Office of Inspector General and CMS protocols?
7. Are there designated individuals responsible for following legislative and regulatory updates, both state and federal, to ensure the hospital is kept compliant? Do these individuals follow pending legislation to help the organization proactively plan for changes?
8. Is the hospital effective in coordinating compliance and quality assurance functions to keep pace with the linking of reimbursement to patient outcomes?
9. Does the CCO or staff monitor the OIG semiannual report to Congress and the annual Health Care Fraud and Abuse Control Program report from the Department of Justice and OIG?
10. Does the CCO review the OIG Work Plan each year?
11. Does the hospital review the requirements of recent corporate integrity agreements to understand the OIG's current expectations of compliance programs from similar organizations?
12. Does the hospital conduct a robust self-assessment at least once per year to evaluate billing, coding and documentation efforts?
13. Does the hospital have an established process where any noted billing errors, problematic contractual issues or other potential violations are promptly reported to an internal team?
14. Does the hospital's compliance department and legal counsel preview any proposed contractual agreements to consider potential violations of the Stark Law or federal anti-kickback law?
15. If the hospital has acquired physician practices, has the organization provided educational programs to ensure employed physicians understand and embrace the protection of personal health information, privacy requirements and other aspects of practice that may be somewhat different as an employee?
16. Does the hospital use innovative data analytics to identify areas of potential fraud for internal investigation?
Employee Relationships
10 Questions to Gauge How Employees See a Hospital
1. Are our core values are deeply ingrained into our decision-making process?
2. Do we have fun at work?
3. Do we have a system in place to show that we care about the personal lives about our employees?
4. Do we hire for fit in addition to skill?
5. Do we quickly and appropriately move the wrong people out of the organization?
6. Do our employees get personally involved in our community service activities?
7. Do we regularly measure employee engagement, create action plans and communicate results?
8. Do we have a robust reward and recognition program?
9. Do we regularly demonstrate our commitment to growing and training our employees?
10. Do our employees feel like they are here for a purpose beyond just their job?
More Articles on Hospital Strategy and Management:
The Hospital CEO's Ultimate Dashboard: What to Check Daily, Quarterly and Yearly
Notes on Leadership: 15 Insights from Hospital & Health System CEOs
11 Most Concerning Issues for Hospital CEOs