The mantra "from volume to value" has been repeated long enough that most hospitals and health systems realize the need to change the traditional way of delivering care. But what exactly should this new model look like, and how can providers get there? Patrick Pilch, managing director of BDO Consulting and former vice president of managed care and new business development at Great Neck, N.Y.-based North Shore-Long Island Jewish Health System, shares four of the many questions hospital and health system leaders should ask when developing a strategic plan for new care delivery models.
According to Mr. Pilch, answering these questions while also evaluating the numerous considerations that come with developing a new healthcare delivery strategy, including physician alignment, payor strategies and IT requirements, will help healthcare leaders develop a roadmap to future success.
1. What are the needs of the community? A good starting point for developing a new healthcare delivery model is to assess the needs of the community and the demographics of the patient population. The patient population needs to be examined to determine the right care, in the right setting and at the right time along the continuum of care, Mr. Pilch says. As the population ages and as patient needs evolve, healthcare providers will need to reevaluate the community's needs and adapt their care models accordingly.
2. Where are we, and where do we need to go? Healthcare leaders need to evaluate their organizations' current and desired role in the community to begin developing strategic plan objectives. They should ask questions such as, "What are the community's needs?," "What are our deficiencies in key services?" and "Knowing this, how do we build out?," according to Mr. Pilch. He says healthcare leaders should "focus on where they need to be in three to five years and build toward that. At the same time, they must continue to focus on day-to-day operations to make sure they're not losing the gains they've made in terms of the transition period, aligned cost structure and performance improvements." He also suggests leaders examine their hospitals' mission and vision and ensure their new healthcare model remains consistent within that framework.
3. What skills do I have, and what do I need? After developing short- and long-term goals, hospital leaders need to assess their organizations' capabilities for meeting these goals. A critical tool in any care transformation project is data. Leaders need to determine their hospitals' data analytics abilities, and if necessary, identify partners that could help provide analytics and decision support services, according to Mr. Pilch. In addition to data capabilities, leaders need to evaluate their hospitals' clinical strengths and align with other providers to help meet the healthcare needs of the community.
4. How can I provide care in the most appropriate setting? To meet healthcare reform's goals of high-quality care and better patient outcomes while lowering the cost of care, healthcare providers need to seek ways to deliver care in the right place and at the right time. Many hospitals are focusing on preventing unnecessary emergency department visits by providing easy access to outpatient options, such as urgent care clinics, and enhancing their primary care service and chronic disease management offerings. Diverting unnecessary ED visits to outpatient locations can reduce costs, ED crowding and wait times.
In addition to better patient outcomes and higher-quality care, the cost savings opportunities of providing care in the most appropriate setting are leading many hospitals to develop and implement an ambulatory care strategy, according to Mr. Pilch. Hospitals need to consider their options for entering the ambulatory care market and how they can expand their services to preventive, wellness and chronic disease management services, he says.
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According to Mr. Pilch, answering these questions while also evaluating the numerous considerations that come with developing a new healthcare delivery strategy, including physician alignment, payor strategies and IT requirements, will help healthcare leaders develop a roadmap to future success.1. What are the needs of the community? A good starting point for developing a new healthcare delivery model is to assess the needs of the community and the demographics of the patient population. The patient population needs to be examined to determine the right care, in the right setting and at the right time along the continuum of care, Mr. Pilch says. As the population ages and as patient needs evolve, healthcare providers will need to reevaluate the community's needs and adapt their care models accordingly.
2. Where are we, and where do we need to go? Healthcare leaders need to evaluate their organizations' current and desired role in the community to begin developing strategic plan objectives. They should ask questions such as, "What are the community's needs?," "What are our deficiencies in key services?" and "Knowing this, how do we build out?," according to Mr. Pilch. He says healthcare leaders should "focus on where they need to be in three to five years and build toward that. At the same time, they must continue to focus on day-to-day operations to make sure they're not losing the gains they've made in terms of the transition period, aligned cost structure and performance improvements." He also suggests leaders examine their hospitals' mission and vision and ensure their new healthcare model remains consistent within that framework.
3. What skills do I have, and what do I need? After developing short- and long-term goals, hospital leaders need to assess their organizations' capabilities for meeting these goals. A critical tool in any care transformation project is data. Leaders need to determine their hospitals' data analytics abilities, and if necessary, identify partners that could help provide analytics and decision support services, according to Mr. Pilch. In addition to data capabilities, leaders need to evaluate their hospitals' clinical strengths and align with other providers to help meet the healthcare needs of the community.
4. How can I provide care in the most appropriate setting? To meet healthcare reform's goals of high-quality care and better patient outcomes while lowering the cost of care, healthcare providers need to seek ways to deliver care in the right place and at the right time. Many hospitals are focusing on preventing unnecessary emergency department visits by providing easy access to outpatient options, such as urgent care clinics, and enhancing their primary care service and chronic disease management offerings. Diverting unnecessary ED visits to outpatient locations can reduce costs, ED crowding and wait times.
In addition to better patient outcomes and higher-quality care, the cost savings opportunities of providing care in the most appropriate setting are leading many hospitals to develop and implement an ambulatory care strategy, according to Mr. Pilch. Hospitals need to consider their options for entering the ambulatory care market and how they can expand their services to preventive, wellness and chronic disease management services, he says.
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