Hospitals and health systems are constantly balancing the need to maintain focus on delivering quality care to all the patients they serve with trying to run a successful business. As shifts in site of care, evolution of payment models and patient choice drive macro changes, how do hospitals and health systems deliver quality care while maintaining financial performance?
Organizations that are most likely to succeed in this environment are those with strong physician input into clinically integrated cost management decision-making.
To learn more about succeeding in this challenging climate, Becker’s Healthcare recently spoke with John Young, MD, chief medical officer and senior vice president of clinical and advisory solutions at HealthTrust Performance Group.
Both acute and non-acute care organizations need help with total cost management
ASC innovation around surgical and anesthesia techniques, as well as recovery strategies, has been a major contributor to the decreasing number of procedures on the CMS “inpatient only” list. That’s good news from a patient perspective, but the impact on hospitals is profound.
“Patient acuity and case mix indexes are going up, leaving more complex care in the hospital,” Dr. Young said. “Caring for these patients requires additional investment in capital and technology. It also demands a higher skilled staff set.”
In response, hospitals are reevaluating their care delivery strategies. Many are consolidating activities, analyzing value streams to remove waste and seeking economies of scale. At the same time, non-acute care organizations like physicians’ offices and ASCs are engaging in similar work to improve their efficiencies.
Physician input to shared decision-making helps healthcare organizations thrive
According to Dr. Young, healthcare organizations that will do well in today’s challenging environment are the ones that engage physicians in shared decision-making and collaborative work. One key to success is focusing on growth areas that ASCs can’t capture.
“You need conversations with physician leaders to identify where savings are possible on the commodity side, so the organization can stand up new growth businesses,” Dr. Young said. “Using cardiology as an example, if you want to start a complex EP program or TAVR program and you have a lot of variation in drug-eluting stents, those are commodities where you can standardize.”
Bringing physician input into organizations with HealthTrust Performance Group
In 2015, HealthTrust Performance Group created a physician advisor group that consists of around 125 physicians from its 1,800 member hospitals. One of the most important roles that physician advisors play is providing the physician’s voice in HealthTrust’s clinically led strategic sourcing process.
“We also reach out to physician advisors about best practice guidance, toolkits and operational efficiencies that they’ve delivered in their health systems,” Dr. Young said. “If members are having trouble standardizing on a product or they need to move from one product to another, we facilitate a peer-to-peer connection with the physician advisor network so they can learn how another organization made a similar change. This has proven to be very valuable and a service that no other GPO provides.”
HealthTrust Performance Group delivers value across acute + non-acute sites of care
Healthcare organizations of all kinds recognize that GPO and contracting services alone aren’t enough to manage costs effectively. In response, HealthTrust has built total cost management capabilities around its core GPO, focusing on areas like capital, facilities, engineering, purchasing, services, workforce efficiencies and clinical and operational improvement.
“Our members expect us to have a differentiated market value and to simplify everything as much as possible,” Dr. Young said. “That means simple models, guidance, toolkits and strategies to promote operational efficiencies. They want transparency in the supply chain, analytics and the business, as well as supply chain resiliency and business continuity plans.”
HealthTrust offers the same robust contracting and clinical strategy services to acute care members and to non-acute physician practices and ASCs. For non-acute members, HealthTrust’s AdvantageTrust group provides simple contracts and standard pricing across all classes of trade and sites of care.
“Seeing the market through both the acute and non-acute lenses gives us a broad view of what’s happening in the market and how care delivery is changing,” Dr. Young said. “It also helps us identify where to focus our efforts to provide the best service to our members.”
HealthTrust Performance Group is committed to helping all members understand policy, payment and regulatory factors, as well as market dynamics. Based on this knowledge, organizations can conduct scenario planning and identify the best ways to deal with today’s evolving business environment.
“At the end of the day, organizations need strong physician leadership and strong physician partners to combat the shifts that are occurring,” Dr. Young said.