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Building a Value Model for Population Health Management

Posted by Matthew Smith on Jun 16, 2017 10:40:18 AM

By Daniel J. Marino, MBA, MHA, Executive Vice President, GE Healthcare Camden Group

Most healthcare leaders understand the importance of managing the health of their patient populations. Building the tools for effective patient population management is key to improving outcomes while “bending the cost curve” in U.S. healthcare.

At the same time, executives are concerned about the cost of population health initiatives. What level of investment is needed to effect change? What is the right pace for transitioning from fee-for-service (FFS) to value-based payment? Finance leaders, in particular, are concerned about preserving margins during the transition.

How can a healthcare organization maintain profitability as spending increases on population health initiatives while FFS revenue decreases?The only way to answer these questions is to use a data-driven “value model” to predict and manage the total financial impact of the population health initiatives.

An ideal value model will accomplish three goals:

  1. Quantify the output of population health interventions, including shifts in utilization and changes in cost of care.
  2. Help identify population health investments that will move the organization forward while retaining margin.
  3. Allow finance leaders to support value-based contracting with predictions of costs and the quality of outcomes.

 To continue reading this article, please click on the button below to download a PDF.

Value Model, Population Health

Topics: Value-Based Care, Population Health, Value-Based Contracting, Daniel J. Marino, Value Model

Healthcare Transformation Complexities Broaden Leadership Development

Posted by Matthew Smith on Jun 12, 2017 11:24:44 AM

By Darryl Greene, MS, Vice President, and Alexander M. Pinto, Ed.D., FACHE, Manager, GE Healthcare Camden Group

Complexity and change are not new terms or realities to manage, yet in healthcare it is the pace and extent of change that is often the topic of conversation, as we all seek solutions to address this new normal. 

This is an environment in which the complexity of day-to-day care delivery and operations now places tremendous demands on leaders and their staff, often causing them to overextend while trying to keep up. This tsunami-like type of change in healthcare can often be characterized by leaders as a sought-after future state without a clear destination and without a pathway for organizations to adapt, thereby compelling them to pursue significant numbers of internal transformations, often simultaneously.

Consider New Roles and Responsibilities

The external drivers, such as new policies, new regulatory requirements, new consumer expectations, and new business models, are driving internal actions like new operating models, new strategic initiatives, new information management needs, new technology, and new processes. The necessary internal changes do not end here; a significant human component exists that also requires consideration of new roles and responsibilities, new skills, new behaviors, and new ways of working together. This degree of change even impacts organizations’ cultures to the point where leaders and their staffs are attempting to develop strategies to refuel the passion and joy they once experienced in practicing medicine.

GE Healthcare Camden Group believes this wave of change can and has flooded the functional capacity of most healthcare organizations, their teams, and their individuals. Adding resources is rarely an available or right option--thus a pause with purpose is needed. A new way of leading must be contemplated while asking fundamental questions such as:

  1. How do we impact the human side of change and create capacity for our leaders and our teams, improving their ability to deal with the complexity and volatility of their current reality? 
  2. How do we design systems of care that embrace a culture of problem-solving and collaboration, in the face of evolving change, growing ambiguity, and our patients’ quest for best-in-class outcomes?
  3. How do we cultivate a new leadership mindset instilling cognitive, behavioral changes in our leaders that advance our relationship building skills, our culture of collaboration, and embraces a new healthcare landscape comprised of interdependent care delivery and systems-based, patient centered care?

Synergistic Leadership Development

We believe the answers begin with individual leadership development, supporting leaders to become more self-aware, while also broadening their perspective-taking skills, and teaching them to engage their teams in methods to co-create solutions relative to existing issues. Additionally, focus is needed on the healthcare leadership team emphasizing unambiguous roles and responsibilities fostered by a collaborative yet interdependent nature of sharing work and accountability amongst clinical (physician, nursing, and allied health), operational, financial, and strategic leaders. Because your leaders’ performances and impact on the organization doesn’t happen in a vacuum, there must also be support for them by advancing and implementing systems and structures in the organization for effective and sustained delivery towards balanced measures and goals. The emphasis on leadership development across three areas we refer to as synergistic leadership development (Figure 1).


Figure1_Greene.png


At the core of our leadership development, a systems and structures framework is needed that supports leaders and teams in strategy to activation efforts. The Culture Driven Performance Management model (Figure 2) provides such a framework. Through implementation of this framework model, the organization’s leaders benefit from the development of individual and team competencies and skills, while working collaboratively in setting the direction for their organization, aligning the organization’s strategic goals, and executing to achieve targets. This empowers active involvement of leaders in a customized curriculum to expand their competencies while immediately integrating those skills in their work. Integrating an experiential learning approach both advances the value proposition to leaders and advances the culture of performance to achieve organizational goals (Figure 3).


Figure2_Greene.png


Figure3_Greene.png


New Leadership for the New Normal

This new norm of transformational change in healthcare requires a new leadership development approach for institutions to thrive--an approach like synergistic leadership development, that is focused on advancing the capacity of individuals and teams, while fostering interdependent functions, maximizing their impact as they leverage supporting management systems. The task ahead of us is:

  1. Assess the current state of organizations relative to a framework with this filter.
  2. Create a tailored roadmap of leadership development (individual, team, and management systems/structures) to capitalize on the greatest leverage or impact areas.
  3. Support our teams and organization through cultural advancement while empowering cognitive, behavioral change at an individual level.
  4. Collaborate to advance these organizations amidst complexity and change to provide even better care delivery to patients.

d.Greene-1.jpgMr. Greene is a vice president for the strategy and leadership practice at GE Healthcare Camden Group. He has more than 18 years of strategy to execution consulting experience, including 11 years in healthcare. He has significant expertise in strategic planning, business management systems implementation, talent management, performance improvement, leadership, and leading and executing transformational and culture change. He may be reached at darryl.greene@ge.com. 

 

Pinto.pngMr. Pinto is a manager with GE Healthcare Camden Group, with more than 15 years of healthcare industry experience spanning allied health provider, health system, and healthcare consulting roles. His experience includes system leadership, performance improvement, and advisory/design roles. Additionally, he has a strong and diverse academic background in adult learning, organizational design, and the development of leadership and engagement programs. He may be reached at alexander.pinto@ge.com. 

 

 

Topics: Healthcare Transformation, Darryl Greene, Leadership Development, Synergistic Leadership Development, Alexander Pinto

Top 10 Reasons to Integrate Your Inpatient Case Management with Your Population Health Initiatives

Posted by Matthew Smith on May 30, 2017 10:42:24 AM

By Mark Krivopal, MD, MBA, Vice President, & Tara Tesch, MHSA, Senior Manager, GE Healthcare Camden Group

Most hospitals understand the importance of inpatient case management. Yet, when asked how care managers are coordinating care for the inpatient population, most responses are focused on discharge planning tactics or utilization management strategies. The patient’s care is not truly being managed – just their length of stay (“LOS”), inpatient progress, and planning for discharge to avoid a readmission.

As the focus on value-based care is increasing, and more care is shifting into the ambulatory space while the U.S. population continues to age, a higher proportion of vulnerable ambulatory patients find themselves in need of holistic supportive care. Health systems are realizing the importance of ambulatory care management as a crucial foundation to managing populations across the care continuum by delivering high quality and patient-centric care while keeping in check avoidable costs. High performing organizations have implemented integrated care management programs focused on managing patients across care settings that include deciphering patients’ various medications, coordinating the many care directives from multiple providers, ensuring safe transitions of care from a post-acute care setting to the home, and helping patients with transportation difficulties or other social barriers to seeking care at the right time and at the right place.

The challenge though, is that many organizations are still thinking about delivering care within silos rather than integrating and aligning the initiatives within a patient-centric care delivery model. Outlined below are 10 reasons you should consider integrating your care management across the care continuum to support your population health initiatives.

1. Integrated care management addresses inefficiencies in managing the high risk populations and addresses LOS challenges and shifts in utilization to support the most effective care resource model.

The shift to value-based care delivery and the strengthened incentives for advancing value-based reimbursement will lead health systems and providers to renew their focus on adopting care models to support management of high-risk, high-cost patients, complex, and chronic care patients, in addition to disease-specific management programs. This will require new approaches to expanding patient access to lower cost sites of care and providing patients a more effective and simpler approach to navigating their care. The integrated care management model supports organizations and providers in developing innovative models (see graphic below) focused on reducing inefficiencies, managing medical spend, and improving patient access. Integration of targeted, evidence-based programs such as post-discharge transitions, complex care management, disease-specific, and episodic care pathways, as well as proactively connecting patients with behavioral health needs to appropriate care management and community services are just some of the strategies that have proven success.

For full-size image, click here.

integrated_care_management-1024x720.png

2. Duplication of care management services causes competing priorities and operational inefficiencies and redundant costs.

An integrated care management model provides a seamless patient experience across the continuum of care when there exists one aligned team to care for the patient. For organizations to achieve an integrated care management model requires not only effective communication channels and standardized care processes, but the analytics and information technology systems to support these care processes. Duplication typically occurs because barriers in technology and lack of standardization of workflow processes limit the ability of care managers to share information as the patient moves across different sites of care. Due to the limitation in electronically aggregating the necessary clinical information, care managers are not able to coordinate their efforts and spend significant time manually gathering information from providers. As a result, time is spent on manual documentation and patient management that could be automated, and more staff is typically added to ensure such information is captured, verified, and reported. The development and implementation of a shared care plan (and tools that will house the care plan) that follows the patient and is accessible by the care team, along with electronically aggregating important clinical information, are key requirements to reduce staff duplication, inefficiencies, and redundant costs.

3. One quarter of patients consume three quarters of resources, many of whom are unmanaged and lack community-based resources.

Integrated care management and coordination is a person-centered, collaborative, and multi-disciplinary process that uses population based risk-stratification and evidence-based interventions to promote optimal outcomes in a value-driven environment. By incorporating tools that allow organizations to understand the health risk level of the populations served, organizations can build more prescribed programs to track and manage high risk (and typically high cost patients), and to help prevent potentially avoidable higher-acuity, higher cost care. As organizations become more proficient in understanding the risk factors of their populations, integrated care management programs will increasingly rely on partnerships and linkages with community-based services and organizations and community health workers to help coordinate care and meet patient needs — driving the most optimal results.

4. Integrated care management addresses suboptimal transitions across the care the continuum.

The most vulnerable time for the patient is when he/she leaves the acute care setting or transitions from a skilled nursing facility back into the community. Today more patients are transitioned out of acute and rehabilitation care settings earlier than even just a few years ago. This is because more services and treatments are deemed safe to be administered in an outpatient setting. Yet, many patients are limited in their ability to thrive when one considers social determinants of health such as ability to afford medications, transportation to providers, or simply required competency level to manage their health. These factors, although likely present before the admission, are not properly addressed as part of the traditional coordinated discharge treatment plan. As a result, providers only come across these social determinants when medical errors occur, important medications are erroneously discontinued, tests are not followed up, or patients end up back in the emergency department after being discharged. Implementing patient-centric integrated care management across the continuum of care that incorporates providers expanding their discharge care plan to include social determinant evaluations helps avoid “fumbled handoffs.”

5. Integrated care management helps providers meet increased expectations around quality, cost, productivity, and patient satisfaction, critical to population health management.

The pressures on and expectations of providers (particularly primary care physicians) are immense. Physicians themselves cannot (nor should they) assume that they can address quality of care, cost, and patient satisfaction on their own. An integrated care management approach provides support to primary care practices by managing these increased expectations and helps the entire risk-bearing organization achieve success. The key is to redesign the care model to incorporate a physician-led and team-driven best practice approach. This should include integrated care plans, coordinated protocols, and outcome tracking. Providers benefit from pre-visit planning to identify complex, chronic, and high risk patients, making practice operations run more efficiently. This, in turn, leads to a more focused care plan, better managed patient flow within the practice, enhanced patient and provider satisfaction, and more coordinated overall care. By incorporating a care model that includes a significant preparatory assessment, chart reviews, and checklists to ensure preventative screening is performed and documented, providers are well-positioned to enhance the quality of care delivered and see real results within their quality performance outcomes. Those organizations that embrace an integrated care management approach find themselves better positioned to meet ever increasing demands on their expertise, time, and resources, and are better able to maximize opportunities within a value-driven healthcare world.

6. Overlap and lack of clarity in roles and responsibilities create staff dissatisfaction that can be ameliorated with integrated care management.

Over the last several years, many healthcare systems have invested substantial resources and efforts into deploying and retraining inpatient case managers to address preventable hospital LOS. As these organizations take on financial risk by participating in value-based contracting, they embed care managers in the primary care physicians’ offices to assist with managing complex patients, help with their social and behavioral needs, and improve communication around transitions of care. However, some providers are not as satisfied with this approach as one might expect. There is significant role confusion and frustration among various healthcare professionals, resulting in multiple calls to patients, for example, from home health, the care manager assigned to them by their payer, a hospital social worker, and an ambulatory care manager. Physicians are then also confused as they receive mixed messages from various care managers, which is exacerbated by lack of clarity around who they should contact in order to address some of the issues. Is it the responsibility of the hospital discharge planner to communicate important information to the ambulatory care manager, or is the ambulatory care manager responsible for contacting the hospital to get this information? Who is truly empowered and accountable for care managing the patient along the entire continuum? This can all be resolved by a single, clearly identified integrated care manager who has the responsibility to work on the patient’s behalf and serve as the single source of truth for the patient and all treating providers. Clarity around care managers’ role designation and empowerment will increase overall provider satisfaction and significantly enhance quality of care delivered to patients.

7. Integrated care management helps improve patient engagement and activation in their care.

Organizations are frequently struggling with getting patients to engage in their health in a proactive way. For many patients, active engagement in creating (and understanding) their care plan is a key to improving their health outcomes and conditions. Education and engagement with the caregivers as well as the patient is an important element in ensuring proper activation of the care plan. The integrated care manager’s care plan should include education and clear instructions to not only the patient but to care giver to ensure a common thread is formed along the complex continuum of care that bridges factors affecting patient motivation, care compliance, and the ability to activate a safe, cost-efficient, and truly patient-centric model of care.

8. Fragmented and uncoordinated care creates a poor patient experience and confusion.

When patients are battling a healthcare issue, the last thing they or their families/caregivers are thinking about is how to navigate the healthcare system. Yet, healthcare providers often overlook the basic coordination needs of patients beyond the actual treatment provided. Integrated care management is designed to ensure a positive experience for the patient and improve satisfaction in how care is provided by understanding the patient’s journey across the care continuum. Thoughtful, coordinated, and patient-centric design ensures patients remain the focus in defining processes for warm handoffs between providers and care settings, eliminating the need for the patients to repeat information or fill out duplicate forms. It provides added clarity in roles of contact with the patient, ensuring the patient/caregiver has one person to contact with questions or for support, and influences how patient materials are created and deployed (e.g., use of pictures and graphics in teaching self-care concepts, use of lay terminology rather than clinical jargon, use of teach-back and follow-up demonstrations, etc.) to reduce confusion and provide a trusted resource for patients and caregivers to access.

9. Implementing optimal integrated care management across the continuum requires support from an analytics strategy, which aligns with population health initiatives.

As organizations continue to expand their systems of clinically integrated care, building an analytics strategy that connects data from disparate IT systems will create opportunity to allow providers to act more quickly on the information. The ability to effectively aggregate data and translate that data into actionable information available at the right time, and at the point of care, should be an ever-striving goal of organizations and the foundation for effective care management. Successful integrated care management uses real time data that is turned into actionable information allowing care managers to quickly identify high risk patients and apply interventions. Gathering the right data and analyzing it correctly requires a combination of skills involving clinical knowledge, medical informatics, and technology capabilities. The analytic strategy begins with creating a culture of transparency requiring diligence in making information accessible, accurate, and easily transferrable to providers within their clinical workflow.

10. Health systems are missing opportunities to partner with payers in redesigning care delivery.

The adoption of an integrated approach to care management that is aligned with health system contracting and population health initiatives provides new revenue opportunities, when implemented successfully. By demonstrating the organization’s ability to deliver high quality, affordable care to various populations, health systems can leverage their value-based performance outcomes to engage in innovative contractual arrangements with employers and payers that align incentives across the system. Since investing in new care models and integrated care management program can be costly, it is most effective when both the providers and payers share in the investment costs and are appropriately aligned on the potential outcomes and medical cost savings. Some of this share investment occurs through innovative provider-payer partnership arrangements where the payer pays providers care coordination fees or reimbursement that is directly tied to care management services across the continuum. This will require a shared philosophy of managing care between the payer and provider as well as integrated approaches around data sharing, alignment in clinical protocols, and resource collaboration. In addition, the coordination of the care management network staff and providers aimed at promoting, maintaining, and/or restoring health will ensure a patient-centric model of care that truly spans the care continuum.

By creating a focused approach around integrated care management operations and breaking down communication barriers, organizations and providers can fundamentally transform how to deliver patient-centric care management in an integrated fashion to achieve the most optimal results possible. Well designed and properly executed integrated care management is of foundational importance for any organization aiming to achieve success within their value-based contracts. Successful implementation of an integrated care management model will empower patients and their care givers to navigate through our complex healthcare systems that lead to better quality outcomes, reduced avoidable medical costs, and improved patient and provider experience.


krivopal_M-963748-edited.jpgDr. Krivopal is a vice president with GEHC Camden Group and an accomplished senior physician-executive with 19 years of healthcare experience across the continuum of care. Dr. Krivopal is responsible for developing and leading innovative, value-based programs addressing client needs in healthcare organizations, hospitals, and physician practices focusing on transformational system integration strategies, service line optimization, throughput and clinical leadership development. He may be reached at mark.krivopal@ge.com

 

Tesch_T_headshot.pngMs. Tesch is a senior manager with GE Healthcare Camden Group with more than 18 years of experience as a healthcare leader and strategist. Ms. Tesch specializes in value-based care delivery strategic planning, CIN development and implementation for commercial, Medicare, and Medicaid populations, health information technology data governance and analytics strategy, as well as care management strategy, design, and implementation. She may be reached at tara.tesch@ge.com

Topics: Population Health, Care Management, Tara Tesch, Mark Krivopal

House of Cards: Using Process Simulation Modeling As the Glue for Practice Transformation

Posted by Matthew Smith on May 26, 2017 9:42:32 AM

Adapting to the current healthcare environment for most medical groups may feel like a house of cards, each card representing a different initiative precariously stacked, one on top of the other, with the slightest slip causing the pieces to crumble.

Medical groups are scrambling to understand changing reimbursement structures, to establish new systems of care and to integrate with larger health systems to manage populations of patients, all while trying to maintain patient and provider satisfaction. With all of these factors competing for attention and change fatigue rampant among providers and staff, it can be difficult to implement the necessary changes to help achieve a vision for practice transformation.

Because of this fragility, practices often fear that the change itself will be their undoing. However, successful change can be achieved with thoughtful planning, the necessary tools and stakeholder engagement to motivate commitment. Simulation modeling is one tool that can assist practices in modifying practice patterns with minimal disruption to operations, resulting in better outcomes.

To read this article in its entirety, please click the button, below, to download a PDF version of this article.

Practice Transformation

Topics: Medical Practice, Practice Transformation, Simulation Modeling

GE Healthcare Included in Fortune Magazine's Healthcare Tech Reinventors List

Posted by Matthew Smith on May 19, 2017 11:00:00 AM

Fortune Magazine recently previewed what a tech-optimized healthcare future might look like and identified 21 innovative companies in five categories—each of which is challenging the conventional approach to medicine.

GE Healthcare made Fortune Magazine's' list of reinventors with its work building a hospital command center at the Johns Hopkins Hospital

Of the partnership between GE Healthcare and the Johns Hopkins Hospital, Fortune writes:

"Cutting costs and catching on to illnesses as early as possible are major goals for this type of tech. But it can also be used to combat administrative headaches like long hospital wait times. Last October, GE Healthcare and the Johns Hopkins Hospital launched a fully digital hub to better manage everyday operations. The Judy Reitz Capacity Command Center gets a constant influx of data about important events at the hospital; it receives about 500 messages every minute from more than a dozen different Hopkins IT systems and with the help of predictive analytics turns this swamp of data into suggestions for action that prevent bottlenecks and get patients both into and out of the hospital faster.

And, according to Johns Hopkins at least, it’s showing impressive early results. The hospital says the command center has shaved more than an hour off the time it takes to dispatch an ambulance to another facility and that emergency room patients are assigned a bed 30% faster than before."

To read the full article in it's entirety on the Fortune Website, please click the button below:

Hospital Command Center 

Contact GE Healthcare to request more information about hospital command centers via the button below:

Capacity Command Centers

Topics: Hospital Command Center, Fortune Magazine, Healthcare Technology

3 Key Priorities in the Perioperative World

Posted by Matthew Smith on May 18, 2017 10:48:47 AM

By Nehal Koradia, RN, MBA, and Ryan Treml, GE Healthcare Camden Group

As has been the case for many years, hospital organizations continue to look to perioperative services to be one of the most important financial engines for the institution – consistently looking for ways to maximize the utilization and efficiency of the department.

As reimbursement declines, new payment models are being explored, and hospitals continue to consolidate, organizations are expanding on and moving beyond past methods to drive improvement. Here are key priorities in the perioperative world that healthcare leaders should keep in mind:

1. Be more deliberate and detailed in linking the strategic plan to perioperative services.

Evaluate volume against capacity. Volume has historically solved most problems. However, with reimbursement changing towards value-based payment, volume has to be analyzed much more thoroughly. The days of adding volume without first understanding the total capacity available and the corresponding costs – labor, equipment, supplies, etc. – are gone. Organizations are tackling this challenge by becoming more specialized in their elective volumes – creating centers of excellence to combine specialty services and procedures in a common location to drive extremely efficient day-to-day processes. In addition, they are increasing their focus in shifting outpatient volume to ambulatory surgery centers, embracing the ability to utilize technology and new techniques to transition traditionally inpatient cases to an outpatient environment. Advanced institutions are also making the tough decision to truly rationalize their capabilities – thoroughly evaluating their market and understanding what the community truly needs and can support long-term. All of these options attempt to maximize the organizations utilization of their highly specialized resources.

Match recruitment to the strategic plan. As noted above, forward thinking organizations are pursuing surgical volume that matches their strategy. Similarly, as these organizations evaluate or recruit potential new surgeons, they are taking much more time than they have historically to consider capacity variables. Equipment and staffing capabilities are usually considered when making offers to surgeons, however rarely does an institution evaluate the inpatient capacity needs for the new surgeon joining and determine the optimal day to allocate block time to both maximize OR and IP Capacity. In order for the entire organization to run efficiently, there has to be a good match between the new providers' needs and the access the organization can provide.

2. A refined focus on operational processes and cost.

Embrace systems-thinking and advanced analytics to inform process improvements. It is well known that the elective surgical schedule typically accounts for more variation in inpatient census than ED admissions. Managing that variation is extremely difficult – very few institutions have been able to create a surgical schedule that maximizes OR utilization while also efficiently smoothing the downstream IP volumes. However, it's becoming more common to utilize simulation and forecasting tools to appropriately match inpatient resources to the demand created by surgical inpatient volume. Nursing, support personnel, ancillary services, etc. are being staffed with much more flexibility to allow for the daily, weekly, and monthly variation in inpatient surgical volume. In addition to these dynamic staffing concepts, organizations are focusing on inpatient operational processes to ensure that downstream capacity is not a limiting factor in growing surgical volume. Units are being re-purposed, the benefits and risks of specialization vs. generalization are being analyzed in detail to ensure that beds are available and utilized in the most efficient manner.

Make difficult decisions regarding supply cost. Organizations have always reviewed surgical supply cost and understood that there were opportunities to streamline/standardize, but the most advanced have taken the difficult step in convincing their surgeons to work with them to manage cost. This requires a very detailed dissection of case cost information while balancing it with quality and utilization measures. Often, the supply opportunity is only viewed from the cost perspective, and decisions are made that can impede utilization, extend case lengths, and impact outcomes. High performing organizations understand these situations and include the information into a surgeon's balanced scorecard – often driving change through awareness rather than forced decisions.

3. Establish governance, don't just talk about it.

Use the governance structure to execute strategy. Governance of perioperative services has typically been a term associated with policy development and enforcement. The problem is that it quickly becomes detached from the consistently changing healthcare environment. Surgeons that sit on committees such as Surgery Executive or Block Management are asked to manage with a set of policies that are infrequently reviewed or refreshed. They are asked to align with strategic imperatives and plans, but are not included in the development discussions. Organizations have realized this is not an effective structure to drive true governance and are incorporating these key strategic decisions into their surgical committees. This drives better alignment with the surgeon community, shortens the adoption of key changes, and actually makes policy enforcement much easier.

Hire a Chief Surgical Officer (CSO). To build on the concept of incorporating strategy into governance, hospitals are hiring a surgeon to drive the surgical portion of the strategic plan. This role is different than the chief of surgery – the CSO is part of the executive team and is involved in the development of the strategic plan, drives the recruitment of new surgeons, and balances the wants of the surgeon community with the needs of the hospital system. This role helps buffer the often contentious relationship between surgeons and the administrative suite – complementing the Chief Medical Officer.

Even though many organizations recognize that these changes need to occur to ensure future success, many have difficulty implementing these strategies due to the complex environment in perioperative services. But overcoming the difficulties and implementing even one to two of these strategies can increase revenue and/or decrease cost significantly for an organization, making it well worth the effort.


KoradiaN.jpgMs. Koradia has been leading healthcare organizations through transformation initiatives for over nine years. Ms. Koradia has worked with many large academic centers and community hospitals to transform their operating rooms, decrease readmission rates, and increasing early morning discharges and reducing ER wait times by utilizing simulation modeling, Lean, Work-Out®, and CAP® methodologies. These initiatives have allowed organizations to improve access for patients, streamline operations and improve financial performance, while creating a culture of continuous improvement. She may be reached at nehal.koradia@ge.com

 

treml.jpgMr. Treml is a manager with GE Healthcare Camden Group, with 12 years of management consulting experience. He has led a broad range of engagements including: improving perioperative service departments through scheduling optimization and specific process improvements, developing comprehensive capacity strategy plans for high occupancy institutions, implementing electronic event reporting tools, streamlining discharge planning processes, and increasing throughput in diagnostic imaging departments. He may be reached at ryan.treml@ge.com

 

Topics: OR Optimization, Hospital Operations, Nehal Koradia, Ryan Treml, Perioperative Services

The Seven Strategic Levers of Value-Based Care

Posted by Matthew Smith on May 10, 2017 1:52:29 PM

Hospital leaders are carefully watching the healthcare industry’s transformation from volume-driven care to value-based care. But while most leaders understand the basics, many are uncertain about how to guide their organizations through this transformation.

The good news is that focus will pay off. Healthcare leaders can guide the development of a value-based organization by concentrating on a handful of key priorities. We have described a list of seven strategies that we call the “levers” of value-based care, ranging from advanced cost management to comprehensive data aggregation.

To immediately read this article in its entirety, please click the button below.

Value-Based Care

Topics: Value-Based Care, Daniel J. Marino, Healthcare Data

Facing Bundled Payments

Posted by Matthew Smith on Apr 20, 2017 11:05:07 AM

By Dominic Foscato, Vice President, GE Healthcare Camden Group

Change in reimbursement isn’t waiting for tomorrow. It’s happening right now. Rather than paying for each procedure and office visit, government and private health plans are moving toward a payment model based on the health of an organization’s patient population. During this transition, an organization’s success depends on its ability to manage a variety of payment models.

Health care organizations must successfully administer these payment models — which continue to evolve and grow more complex —while optimizing quality, outcomes and patient satisfaction. In short, they must manage “fusion reimbursement” or risk significant cuts in revenue.

Clinical Integration, Clinically Integrated Networks

Reprinted with permission from the February 2016 issue of Trustee magazine, vol. 69, no. 2. © Copyright 2016 by Health Forum Inc. Permission granted for digital use only

Topics: Bundled Payments, Value-Based Payments, Alternative Payment Models, Dominic Foscato

New White Paper Download: Top 10 Characteristics of High-Performing Healthcare Organizations

Posted by Matthew Smith on Apr 18, 2017 11:30:49 AM

By Darryl Greene, MS, Vice President, and Robert Green, MBA, FACHE, CHFP, Senior Vice President, GE Healthcare Camden Group

high-performing healthcare organizations

Prompted by the Affordable Care Act and numerous other environmental factors, many healthcare organizations, physicians, employers, and newcomers to the industry have been simultaneously focusing on multiple objectives to decrease an unsustainable cost of care growth while improving the quality of care and access for millions of patients. A question for healthcare organizations to consider is how to remain relevant to patients and financially viable in an industry that has been in and will likely continue to be in a constantly developing landscape?

We have observed consistent and common characteristics or attributes among the leaders and many of the employees who work in the highest performing organizations. Our new White Paper discusses 10 characteristics to consider as you journey through this sometimes uncertain and sometimes turbulent, but always challenging and many times rewarding industry we call healthcare. 


GreenB1.pngMr. Green is a senior vice president and the practice lead for the financial operations and transaction advisory practice at GE Healthcare Camden Group. He has more than 26 years of healthcare experience with 13 years of healthcare consulting experience and 13 years of provider-based financial, operational, and strategic experience among health systems, hospitals, medical groups, management services organizations (“MSOs”), and physician hospital organizations (“PHOs”). Mr. Green has significant expertise in building high-performing teams and leading and executing transformational change. He may be reached at robert.t.green@ge.com. 


d.Greene-1.jpgMr. Greene is a vice president for the strategy and leadership practice at GE Healthcare Camden Group. He has more than 18 years of strategy to execution consulting experience, including 11 years in healthcare. He has significant expertise in strategic planning, business management systems implementation, talent management, performance improvement, leadership, and leading and executing transformational and culture change. He may be reached at darryl.greene@ge.com. 

 

Topics: Top 10, White Paper, Robert Green, Health System Integration, Staff Planning, Darryl Greene

Which Do You Prefer…Tax Preparation or a Visit to the Doctor?

Posted by Matthew Smith on Apr 17, 2017 11:12:52 AM

By Robert Zisman, Vice President, and Mark Krivopal, MD, MBA, Vice President GE Healthcare Camden Group

Spring is here, and Tax Day is almost upon us. Hopefully you’ve filed your taxes. You’re not one of those procrastinators, right?

It’s hard to miss the noise related to potential changes in healthcare and tax policy. Given all the talk on these two topics, comparisons of these two “facts of life” cannot be avoided.

Our united view: As divided as our country may be at times on these two issues, it’s easy to miss where we are united. Most people don’t enjoy doing their taxes, nor do they enjoy going to the doctor. Understand the necessity? Absolutely. Enjoy it? Likely not.

So, let’s explore our common lack of enjoyment for these two industries and dream a bit as to how these experiences could catch up to those we truly enjoy (or at least look forward to).

Access: For most people, booking an appointment with a tax pro or completing your taxes online isn’t that bad. However, finding time on your doctor’s calendar or researching the right provider for a specific ailment tends to be a bit more challenging. Once you’re in—especially if you’re the first appointment of the day—congratulations, you’re golden! If you receive any other appointment slot, be prepared to wait. Sometimes after waiting weeks and months for the appointment in the first place, you realize that you need a different specialist to help you with a problem.  

Ability to figure it out on your own: Fortunately, the ability to do your taxes online has been simplified by companies like TurboTax and their proclamation, “You answer simple questions about your life. We do all the math.” The good news here is that taxes are fairly formulaic, so this approach can work. They also have online experts available for questions. On the healthcare side, when someone has a health issue, where do they turn? You guessed it – Google. Not the best idea when there are websites out there such as WebMD where you can utilize a symptom checker and online doctors to answer questions you may have. While the possibility exists in both industries to figure it out on your own, many still prefer meeting with your tax pro or doctor, eye-to-eye.

Ability to meet eye-to-eye… from your couch! When it comes to doing your taxes online, the market hasn’t dictated the need for video chat. While taxes are complicated - and no two returns are the same - they don’t have feeling or emotions (although many can admit to having wept silently and experienced a sense of loss after pushing the “file your return” button). On the other hand, the human connection in healthcare is still extremely important and virtual doctor visits are beginning to take off. Health insurance coverage is finally catching up to market demand, and several experts predict the number of virtual visits to double over the next several years. However, few physician practices have adopted virtual visits into their care delivery system and workflows. Yet some pioneers have figured this out and offer a glimmer of hope for the future of virtual medicine. For example, Kaiser Permanente performs more virtual visits than in-person office visits. Other progressive healthcare systems are dipping their toes in the world of telemedicine with a focus on improving convenience and reducing costs.

Value for the dollar and payment: Whenever paying for a service, it’s expected that you receive value in return for the money you spend. With taxes, we start with a formulaic approach set by the government. Then, each person has their own, unique opportunity to impact that approach. Fees are usually stated up front, but somehow they always seem to change (rarely decreasing) by the end of the tax meeting. However, if you receive a refund, those fees usually aren’t too hard to swallow (i.e. H&R Block – Get your billion back!). When visiting the doctor, it feels eerily similar—except you often don’t know how much your visit, tests, and procedure will cost until you receive several bills post-visit. Unfortunately, paying your medical bills is far more complicated and seems never-ending. And you don’t get money back…unless you mistakenly pay the same bill twice. Greater transparency from the healthcare system’s side—as well as simplified processes and enhanced consumer engagement—must be developed to improve the overall experience.

You receive the best possible outcomes based on data and science: The tax code itself is extremely complex (74,000 pages) and no two returns are the same. H&R Block recently took a step in the right direction by partnering with IBM’s Watson. They’ve taken H&R Block’s 60 years of experience and 600 million data points to figure out how to deliver each customer the best outcome--in most cases, a refund. In healthcare, it seems we still have an opportunity to catch up. When seeing a doctor in person, the digital data capture of that appointment has not kept up with advancements in other industries. You often check off your symptoms, review your medical history (sometimes electronically, more likely in a manila folder) and arrive at a solution that we “believe” will address the symptoms outline. The ability to use data, artificial intelligence, and predictive analytics is becoming more prevalent in healthcare and will soon transform how you interact with your doctor, how hospitals are managed, and more. There are some great highlights recently mentioned on this topic by The Economist.

Looking to a better future: It seems both industries and experiences are making advancements to move up the likeability chain. Yes, potential policy reform still lingers above both industries, but ultimately improving the experience will rely more on innovation led by the public and private sectors. We welcome your thoughts in the comments section below on which experience you like the most and what these industries can do to move up your likeability list.

P.S. Just one more day left to file. Don’t miss the deadline!


Robert_Zisman.pngMr. Zisman leads the GE Healthcare Camden Group’s US operations team, responsible for recruiting, staffing, marketing, business development, operations and knowledge management. He also leads efforts related to 3rdparty strategic partnerships and collaboration with GE Healthcare Partners consulting businesses around the world in areas such as Canada, Latin America, Europe and the Middle East. His previous roles included leading large and complex engagements focusing on improving key performance metrics such as growth, margin, quality, patient satisfaction, and sustainable results. He may be reached at robert.zisman@ge.com.

krivopal_M-963748-edited.jpgDr. Krivopal is a vice president with GEHC Camden Group and an accomplished senior physician-executive with 19 years of healthcare experience across the continuum of care. Dr. Krivopal is responsible for developing and leading innovative, value-based programs addressing client needs in healthcare organizations, hospitals, and physician practices focusing on transformational system integration strategies, service line optimization, throughput and clinical leadership development. His experience spans not-for-profit and privately held organizations of various sizes as well as start-up environment in the healthcare information technology space. He may be reached at mark.krivopal@ge.com

Topics: Patient Access, Patient Activation, Robert Zisman, Mark Krivopal, Integrated Care Delivery

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