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GE Healthcare Camden Group Insights Blog

What Can Clinically Integrated Networks Offer Physicians?

Posted by Matthew Smith on Apr 13, 2017 9:00:00 AM

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

Much has been written about clinical, post-acute care facilities and physicians, has led health system executives to invest substantial financial and human capital to set up infrastructure and operating processes that improve value in health care.

These organizations intend to be prepared for current and future challenges such as increased regional competition, government regulations and payment reform. If the value proposition of these organizations is articulated and delivered in a genuine patient and physician-centric way, significant rewards can be gained not only by the health system itself but also by its individual physicians.

To continue reading this article and the 10 considerations for physicians when deciding whether to join a CIN, please click the button below.

NOTE: This article is password protected on the American Association for Physician Leadership website, but may be accessed by logging in with the following credentials:

Login: gehccamden@ge.com
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Clinical Integration, Clinically Integrated Networks

krivopal_M.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: Clinical Integration, Clinically Integrated Networks, Physician Leaders, Mark Krivopal

What Clinically Integrated Networks Offer Physicians

Posted by Matthew Smith on Apr 12, 2017 3:05:58 PM

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

Much has been written about clinical, post-acute care facilities and physicians, has led health system executives to invest substantial financial and human capital to set up infrastructure and operating processes that improve value in health care.

These organizations intend to be prepared for current and future challenges such as increased regional competition, government regulations and payment reform. If the value proposition of these organizations is articulated and delivered in a genuine patient and physician-centric way, significant rewards can be gained not only by the health system itself but also by its individual physicians.

To continue reading this article and the 10 considerations for physicians when deciding whether to join a CIN, please click the button below.

NOTE: This article is password protected on the American Association for Physician Leadership website, but may be accessed by logging in with the following credentials:

Login: gehccamden@ge.com
Password: gehccamden
 
Clinical Integration, Clinically Integrated Networks

krivopal_M.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: Clinical Integration, Clinically Integrated Networks, Physician Leaders, Mark Krivopal

Measuring the Importance of the Human Side of Change

Posted by Matthew Smith on Apr 10, 2017 1:59:30 PM

By Elina Spule, MBA, Senior Consultant, GE Healthcare Camden Group

Have you ever been part of a change that was very successful? Have you ever experienced a change that was not very successful? What were some of the key elements that distinguished each of them?

Research conducted by GE across hundreds of change initiatives concluded that “100% of all changes evaluated as ‘Successful’ had a good technical solution or approach. Over 98% of all changes evaluated as ‘Unsuccessful’ also had a good technical solution or approach.1

So what is the differentiating factor?

I posed this question to 23 individuals during the Change Acceleration Process (“CAP”) training that I led at one of the premiere healthcare systems in the nation, and these were some of the answers regarding successful change initiatives:

  • There was a strong leader
  • The change was sustained
  • People supported it
  • Staff understood why we needed to do it
  • There was a strong communication
  • The team was knowledgeable
  • The team was aligned
  • The new process was better than the old one
  • People were excited
  • It had a start and an end date
  • People were recognized for their hard work

I then shared with the class that one of the key concepts in this class is the formula Q X A3 = E1 that translates into the following:

Quality of Solution     x     Alignment       =      Effective Results

Acceptance

Accountability

This means that in order to have effective results, it is not enough to simply have a great solution (e.g., a new process, a better system, a new technology, a new strategy etc.) but one has to gain the human buy-in for this new solution.

For example, as a part of a project to reduce denials for a certain type of lab tests, a client developed a payer grid (a solution) that would help administrators determine upfront which tests are covered by which payers and which are not.

Let’s assume that on an arbitrary scale of 1-10 where 10 is the best, the quality of the grid is at 8 (it is regularly updated, it contains a comprehensive list of payers, it is user friendly, etc.).  But if we don’t have the buy-in from the clinic administrators to use it, the change formula would be as follows—indicating there will be no results.

8 x 0 = 0

Look what happens when we spend just little more time explaining why we need to adopt this new grid, what we hope to achieve with it, and how to use it. The results already are much better!

8 x 33 = 216

Now imagine what would happen if we spent little more time planning who should be on the team, how to involve our stakeholders, and how to communicate it better. Our results could be more like:

8 x 83 = 5632

That’s already 26 times the difference!

While we were reviewing the formula, one of my colleagues helped me organize the ideas that the class brainstormed and provided across the change formula Q X A3 = E1 as to the differentiating factor between successful and unsuccessful changes. What do you notice about it?

qae.pngDuring our outcomes based process improvement projects, we encourage our teams to take it one step even further – can you look for ways to measure all three sides of the equation? As the old saying goes: “If you can't measure it, you can't manage it.” I have listed below some of the ideas related to measuring the denials project:

qae2.png

Although this particular initiative is still ongoing, our historic experience shows that it is possible to achieve process improvements of greater than 50 percent improvement. However, it is critical to focus on and measure both sides of the equation: the quality of the technical solution as well as the human side of change.

Think about the current change that you are implementing or your organization as a whole: What would a typical Q X A3 = E equation look for you? What do you measure on your process improvement process? How have you measure the alignment, acceptance, and accountability?

1 Slide 14 in “Change Acceleration Process” (CAP) training developed by GE Crotonville

Change Acceleration Program (CAP)


Spule.jpgMs. Spule is a senior consultant with GE Healthcare Camden Group specializing in the areas of outcomes based process improvement and clinical transformation. Ms. Spule has also experience in capacity strategy, governance, analytics, and leadership development. She is a GE Master Change Agent certified to teach and coach process improvement and change management. She may be reached at elina.spule@ge.com. 

 

 

 

Topics: CAP, Change Leadership, Change Acceleration Program, Elina Spule

Top 10 Characteristics of High-Performing Healthcare Organizations

Posted by Matthew Smith on Apr 4, 2017 3:34:17 PM

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

The following is an abbreviated version of ourwhite paper with the same title. For the full white paper, which offers additional insights on each characteristic or attribute, please click on the button at the bottom of this page.

Prompted by the Affordable Care Act (ACA) 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. Here are 10 of these characteristics to consider as you journey through this sometimes uncertain and sometimes turbulent, but always challenging and many times rewarding industry we call healthcare. Some of the characteristics below are basic, but well worth mentioning again because of their foundational importance.

1. Continuously Learning, Well-informed, and Insightful. These organizations understand the current environment with an eye toward the future change trajectory. It is only by keeping a constant pulse on the numerous environmental factors that have multi-faceted impacts such as political (government), economic (market segment), social (population), and technology (information, devices, web) that high-performing organizations can begin to make meaning of the trends and organizational changes required. In turn, they can set their course and pursue imperatives that best position them to be successful in this dynamic environment of healthcare.

2. “Change-Forward” with Bold, Inspiring Vision. High-performing organizations are not satisfied with incremental change, but desirous of “breakthrough, transformative change.” They are not just “change ready,” but embrace change management as a competitive advantage. The type of change underway in healthcare is clearly significant, and the pathway to the transition from fee-for-service to value-based care is not a clear one. It is being discovered through pilots, trial and course correction, and some failed attempts.

3. Agile and Adaptable.  High-performing organizations continue to pursue strategy and find value through staying agile and adaptable. Because the world is accelerating the time frame, the strategy needs to be more flexible and “opportunistic” and is rarely beyond one to three years with an emphasis of planning the specific goals of the most immediate year. Prioritizing the change underway for the organization according to strategic pillars and related value proposition is important to manage the diverse portfolio of imperatives. These pillars translate into multiple project efforts that are more synergistic with similar goals (and measures to impact). For example, improving OR throughput, while addressing readmission issues, and while creating new care models of evidence-based care, are not an unusual portfolio of programs with different timelines and needs of an organization.

4. Actionable Information-Oriented. These organizations understand how to translate data into data analytics, into information, into transparent, actionable-information and ultimately, into “predictive analytics.” Many organizations are challenged by the following: overall analytics framework that does not outline and prioritize information or reporting needs; overlapping reporting efforts across various analytics silos; limited transparency and understanding of reporting capabilities and queues of each silo; and limited or no understanding of alignment of analytics efforts against strategic and operational goals. Unfortunately, much of this disarray and uncertainty stymies action or creates “analysis paralysis.” Many high-performing organizations have analytic strategies to ensure they are leveraging data and actionable information to gain a strategic market position and incorporate that into their value-based payer strategies. When successful in addressing the challenge of “actionable information,” these high-performing organizations can, for instance: Improve access to care across the network; create information architecture in support of population health initiatives; continually improve provider network’s performance while decreasing spend; evaluate clinical programs and initiatives and understand the effect of the interventions and return on investment; and reduce out-migration of patients and better understand referral patterns across the network.

5. Financially Disciplined. High-performing organizations have financial discipline as a priority. This is to meet the vision and mission of the organization while achieving a financial balance between the capital needs and financial capabilities. This translates to clarity on the level of strategic investment the organization can make relative to an overall operating profit and loss portfolio and credit rating objective. A well-integrated, strategic, financial, and capital planning process is paramount to achieving the balance. Defining the financial goals forecasted out 5 years and annually, along with clear objectives designed to meet the expected well-defined capital needs is a key goal.

6. Respectful and Optimized Staffing. One of the greatest “wastes” in healthcare is not deploying staff at their “highest and best” use. With labor typically comprising more than 50 percent of any hospital or health systems expenses – salaries, wages, and benefits are typically a common “target” for cost savings. Unfortunately, an “across the board” cut or an even more focused reduction in force, tends to never get to the “root cause” of underlying disjointed, ambiguous, and sometimes even broken processes, and certainly the savings are never sustained.

High-performing organizations engage their staff from the “ground up” or by the “diagonal slice” in helping to resolve the long-standing challenges of more efficient and effective care. These organizations will assess the entire “human capital value chain,” ensuring best practices in strategy and talent management (workforce planning, employee engagement, learning and development), workforce management (scheduling, staffing and assignment, span of control, productivity, coaching and mentoring) and human capital operating model (reporting and analysis, improve and control, training, benchmarking).

7. Accountable and Execution-Focused. Many organizations, if not most, struggle with implementation and effective execution. The reasons are numerous: inability to effectively prioritize; multitude of initiatives dilutes effectiveness; “analysis paralysis”; “no one is accountable”; and overwhelmed staff already busy doing their “day jobs.” Effective transitions from direction setting and strategic planning by the leadership of the organization to execution by the middle management and frontline levels of the organization are done best by high-performing organizations. High-performing organizations have found a nuance to increase accountability – creating venues to ensure bi-directional input between owner and sponsor for the imperative, project, or task – at the organization level and the local level at which the individual contributes. And what to do when the accountability goes beyond the four walls of the hospital? At a time when leadership extends to new groups and partners, some of which are not inside the four walls of the hospital this bi-directional exchange and development of local plans to deliver are critical to best create ownership.

8. Patient-Centric and Operationally Proficient. These organizations are focused on standardizing care processes, embracing clinical protocols, and effecting seamless, patient access. Efficient and effective operations discipline in the way care is delivered and supported, as well as, broad and deep ongoing improvement efforts, are key attributes of high-performing organizations. Maximized operational efficiency with top-decile clinical quality is the priority, with emphasis on areas that impact patient access, patient flow through the system, and effective discharge to the right post-acute care entity (“right care, right place, right time”). As well, standards set relative to evidence based care and effective standard care plans for treatment types are important to providing reliable care with reproducible patient experience and quality outcomes. Process improvement work is a key enabler to achieving these goals through practices, tools, and methods addressing waste elimination, improving inefficient operations, redesigning care processes, and standardizing work delivery. Additionally, many high-performing organizations are utilizing real-time decision-making driven by predictive analytics, enabling ability to accommodate capacity demand, complex transfers, ED boarding, and PACU holds while driving seamless patient access and maximizing resource utilization.

9. Creative Collaborators. A key attribute is partnerships and joint ventures with other providers, payers, employers, clinical technology companies, and other key stakeholders, all intended to create and increase value for patients and communities. Many organizations are challenged in determining the right value-based payment arrangement programs and investments to set up over a multi-year window (3-5 years) to realize the organization’s strategic vision and achieve financial strength. For high-performing organizations, it starts with addressing the basics of creating reliable quality care highlighted in patient centric and operational proficiency. Along with this, high-performing healthcare organizations expand this focus to connect and align the fragmented system of care delivery to improve patient experience, cost, access, and quality outcomes vertically and horizontally across the care continuum. This effort is incentivized by CMS’ continued transition to value-based payment reimbursement. New partnerships are expected, aligning physicians, payers, employers, providers, and consumers helping healthcare payments transition more quickly from pure fee-for-service to alternative payment models. Identifying the clinical programs, care models, and care interventions coupled with aligning and coordinating the physicians in the care continuum around common goals of value-based care, is a priority. Population health models and clinical and financial integration vehicles will continue regardless of administrative or legislative action as employers, providers, and patients are expecting and even demanding greater value.

10. Realizing the Value of System Integration.  Many healthcare organizations, in pursuit of economies of scale and scope, have acquired a collection of overlapping units that have failed to achieve the intended goal of system integration and transformation. High-performing organizations create value through economies of scale and scope with system integration and optimizing synergies. They enact a unifying vision, strategy, processes, technology, and especially culture to achieve improved performance expected as an integrated system. With a deep understanding of financial operations and clinical care as well as the related decision-making structures and processes, high-performing organizations tend to work a customized problem-back approach to system integration, understanding the “precious few” areas to focus on that will be prioritized and sequenced in a way that creates the most value for the organization.


This top 10 is an abbreviated version of our white paper with the same title. For the full white paper, please click the button, below.

high-performing healthcare organizations


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, Robert Green, Health System Integration, Staff Planning, Darryl Greene

Navigate the March Madness of Hospital Operations

Posted by Matthew Smith on Mar 22, 2017 11:07:51 AM

By Stephen Verdi, MS, Manager, GE Healthcare Camden Group

As a lifelong sports fan, a former athlete, and a Duke alum, there’s no month on the calendar that commands my attention quite like March. With March comes brackets, Cinderellas, buzzer-beaters, nail-biters, and the best 67 basketball games of the year. It’s time for the NCAA men’s Division I basketball tournament – affectionately and appropriately known as “March Madness.”

More than 350 teams have played through their 30-game regular season schedule for the opportunity to compete in the tournament. Now, for the 68 teams who made the cut, the real season starts. The National Championship is in sight, but now the stakes are higher, the room for error is gone, and the pressure is on.

In the world of hospital operations, it feels like we have entered our own version of March Madness. Years of process improvement and creative solutions to complex access challenges have served us well, allowing us to provide care to our patients as bed capacity has dwindled. We’ve competed well in a tough environment over the course of time. Despite our sweat and tears, the capacity challenges haven’t let up, and an evolution of policy, demographics, and models of care have put pressure on costs, created volatility, and continued to fill our beds. This has created a new environment that demands a different operating point to be successful. We’ve made it through our own sort of "regular season," but the tournament has started, and the games have gotten tougher.

At GE Healthcare, we work with health systems to develop Hospital Command Centers that shift us to a new operating point. We stay true to our belief that a strong foundation of mindful strategy and efficient process still punches your ticket into the tournament, while also recognizing that the decision support, situational awareness, and visibility offered by a Hospital Command Center are now necessary to excel in healthcare’s March Madness.

Fundamentals – Your Ticket to Play

To get the chance to compete for the NCAA National Championship, a team must first be one of the 68 teams selected to play in the annual tournament. The teams selected are those that assemble the best bodies of work over the course of the regular season (or those who get an automatic bid by winning their conference championship, but let’s keep it simple). Success in the regular season comes to those who generally get the fundamentals right-–take smart shots, limit turnovers, box out, hit free-throws, play hard-nosed defense, and so on. Strong execution of the basics helps a team win games, and teams who win games get the chance to play for the Championship. During the regular season, individual games matter less than the sum of a team’s performance. No single turnover will wreck the season. No single loss will exclude a team from contention for the NCAA tournament.

Like a team fighting to make the tournament, when we think about a hospital striving for world class operational performance, we first imagine a hospital that is nailing the basics – staffing nurses and ancillaries to match demand, aligning discharges to bed requests, reducing waste from the bed assignment process, designing efficient OR block schedules, right-sizing their bed mix, and so on. This is the work that many of us have been doing for a long time now, fending off the high costs of inefficiency. Process improvement has allowed us to operate at inpatient utilization rates near 80 or 85 percent. We still may not always feel comfortable at these occupancy levels, but we can care for our patients and deliver good outcomes. We may have declined the occasional outside transfer or left the occasional bed open while patients lined up in the Emergency Department, but we have performed well overall. By building smart capacity strategies and activating them through process improvement, we have made it through the regular season portion of our journey to top performance.

Stepping Up Your Game

After Selection Sunday, when the 68 tournament teams are announced, the whole game changes. There is a new level of pressure on teams who are now just one loss away from falling short of their goal. Whereas individual mistakes may not matter in the regular season, they can spell the end for a team during March Madness. Without a doubt the fundamentals these teams relied on all year will be critical during the tournament, but they now need to reach a new level of performance. They need to play flawless basketball through six (or seven) games while under intense pressure.

Today, under the many stresses of healthcare, our hospitals and health systems need to find ways to reach that next level of performance. We need to continue to pull the levers of capacity strategy and performance improvement, while also finding new ways to perform under more and more pressure. We are getting used to managing at 80 or 85 percent occupancy, but the time has come where we need to be capable and comfortable operating at 90 percent or 95 percent without sacrificing outcomes. Now is the time we look to Hospital Command Centers to raise our operating point. By bringing people, data, and information together, we make decisions faster and act faster. A Wall of Analytics with custom-built analytic tiles provides us with the situational awareness we need to see around corners. The ability of those tiles to make accurate predictions about the future allow us to prevent problems before they arise. With more information, more insights, more speed, and more operational horsepower, we hit a new level of performance. We no longer have to decline that transfer, or board that patient in the Emergency Department, or cancel that surgical case.

The Lasting Impact of Success

Winning the NCAA National Championship delivers much more than a banner in the rafters. The team that takes the trophy achieves a new stature on the national stage, forever to be recognized as a national champion. This recognition helps them recruit talented players who want to be part of a winning team. Better recruits lead to better teams, and better teams get prime-time games on television that attract viewers and sponsorships--further filling the recruiting funnel. On April 3rd, one of the 68 teams will win that last game of the tournament and be crowned National Champion. And while the celebration that night will be a good one, the real impact of the win will be felt for years to come.

A large East Coast academic medical center partnered with GE Healthcare to set out on their Hospital Command Center journey, seeking to bring their people and information together to help them better manage the operations of the hospital. In the summer of 2016, they opened a 2,550 square-foot Hospital Command Center in the center of their main hospital. While the opening ceremony was a great day for the staff and patients, the Command Center has continued to produce results well beyond the ribbon cutting:

  • Patient transfers from other hospitals: There has been a 60 percent improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country.
  • Ambulance pickup: A critical care team is now dispatched 63 minutes sooner to pick up patients from outside hospitals.
  • Emergency Department: A patient is assigned a bed 30 percent faster after a decision is made to admit him or her from the Emergency Department. Patients are also transferred 26 percent faster after they are assigned a bed.
  • Operating room: Transfer delays from the operating room after a procedure have been reduced by 70 percent.
  • Patient discharges: Twenty-one percent more patients are now discharged before noon, compared to last year.

For the next few weeks I’ll be tuned in to see how each of the 68 teams perform under the bright lights of the NCAA tournament. Each of them has done their job to deliver a strong regular season performance, now they will be shifting into a different gear to succeed in the tournament. By relying on their basics and playing mistake-free basketball, they’ll give themselves a good chance. At the same time, our hospitals will be striving for a path to their own version of success under the bright lights of high occupancy. By supplementing a culture of process improvement with the horsepower of a Hospital Command Center, they’ll get there.


Verdi.jpgMr. Verdi is a manager with GE Healthcare Camden Group specializing in the areas of patient throughput, capacity management, hospital simulation, data analysis, and change management. He also has experience in operating room scheduling, governance, care management, and length-of-stay reduction. Mr. Verdi brings over 10 years of GE experience in engineering, project management and healthcare consulting. He may be reached at stephen.verdi@ge.com. 

Topics: Hospital Operations, Hospital Command Center, Capacity Management, Stephen Verdi

Command Centers: Shining the Light Between the Seams

Posted by Matthew Smith on Mar 16, 2017 1:09:49 PM

Don't miss Command Centers: Shining the Light Between the Seams--co-presented by GE Healthcare Camden Group and The Johns Hopkins Hospital at Becker's Hospital Review 8th Annual MeetingApril 17-20, 2017 in Chicago.

Session Overview:

Physicians want the best outcomes for their patients, but have minimal control at the juncture where treatment delays and many problems develop--at the seams between caregivers, facilities and hospital units in a patient’s journey. That’s about to change. The emergence of command centers in hospital settings delivers real-time and predictive decision-support tools, enabling optimal decisions at the moment they are required. These technological resources permit multiple systems in an enterprise to work in harmony with each other by applying data science to redesign system dynamics across a delivery network.

The Johns Hopkins Hospital, for example, employs GE’s Command Center to reduce patient wait time in the emergency department, accept more highly complex patients, and reduce waits following surgery. The facility has experienced a 70 percent reduction in OR holds and a 24 percent increase in pre-9:00 a.m. discharge orders.

Command Centers shine a light into the seams in care, maximizing efficiency, enhancing utilization, reducing risk and improving outcomes. While there’s a lot of talk about delivering seamless care, these resources offer the missing link providers need to explore this territory and retrieve vital information at the moment it is most essential.

Presented by:

Bree Theobald, Vice President, GE Healthcare Camden Group

James Scheulen, PA, MBA, Chief Administrative Officer, Emergency Medicine and Capacity Management, The Johns Hopkins Hospital

Date:

Wednesday, April 19

3:05-3:45 PM

Location:

Hyatt Regency Chicago
151 E. Wacker Drive
Chicago, Illinois 60601

Register for Becker's Hospital Review 8th Annual Meeting:

Command Center, Capacity Command Center

Topics: Care Management, Command Center, Bree Theobald, Capacity Command Center, Capacity Management

Beyond Risk Sharing: Forming Relationships Based on Outcomes

Posted by Matthew Smith on Mar 7, 2017 1:03:26 PM

By Helen Stewart, Managing Principal, GE Healthcare Partners

Health care organizations face incredibly complex problems, including regulatory pressures, dropping revenue from public and private payers, and consumer demands for greater convenience, transparency and connectivity. These stressors are heightened by the current political uncertainty around health care reforms.

In these rapidly changing times, traditional fixed-price, transactional relationships between health care providers and vendors are of little value. When providers buy a discrete product or service, they do so with the intent of integrating it into their strategy, assigning it a specific role in achieving their goals. But if the market shifts, if regulations change, if their strategy runs into roadblocks, they are left with what they bought.

As a result, many organizations have turned to risk-sharing or risk-balanced relationships in which both sides — health care providers and vendors — take on specific accountabilities. In risk sharing, there are always two sides: the underlying assumption is that “you will be responsible for a, b and c” and “I will be responsible for x, y and z.”

In an environment as interdependent and complex as health care, someone is always left holding the bag if the original strategic assumptions do not prove out in the long run. Even with so-called risk sharing, most or all of the risk of achieving the goal falls on provider organizations. If they can’t effectively connect what they purchased — products, services or consulting — to the action they are trying to drive, they are often left to figure it out on their own.

To read this article in its entirety, please click the button below to be immediately directed to the full article posted on Hospitals & Health Networks.

Hospitals and Health Networks, Risk, Hospitals

Topics: Risk, Helen Stewart

Webinar OnDemand: New Approaches to Capacity Optimization and Command Centers

Posted by Matthew Smith on Mar 2, 2017 11:17:31 AM

This webinar, hosted by the Association of Academic Health Centers and presented by GE Healthcare Camden Group, University of Michigan Health System, and The Johns Hopkins Hospital, focuses on innovative, forward-thinking approaches that two leading Academic Health Centers have undertaken. Specifically, the goals for these organizations include the improvement of patient flow and the optimization of capacity to achieve measurable outcomes, including designing and implementing a first-of-its-kind Command Center.

Using both systems as case studies, the speakers share their experiences, challenges, and successes with achieving capacity transformation without expansion, as they enable the transformation needed to thrive as an AHC of the future.

Speakers

Bree Theobald, Vice President, GE Healthcare Camden Group

Jennifer Naylor, Senior Consulting Manager, GE Healthcare Camden Group

Mary Martin, MPA, Associate Hospital Director – Surgical Services, University of Michigan Health System

James Scheulen, PA, MBA, Chief Administrative Officer for Emergency and Capacity Management, Johns Hopkins Medicine

To view the webinar, please click on the button below and complete the short form. The webinar will launch in a new window. 

Capacity Optimization, Command Centers

Topics: Webinar, Capacity Command Center, Capacity Management

GE Healthcare Included in Fast Company's "Top 10 Innovative Companies in Health"

Posted by Matthew Smith on Feb 13, 2017 1:42:10 PM

GE Healthcare is featured as one of Fast Company's Top 10 Innovative Companies in Health of 2017. As part of the magazine's World's Most Innovative Companies ranking, the Fast Company reporting team reviewed thousands of enterprises searching for those that tap both "heartstrings and purse strings" and use the engine of commerce to make a difference in the world.

From Fast Company:

GE Healthcare works with partners ranging from the University of California San Francisco to Johns Hopkins to develop both hardware and software technologies that solve some of the most pressing problems in health care. Some are drawn from health systems; for example, UCSF needed a partner to develop machine learning algorithms for medical imaging, and Johns Hopkins needed a NASA-style command center to better manage patient flow in and around the hospital. Early results from Johns Hopkins have been promising: The hospital has reported a 60% improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country; its ambulances are able to get dispatched 63 minutes sooner to patients at outside hospitals; and its emergency department is assigning patients to beds 30% faster.


To learn more about The Johns Hopkins Capacity Command Center, watch this short video and click on the links to Modern Healthcare and Health Facilities Management, below.

 

To speak to the GE Healthcare team about Capacity Command Centers, please click the button below:

Capacity Command Centers

 

Topics: Hospitals, Hospital Operations, Command Center, Capacity Command Center, Capacity Management, Hospital Occupancy

Is Your Board Prepared for These 10 Trends?

Posted by Matthew Smith on Feb 6, 2017 12:53:13 PM

By Laura P. Jacobs, MPH, President, GE Healthcare Camden Group

Boards need to focus on healthcare delivery transformation — and keep their eyes peeled for changes in federal law

The past few years have been tumultuous for most health care organizations as payment models, competition, regulatory changes, clinical advances, digital and information technology, and workforce trends have created the need for rapid transformation in just about every area of healthcare delivery and management. Layer on top of that uncertainty about the future of the Affordable Care Act, and 2017 should be another watershed year for healthcare.

So, has your organization discussed and developed responses to these 10 trends?

1. An uncertain reimbursement landscape

The degree to which reimbursement models will change in 2017 remains uncertain. Given the recent double-digit rise in premiums on the ACA's Health Insurance Marketplace, or exchanges, and calls for the redesign of Medicaid and Medicare, as well as commercial insurance regulation, we should expect an active year of debate in the federal and state ranks. The move to fee for value and expectations for efficiency and data-driven outcomes are not likely to abate. Also likely to be encouraged is consumerism, with a greater focus on health savings accounts and health reimbursement accounts, high deductibles and price transparency.

What trustees should keep their eyes on: federal and state legislative and regulatory changes. Financial plans for 2018 and beyond must consider the impact of higher deductibles, possible increases in bad debt, and even greater transparency on price and outcomes. Expect payer-mix shifts as the health insurance landscape responds to federal (and state) legislative changes.

2. Payment models continue to shift to value

With Medicare as a bellwether, payment models are increasingly reliant on measures of performance (e.g., hospital-acquired conditions, readmissions, patient experience and quality scores). There is no indication that this movement will stop. Medicare Advantage plans are likely to continue to see double-digit growth in enrollment, and, in some cases, health plans may seek risk-based arrangements with providers for these products.

The Medicare Access and CHIP Reauthorization Act of 2015 will have significant effects on the physicians in your market. While the Centers for Medicare & Medicaid Services is allowing different paces of entry, the bottom line is that physician payment will increasingly be dependent upon quality, patient experience, use of electronic health records and resource utilization. This may be the last straw for some smaller practices that don’t have the infrastructure to report the required metrics. Even if your market hasn’t yet experienced risk-based (e.g., downside risk, capitation or percentage of premium) models, private commercial carriers are emulating many of the CMS models, including accountable care organizations, pay for performance and bundled payment.

The lines between payer and provider will continue to blur, as payers acquire or provide services to providers and providers become payers. In some markets, regional health systems have moved into the payer marketplace — often as a Medicare Advantage plan or a plan to cover the health system’s own employees — to create competition and affordable options for their consumer base. Some payers will be increasingly open to partnerships with providers in launching new health plan products or delivery models. We will also likely see more large, self-insured employers reach out to providers as employers seek performance-based payment models to drive lower total health costs and better outcomes.

Overall, one of the most difficult challenges for healthcare organizations in 2017 will be harmonizing population health strategies with the market’s movement to value-based payment; moving too fast or too slowly in this area will challenge financial performance. This, along with a general uncertainty in the health care marketplace, will require astute and nimble financial planning.

What trustees should keep their eyes on: payer trends and the organization’s payer mix; the health system’s payer strategy and readiness for (and results with) performance-based payment; initiatives to help physicians respond to MACRA requirements; potential partnerships with payers or large employers to offer new products.

3. Pressure to reduce costs

Hospitals in general have experienced relatively stable financial performance over the past year or two — for some, even better than expected. In many cases, this has been a function of fairly strong volume, particularly in outpatient services. But the marketplace is putting pressure on payers — and thereby providers — to further reduce costs.

With higher employment rates, coupled with expanded coverage for individuals through the ACA, yet continued primary care shortages, emergency department volume is high. This can put pressure on inpatient capacity, operating room schedules and care management resources.

Pressure to reduce costs because of lower rate increases from payers means that managing patient flow efficiently, and reducing variation through defined workflows and clinical protocols are both critically important for a health system if it wants to achieve or maintain financial sustainability. Ensuring that precious resources like hospital beds and operating rooms are optimally utilized is also important to avoid making potentially unnecessary capital outlays for new bed towers or surgery centers. Some leading hospitals are exploring capacity-command centers that combine systems-engineering principles, commonly seen in complex industries such as aviation and power, with predictive analytics to manage and optimize patient flow, safety and experience.

It also is critical that the health system physician enterprise, which in most cases operates at a loss, optimizes physician time and aligns compensation models with goals and population health strategies, as well as engages in rigorous clinical performance management.

What trustees should keep their eyes on: changes in volume; hospital costs (labor and nonlabor) compared with industry benchmarks; length of stay; episode of care (diagnosis-related group) costs compared with Medicare rates; performance benchmarks of employed-physician practices.

4. Creating 'systemness'  

Many health systems have grown in recent years — vertically, horizontally and geographically. The opportunities to create a seamless patient experience, achieve efficiencies, enhance access to capital, promote innovation and optimize population health management are among many of the reasons for this growth. To realize these goals requires the harmonization of multiple cultures, operating mechanisms, IT and approaches to governance. To accelerate “systemness,” some systems will move from a “holding company” model to a greater degree of integration — across governance, management and clinical systems. Creating a single brand experience for consumers and employees will require a systemwide articulation of and focus on every aspect of care delivery across the continuum, including clinical and administrative functions.  

What trustees should keep their eyes on: a well-defined health system vision and strategy that guide decision-making on growth and system development; a system integration plan that establishes a governance and management structure to reinforce the desired goals, culture and brand; a disciplined and focused approach to achieve desired efficiencies and clinical integration.

5. The consumer is king

Health care has traditionally not been very consumer-friendly. But with deductibles set to increase again in 2017, as well as new disrupters in both the digital and care delivery spaces, providers will have to pay closer attention to the consumer experience (beyond the “patient” experience). This means price transparency; access where, when and how the patient desires; quality reporting; a social media strategy; and digital outreach to create consumer awareness and loyalty. All these will be increasingly important in 2017 and beyond.

Patient-focused care must be more than a stated value. It must be actualized through physical space, logistics, communication and approach to care.

What trustees should keep their eyes on: market share measured by share of the population, not by use of inpatient beds; the health system’s branding and consumer strategy, including dealing with price and quality transparency and a consistent consumer experience across the continuum and locations.

6. Care everywhere

With the explosion of mobile technology, and applications for home and self-monitoring, not to mention the expansion of urgent care and retail care centers, 2017 will be another year of evolving care models. Private equity–backed as well as employer-backed new models for primary care and complex care, and digital tools will continue to proliferate. Health systems will have to decide whether to partner, adopt or compete with these new entities and models.

Telemedicine will be used increasingly not only for remote rural areas but for the convenience of consumers who would prefer not to leave their home or office for care. This means competition could come from anywhere accessible by smartphone. Home and self-monitoring will be used to help make care for the elderly and other patients with complex conditions more responsive, as well as avoid costly hospitalizations.

What trustees should keep their eyes on: your organization’s strategy for accessible care delivery, including the use of urgent care centers, retail clinics, employer-based clinics, mobile technology, telemedicine and home monitoring. Consider partnerships to accelerate market entry and success in new areas.

7. Analytic tools and digital medicine

Most health systems have implemented at least one electronic health record (some are on their second or third implementation) and also have invested in a plethora of other IT tools for finance, data warehousing, care management, predictive analytics, disease management, scheduling and so forth. The key in 2017 will not necessarily be what the next IT purchase should be (although there will be many of those still) but how these systems work together to optimize decision-making and forward-looking actions.

Having a clear data governance structure and system architecture focused on what operational and clinical outcomes are required will be essential. Furthermore, emerging artificial intelligence (e.g., IBM Watson) and the “internet of things” (digital equipment communicating with other equipment) will begin to change the roles and responsibilities of health care providers and team members as well as care pathways.

What trustees should keep their eyes on: creating a digital and analytics road map that optimizes systems and IT platforms already in place and identifies gaps to guide future purchases; understanding the role of artificial intelligence and digital equipment as health care delivery evolves.

8. Health care cost drivers

While inpatient and physician care still account for the majority of health care costs, pharmacy costs have been increasing at a faster pace than they have and will likely continue to do so in 2017.

Behavioral health will also come into increasing focus, because individuals with mental health disorders often have higher medical costs and greater use of emergency departments. Yet, reimbursement for behavioral health is generally poor, and access to providers is often lacking. This is a particular concern with the Medicaid and Medicaid/Medicare dual population, for whom behavioral health problems often are untreated and socioeconomic conditions such as lack of housing or nutrition can exacerbate health risks. The social determinants of health will be raised more frequently as factors to be considered in population health programs, requiring health systems to connect with community service organizations to drive better outcomes and better health for at-risk individuals.

What trustees should keep their eyes on: your organization’s strategy for behavioral health; creating partnerships or relationships with community service providers as a means of improving the health status of the population.

9. Clinical advances will march forward

Precision medicine based on the genetic profile of an individual will be more accessible to more people but will still be used in only a minority of cases. Cancer care is the early adopter. But watch this trend — it could accelerate fast.

New 3D printers will enhance the ability to replace organs and tissues but will still largely be tested in research labs — for now.

Robotics will continue to be used in operating rooms but will also find a place at the bedside — for lifting or moving, or even interacting with, patients.

Mobile technology, as already noted, will continue to explode, enhancing the ease with which diagnosing, monitoring and treating patients occurs.

All this will require astute assessment by medical staff for the adoption of new approaches, and academic medical centers may find expanded opportunities to partner with community providers in the research and deployment of new clinical treatment options.

What trustees should keep their eyes on: medical staff policies and approaches to reviewing biotechnology and clinical protocols; understanding the role of emerging medical trends in key service lines.

10. Human capital needs are changing

In an industry in which labor costs still comprise the lion’s share of operating expenses, workforce management has always been paramount. Today, with the role of the health system changing as population health and value-based care models take center stage, the roles and responsibilities of clinicians and nonclinicians are also changing.

Generational differences demand different approaches and even policies in human resource management.

Health care workers, including clinicians and nonclinicians as well as the management team, are increasingly facing burnout due to constant change and ever-rising expectations.

New approaches to recruitment, talent development and training, workforce management, and engagement will be required to optimize your most valuable resource — your people.

What trustees should keep their eyes on: potential workforce shortages as unemployment rates continue to drop; understanding the organization’s workforce development and management plan and ensuring it is responsive to changing roles, responsibilities and expectations.

Strategic Planning in Uncertain Times


Jacobs.jpgMs. Jacobs is president at GE Healthcare Camden Group and has been with the firm since 1990. She has more than 30 years of experience in the areas of integrated delivery system development, payer strategy, population health management, healthcare strategic and financial planning, transactions, and governance/ management systems. She is a noted speaker and industry resource on the impact of healthcare trends, most notably the requirements for success in value-based payment models, clinical integration, and creating successful integrated delivery systems. She may be reached at laura.jacobs@ge.com. 

Topics: Trends, Laura Jacobs

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