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GE Healthcare Camden Group Insights Blog

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

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

Utilizing Analytics to Measure Risk and Evaluate ROI in Your Organization's Value-Based Care Initiatives

Posted by Matthew Smith on Oct 4, 2016 2:06:19 PM

By Shaillee Chopra, PMP, Senior Manager, and Daniel J. Marino, MBA, MHA, Executive Vice President, GE Healthcare Camden Group

Data AnalyticsHealthcare organizations transitioning from fee-for-service to value-based models are making substantial investments in building technology and operational infrastructure to drive new services and workflows. Developing an effective and an efficient care delivery system from which to identify and drive profitability under risk arrangements remains of utmost importance. However, developing an analytics framework to support population health management, evaluate potential and expected returns from investment continues to be a struggle for many healthcare organizations.

Creating an analytics-based evaluation model enables healthcare organizations to quantify risks and evaluate viability and value-add of outcomes associated with various decisions. It also allows them to measure and track return on their investments in technology and resources associated with various programs aimed at managing health of populations they serve.

An Analytics-Based Value Model for Population Health

The framework for this model is grounded in measurement of utilization by place of service. It provides near real-time insight into “what works and what does not” in an operational environment. It also serves as a mechanism to ensure an organization’s positive position during re-contracting discussions with payers since it is supported with demonstrable value of delivering the right care to the right patient at optimal cost in the most appropriate setting. It serves as an information-based decision making model that enables the organization to make the transition to pay-for-value while preserving margins and without upsetting the apple cart of existing payer -provider relationships.

The Need for a Value Model Within an Organization’s Population Health Framework

A value model allows your organization to develop a deeper understanding around which variables drive outcomes that impact decisions about investments and resource allocation. For example, high-performing and value-based organizations are committed to improving quality and reducing avoidable utilization and costs. Cost reductions are a byproduct of the reduction in avoidable ER and acute inpatient utilization for individuals with chronic conditions. These costs are offset by an increase in “good utilization” such as increased PCP visits, wellness screenings, and pharmacy costs associated with medication adherence.  An analytics-based value model allows your organization to meaningfully sift through large amounts of data to identify and isolate important variables for future strategic success.

It allows for assessment of returns on investments made in various disease management intervention programs for at-risk, rising-risk and chronically ill population cohorts. It identifies assets and value levers that can be leveraged to prioritize and tweak the operational models for optimal returns.

Finally, it allows your organization to use analytics as a cornerstone for an innovative and data-driven approach to population health management.

Key Questions to Ask Within Your Healthcare Organization

Top performing healthcare organizations that are invested in developing their analytic capabilities begin with the end in mind and work from an analytics roadmap. Below are some of the key questions to consider to ensure you are achieving outcomes you desire without “boiling the ocean” and wasting valuable resources on programs that have minimally aligned outcomes:

  • What are the key questions you want to answer? Do you have 3-5 clearly defined use cases?
  • Accuracy, validity and credibility of your data: Do you know what data is needed? Do you have the right data? Is the data useable, i.e., accurate and credible? What data do you not have? Do you have a data acquisition strategy?
  • Analytics roadmap: Have you established a needs based analytics framework within your organization? Do you have right skillset and adequate tools to conduct analytics? After you perform analytics do you know how to interpret the results and make them actionable?
  • Driving actions: Do you have an actionable strategy for executing on the results? What are the actionable opportunities to execute against? How are you evaluating competing analytic priorities for resources and investment?
  • Monitoring impact and evaluate results: Have you implemented processes to track performance as part of your activation plan? Are you tracking both outcomes and the steps required to achieve the outcomes? Are you leveraging predictive modelling to consider varied “What if” scenarios to continually optimize the focus areas of your operational work plan?

Utilizing an analytics-based value model allows your healthcare organization to optimally invest resources and dollars towards operational programs that generate outcomes and value most alignment with strategic goals.

Value Model, Health Analytics


chopra2-110511-edited-239718-edited.jpgMs. Chopra is a senior manager with GE Healthcare Camden Group and specializes in developing and managing innovative technology portfolios for value-based and clinically integrated healthcare networks. She is highly experienced in leading information technology and consumer experience strategy development, as well as transformations to enable clinical integration, accountable care, and population health management strategies for organizations invested in innovation and transformation of care delivery models. She may be reached at [email protected].

 

Marino_Dan.jpgMr. Marino is an executive vice president with GE Healthcare Camden Group with more than 25 years of experience in the healthcare field. Mr. Marino specializes in shaping strategic initiatives for healthcare organizations and senior healthcare leaders in key areas such as population health management, clinical integration, physician alignment, and health information technology. With a comprehensive background in all aspects of practice management and hospital/physician alignment, Mr. Marino is a nationally acknowledged innovator in the development of Accountable Care Organizations and clinical integration programs. He may be reached at [email protected].

Topics: Value-Based Care, Healthcare Analytics, Daniel J. Marino, Data Analytics, Shaillee Chopra, Digital Health Services and Data Analytics, Value Model

Determining ROI From Your Analytic Technology Investment

Posted by Matthew Smith on Sep 8, 2016 8:49:14 AM

By Mmekom Ekon, PMP, Consultant, GE Healthcare Camden Group

As the healthcare industry continues to make an accelerated move toward value-based care models, organizations are investing substantial amounts in analytic platforms to deliver insights that will drive  improved quality and reduced costs. Stakeholders also believe that these analytic solutions, with their predictive forecasting and trending capabilities, are key to successful value-based programs where they can help transform clinical and financial initiatives and address various regulatory and financial challenges that lie ahead.

The healthcare analytics market is stimated to reach $18.7 billion by 2020 (from $5.8 billion in 2015) at a combined annual growth rate of 26.5% during this forecast period. This places analytics among the top areas of spending growth for hospitals and health systems during this decade. 1 Given the projected increase in the overall analytics spend paired with low hospital operating margins, executives are faced with tough questions around return on investments on these technologies. Are these suite of business intelligence tools delivering as promised? How do you determine if these analytic platforms are providing value to your organization or if there’s any return on your technology investment?

Here are 3 key categories to consider when determining ROI on your analytics investment:

1. Organizational Penetration

What is the “analytics market share” within your organization? Who’s using it, and what is the percentage of your organization that uses or is aware of the capabilities of the analytic tool? Is there opportunity to “increase analytics market share” within your organization to get the tool to the right folks and get them to use the information from the tool?

The biggest challenges to the penetration of an analytic technology culture is fragmented ownership and limited access to skilled resources (super users) . A quick assessment of the departments and staff that use your current analytics platform will indicate how well your analytics platform is embedded in an organization, department, or individual workflows.

2. Utilization

What types of data and information are frequently produced from these reports? Without access to action-oriented reports with pertinent information, the ability to derive value from your investment is constrained. The true value of an analytic tool is to produce efficient and consistent reports. These reports are used at the executive or board level to make key decisions around hospital operations and allow key patient care staff (such as physicians, nurses, allied health professionals, and ancillary staff) to access key performance indicators and interactive dashboards. Such access allows them to deliver optimum quality of care while adhering to clinical best practices and minimizing costs for their patients.

3. Organizational Goal Alignment

What were your original goals for this investment? Can you tie any recent operational change to your analytic tool? The ability of your technology investment to contribute toward financial, clinical, and operational improvement projects is paramount to achieving value out of your technology.

Analytics has no value unless it is acted upon. Strong linkages to information produced from your analytic platform to cost and quality improvement is the chief value of any technology investment.

The successful use of any analytic tool requires establishing a framework that identifies the value-add of a product and its alignment to your organization’s strategic goals and objectives early on. Monitoring and measuring usability against this framework while adjusting utilization workflows and addressing organizational needs for data literacy and alignment with operational objectives are key factors that quantify ROI against your investment.

  1. http://www.marketsandmarkets.com/PressReleases/healthcare-data-analytics.asp

ekon.jpgMs. Ekon is a consultant with GE Healthcare Camden Group, specializing in the digital health and analytics. Prior to joining GE Healthcare Camden Group, Ms. Ekon served as a technology consultant with Crimson performance software. In this role, she managed several hospitals and health systems through Crimson software implementation to analyze and improve operational, clinical, and financial performance. She has also helped members to identify opportunities to improve operational, clinical, and financial performance as well as implement solutions to improve bottom line. She may be reached at [email protected].

 

Topics: Value-Based Care, Healthcare Analytics, Digital Health Services and Data Analytics, ROI, Mmekom Ekon

MACRA: How the New Merit-Based Incentive Payment System Will Impact Physician Practices

Posted by Matthew Smith on Jul 14, 2016 4:15:34 PM

By Nidhi Chaudhary, Consultant, GE Healthcare Camden Group

Healthcare delivery and its corresponding costs are changing due to recent industry trends. Value-based programs reimburse healthcare providers for the quality of care they provide to patients. To support this, the Medicare Access & CHIP Reauthorization Act of 2015 (“MACRA”) intends to reform Medicare payments to physicians over the next several years. MACRA has two pathways:

  1. The Merit-Based Incentive Payment System (“MIPS”)
  2. Alternate Payment Models (“APMs”), which will take effect starting in 2017.

In order for practices to survive and compete in this value-based environment, specific initiatives must be deployed this year. 

MACRA1.png

Transitioning to the MACRA MIPS model

There are currently multiple quality and value programs for Medicare providers: Physician Quality Reporting Program ("PQRS"); Value-Based Payment Modifier; and the CMS EHR Incentive Program. 

MACRA streamlines those programs into MIPS and adds a fourth category called Clinical Practice Improvement Activities. Below is an example of MIPS Scoring for Year 1:

MIPS1.png

Challenges Faced by Physicians:

  • Uncertainties surrounding the shift from volume-to-value
  • Potential reduced reimbursement for services
  • Tracking of quality and cost management
  • Optimizing electronic health record (“EHR”)/registry use

Key MACRA questions for medical groups:

  • What does the current Quality and Resource Use Report (“QRUR”) tell you?
  • What is the implementation plan for 2016 and 2017?
  • What are the right measures that should be tracked and reported? Are workflow changes required?
  • What clinical practice improvement activities will be added?
  • How will the current infrastructure support the initiatives?
  • Is additional technology required?
  • How will the composite score be optimized?
  • Do we have adequate resources and education opportunities to be successful?

How can GE Healthcare Camden Group help organizations create and navigate a MACRA roadmap for 2017?

We help organizations:

  • Identify gaps and priorities by performing a MACRA readiness assessment
  • Help groups form and facilitate a steering committee with a shared vision
  • Integrate change management methodologies to ensure success
  • Create education and communication plans
  • Develop a tactical MACRA roadmap focusing on strategic and operational objectives   
See our sample work plan and timeline below:

MACRA_Roadmap.png

If you want to get started with your own, personalized MACRA roadmap, click the button below and a GE Healthcare Camden Group MACRA expert will be in touch to start you on your way.

MACRA


ChaudharyN.jpg

Ms. Chaudhary is a consultant with GE Healthcare CamdenGroup specializing in delivering strategies, working to provide more efficient and lean processes as well as coaching leaders and management. Ms. Chaudhary joined GE Healthcare in 2007 and has extensive experience in Regulatory Affairs and Quality Engineering pertaining to both medical and pharmaceutical devices. Ms.Chaudhary has provided support for strategic and business planning while working within the business and with the medical staff at multiple hospitals. She may be reached at [email protected].

 

Topics: Value-Based Care, Payment Reform, Value-Based Contracting, Payment Models, MACRA, MIPS, Nidhi Chaudhary

New Download: Digital Health Services and Advanced Analytics

Posted by Matthew Smith on Jun 15, 2016 12:51:33 PM

Are you unsure of how to start the process of building a data strategy and an information roadmap? Are you worried that you're not aggregating the right data? Are you stuck in neutral and not making any headway with your population health analytics vendor? 

If so, GE Healthcare Camden Group can start you on the right path.

Start here...with our PDF outlining ourDigital Health Services and Advanced Analytics practice.

The PDF includes pages on:

  • Our Philosophy and Approach
  • Reasons Why Healthcare Analytics Vendor Implementations Fail
  • Initial Questions from Leadership and Teams
  • Data Analytics Strategy Components
  • Information Services and Advanced Analytics

Simply click the button below to get started!

Digital Health, Advanced Analytics

Topics: EHR, EMR, Value-Based Care, Data Analytics, Digital Health Strategy, Digital Health Services and Data Analytics

Meet the Practice: Digital Health Services and Advanced Analytics

Posted by Matthew Smith on Jun 14, 2016 1:45:24 PM

This Meet the Practice overview, examining the new Digital Health Services and Advanced Analytics practice, is part of an ongoing series in which GE Healthcare Camden Group's senior leaders share insights into our six practice areas.

Practice Lead: Daniel J. Marino, Executive Vice President

Explain the needs and problems you solve for clients through this practice.

The U.S. healthcare system is experiencing significant shifts in the way healthcare is accessed and delivered, fueling a strong desire for operational efficiencies, value-driven outcomes, and action-oriented information. In order to ensure that intelligible, actionable information is created, organizations are creating digital health strategies that focus on producing value-driven analytics while supporting their operational capabilities and needs.

As a result, there is a need to assist healthcare provider organizations in:

  • Building an operationally-focused information services and analytic strategy
  • Provide direction in creating comprehensive and powerful advanced analytics
  • Incorporating enterprise-wide data governance integrating clinical, financial and technical master data management
  • Focusing on analytic deliverables and capabilities and less on application functionality
  • Improving integration of applications and technology with provider workflows and care model delivery
  • Maximizing the optimal use of existing applications
  • Providing objective, vendor agnostic professional advisory services to provider organizations

Ultimately, we enable clinically integrated organizations to maximize value through an operationally driven digital health strategy.


Building_Action_Oriented_Information-1.png


What is the value or ROI that is provided by solving these challenges?

Organizations with a comprehensive digital health and analytics roadmap will be able to realize benefits in strategic development, operational optimization, and performance effectiveness.

From a strategic development point-of-view, organizations will be able to expand their provider networks through enhanced connectivity, integrated care management, analytics, and value-based programs. Operationally, they will benefit from real-time performance data which supports operational output for clinical, financial, and contracting objectives. They will also see improved performance effectiveness via cost-of-care modeling to support value-based contracting, and improved outcome tracking and clinical program effectiveness measures.

What types of organizations need your services?

We engage provider organizations at various stages of digital preparedness. Many organizations are simply looking for a starting point in working with their population health analytics vendor and want to ensure that they have a results-oriented digital health development blueprint and are aggregating the right data that leads to meaningful information. Other organizations are looking to create a complex data strategy and roadmap amidst a sea of ever-changing priorities and information requirements.

What synergies differentiate this practice area (and GE Healthcare Camden Group)?

Within GE Healthcare Camden Group, our Digital Health Services and Advanced Analytics practice provides a 360 degree operational perspective to the information services and analytic challenges existing within healthcare organizations.

Because we are vendor agnostic, our objective experts understand the clinical and operational impact of the ever-changing technology landscape and are equipped to advise on IT/IS strategies, system selection, activation support, and advanced analytics.

As a firm, GE Healthcare Camden Group provides professional advisory services across the care continuum incorporating our expertise in information services and analytics. We have built a reputation as a trusted partner to clinical, operational, and financial healthcare leaders by helping them close the gap between their challenges and the optimal solutions for success.

To learn more about GE Healthcare Camden Group's Digital Health Services and Advanced Analytics practice, please click the button below for a PDF download.

Digital Health, Advanced Analytics


Marino_Dan.jpgMr. Marino is an executive vice president with GE Healthcare Camden Group with more than 25 years of experience in the healthcare field. Mr. Marino specializes in shaping strategic initiatives for healthcare organizations and senior healthcare leaders in key areas such as population health management, clinical integration, physician alignment, and health information technology. With a comprehensive background in all aspects of practice management and hospital/physician alignment, Mr. Marino is a nationally acknowledged innovator in the development of Accountable Care Organizations and clinical integration programs. He may be reached at [email protected].

Digital Health Services and Advanced Analytics

Topics: Value-Based Care, Daniel J. Marino, Data Analytics, Digial Health, Digital Health Strategy, Digital Health Services and Data Analytics

The Move from Volume to Value: Now is the Time for Change

Posted by Matthew Smith on Jun 2, 2016 12:19:54 PM

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

Healthcare delivery (and physician reimbursement specifically) is undergoing unprecedented transformation. While most physician practices still operate largely in a fee-for-service ("FFS") world, government and commercial payers alike have signified their intent to reimburse physicians and other providers based on value.

Thriving in an Uncertain World

Many physicians recognize that the FFS system is imperfect at best, but the evolving value-based reimbursement system is ill-defined, leaving physicians facing a great deal of uncertainty. During this time of uncertainty, medical practices have opportunities to improve performance and position themselves for success in the rapidly changing healthcare market. It is natural to begin focusing on clinical measures and outcomes as a means for proving value, but it is just as important to remain financially viable during the transition. By understanding the structures of evolving reimbursement methodologies, changing health plan dynamics, and developing market trends, we can thrive in this uncertain world.

The Department of Health and Human Services’ (HHS) is actively involved in the fundamental shift in reimbursement, moving from volume to value in Medicare payments, reinforcing the shift to value-based care. Organizations that begin to incorporate strategies around the “value proposition” will be in the best position to meet industry demands for value-based reimbursement. This will require a dedicated strategic “call to action” across organizations and their provider community.

Controlling the Momentum of Change

There remains a fundamental question regarding how quick an organization should move to value-based care and controlling the momentum of change. Although some of the drivers are market dependent, others are based on embracing key concepts around the “triple-aim principles” and preparing the organization for the future. High-performing organizations are building their clinically integrated networks, forming ACOs, and incorporating reimbursement programs around bundled payments and minimal risk-based contracts, while still reaping some opportunities from the current fee-for-service contracts. 

The transition into value-based care is a paradigm shift of culture, care model redesign, reimbursement, and quality outcomes that takes time. Organizations that begin to plot the “value-based care” path now, while fee-for-service is still their predominant reimbursement, will be in the best position to refine their care delivery models and protect their revenue streams. It will come down to embracing the concepts of patient-centered care while focusing on improving access and reducing the cost curve. Health systems must begin to squeeze operating costs out of the system and incorporate patient-centered care models focusing on an “ambulatory-focused” model of care that carefully manages transitions across the continuum.

Balancing Risk

Many commercial payers in some markets have already begun the transition, with many more to follow.  A strong value proposition along with creating the patient-centered strategy is key to finding the right “change momentum” for your organization. Focusing on providing the value proposition, engaging physicians to lead the care redesign, and incorporating programs such as bundled payments and shared savings help to make sure organizations appropriately embrace the pace of change within their market. It also ensures the organization can maintain a steady forward pace by balancing appropriate risk with solid potential for clinical and financial gains.

Volume to Value


Marino_Dan.jpgMr. Marino is an executive vice president with GE Healthcare Camden Group with more than 25 years of experience in the healthcare field. Mr. Marino specializes in shaping strategic initiatives for healthcare organizations and senior healthcare leaders in key areas such as population health management, clinical integration, physician alignment, and health information technology. With a comprehensive background in all aspects of practice management and hospital/physician alignment, Mr. Marino is a nationally acknowledged innovator in the development of Accountable Care Organizations and clinical integration programs. He may be reached at [email protected].
 

Topics: HHS, Bundled Payments, Department of Health and Human Services, Value-Based Reimbursement, Value-Based Care, Daniel J. Marino

A Business Plan of Operational Efficiency for a Value-Based World

Posted by Matthew Smith on May 17, 2016 10:34:14 AM

By Brandon Klar, MHSA, Senior Manager, GE Healthcare Camden Group

As health care continues its rapid evolution toward value-based reimbursement, health system leaders face escalating pressure to reduce their cost structure and enhance their value propositions. For many, the solution is to join forces with another provider through a formal partnership agreement. 

But once a new partnership has cleared the planning hurdle and avoided early pitfalls, it still faces a big challenge. How do you make sure the combined system achieves the full benefits of operational integration?

Our experience with providers nationwide has indicated that successful healthcare partnerships rely on one indispensable tool — a business plan of operational efficiency ("BPOE"). A detailed BPOE helps partnering organizations achieve the large-scale cost reductions necessary for value-based care and declining reimbursement.

The Business Plan of Operational Efficiency

A health system BPOE is a comprehensive, action-oriented system integration plan. It is designed by and for organizations that are forming a single corporate structure strategically and operationally. Simply defined, a BPOE is a road map for achieving the full benefits of an affiliation — operational efficiencies, cost savings and enhanced clinical value.

The most effective BPOEs are developed from the ground up. Departmental leaders identify detailed action items for aligning administrative, support, infrastructure and clinical functions. The key is to capitalize on the operational strengths of each organization and each department. A BPOE should:

  • identify and quantify specific affiliation-related cost-saving opportunities within each department;
  • identify barriers to achieving the efficiencies;
  • identify the resource and time requirements necessary to implement the action plans;
  • lay out a game plan for aligning specialty programs throughout the system;
  • ensure accountability by specifying the individuals responsible for implementing the plan.

Ultimately, the goal is to develop a clear list of achievable and sustainable performance improvement initiatives that will enhance efficiency and reduce the underlying cost structure of the system.

When Should You Develop a BPOE?

Many partnering organizations craft a BPOE before any affiliation agreement is signed. This lets system leaders proactively identify savings opportunities after the transaction. A pre-transaction BPOE also might be required for regulatory approval by the state department of health, state attorney general, Federal Trade Commission or the Department of Justice.

An inherent limitation of a pre-transaction BPOE is that the prospective partners are unable to share competitively sensitive information before closing. This limits the specificity and detail of cost-saving opportunities and action plans. But provisional BPOEs developed before the transaction are directionally accurate; they can also ensure that the prospective partners are strategically and culturally compatible.

A BPOE can be developed or refined with specificity and clarity after the transaction, even if the merger or affiliation took place some time ago. Many systems that have merged or affiliated in recent years have yet to realize the full benefits of operational integration. If this is your situation, commission a multidisciplinary team to revisit previous efforts. The team should develop a BPOE that identifies redundant costs as well as new strategies for better integrating, standardizing and consolidating functions.

Four Reasons to Invest in a BPOE

Every affiliation, merger or acquisition is unique. Every health system's story — and how it came to exist in its current form, with its current culture — is unique. In the background are variations within the consumer and payer markets, differences in strategic and operational strengths and weaknesses, and cultural nuances. These factors drive the need for a customized integration plan for every new partnership. A well-designed BPOE offers four important benefits:

1. A clear leadership structure. The most contentious point in transactions often centers on a single question: Who will be in charge? While it is critical to clearly define the executive hierarchy for the system and its business units (e.g., hospital, physician group, post-acute), it is just as important to outline the cascading leadership structure throughout all departments within the system.

Effective BPOEs identify the leadership positions most appropriate for consolidation; they also establish centralized management for all administrative, support and infrastructure functions. This not only creates consistency in decision-making, it facilitates and streamlines integration efforts. Adopting matrix organizational and reporting structures also will foster standardization of system processes, while allowing for moderate variation when needed to account for distinct organizational variables. In addition, developing a centralized leadership structure as part of the BPOE will help middle managers align interdependent integration plans through multidisciplinary teams.

2. Clear ground-level integration plans. For most system integrations, success or failure occurs at the department level. Effective BPOEs use a ground-up planning process to develop detailed departmental action plans that identify specific opportunities, obstacles and accountabilities.

Department-level plans set clear goals that are consistent with the system's integrated vision. Objectives should include standardization of policies and procedures, optimization of staffing resources, alignment of contracted services, standardization of equipment and supplies, and cost reduction through joint purchasing. Departmental plans also should address specific resource requirements, interdependencies with other unit plans, implementation timelines and responsibilities, and specific cost-saving targets.

Departmental action plans provide a detailed implementation path that can be monitored and measured. This establishes a platform for consistent and timely communication about integration activities and milestones. Collectively, the departmental integration plans will lead to a more integrated and streamlined system.

3. Realistic and sustainable cost-saving targets. Carefully developed BPOEs can lead to annualized system cost savings between 4 and 7 percent. However, during the development of the departmental integration plans, all savings opportunities should be validated by both the responsible department and the financial team prior to inclusion in the plan.

BPOE action items should be incorporated into budgets and could require capital resource allocation for implementation, so it is critical to quantify and rigorously validate cost-reduction opportunities in administrative, support, infrastructure and clinical departments. Operational and financial leaders should assess each savings opportunity to ensure it is realistic, achievable and sustainable. This applies to both salary and non-salary savings opportunities.

Non-salary savings opportunities are often easier to implement culturally. Health systems can achieve significant early cost reductions by standardizing equipment and supplies and aligning contractual services. These savings are not only typically achievable in the short term, but are also sustainable.

Salary savings typically are realized over a longer period. While centralizing management leads to early savings, staffing integration and optimization can take time and resources to fully achieve.

4. A strong foundation for a system-oriented culture. Joining two disparate business entities within a single consolidated health system is inherently difficult, and effectively integrating long-standing legacy cultures is a critical hurdle that can cause a partnership to succeed or fail. Leaders must encourage a cultural transition that moves the organizational focus from business unit priorities to collective system goals and overall performance. A robust BPOE process can aid this cultural transition.

BPOE development uses a structured approach that includes a blend of objective quantitative analyses and key stakeholder engagement. Stakeholder meetings provide a thorough understanding of the existing cultures and organizational barriers to integration. This helps to engage key stakeholders in the process while grounding discussions and action plans in organizational realities. Ultimately, the BPOE process challenges the existing provider organizations individually and collectively to think beyond current practices and strive collaboratively to improve performance as a system.

Protection Against Inaction

In a world that is becoming less hospital-centric, hospitals and health systems are trying to refashion themselves as care continuum organizations through strategic mergers and affiliations. But too often, good intentions fall by the wayside as inertia, politics and other obstacles prevent partnering organizations from realizing the opportunities of integration.

A well-designed business plan of operational efficiency guards against inertia by providing specific, achievable integration goals and action plans. Whether your organization is pursuing a new affiliation or is looking to maximize existing health system performance, a BPOE is an essential tool to achieving true system-level operational integration.


B_Klar.jpg

Mr. Klar is a senior manager with GE Healthcare Camden Group with over 12 years of experience in healthcare management. Mr. Klar specializes in strategic and business planning advisory services, including service line planning, master facility planning, and transaction work (e.g., mergers, acquisitions, affiliations, joint ventures). He has extensive experience in the creation of strategic partnerships, the facilitation of inaugural health system strategic plan development, as well as the creation and implementation of business plans of operational efficiency, system-wide integration plans, and clinical programmatic alignment plans. He may be reached at [email protected].

 

Topics: Value-Based Care, Payment-for-Value, Business Plan of Operational Efficiency, BPOE, Brandon Klar, Value-Based Payments

New Download: Building the Information Management and Data Governance Strategy for Value-Based Care

Posted by Matthew Smith on Apr 27, 2016 2:12:00 PM

The U.S. healthcare system is experiencing significant shifts in the way healthcare is accessed and delivered, fueling a strong desire for operational efficiencies, value-driven outcomes, and action-oriented information. 

This new 15-page download from GE Healthcare Camden Group focuses on how successful organizations transitioning to value-based care delivery systems can:  

  • Define strategic and operational goals that an integrated care delivery systems needs to address
  • Identify key challenges organizations face when defining a roadmap for an analytics strategy
  • Outline components of an action-oriented information systems framework for an integrated care delivery system
  • Define steps to create the information architecture to support a data governance strategy

To download this document, please click on the button below.

Data Governance

Topics: Value-Based Care, Health Information Exchange, Healthcare Data, Data Governance, Information Management

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