Sg2 Strategic Countdown: The Case for Well-Timed Care Redesign
Health system change is accelerating. How will your organization revamp care delivery and time adaptive approaches based on universal imperatives, organizational realities and market nuances? Sg2 offers the following five strategies:
- Pinpoint opportunities via data analysis and a two-part decision framework. Assemble and mine comprehensive data to gain insight on diseases and service lines that offer the most significant performance opportunity, represent the greatest revenue at risk, provide low or negative margins, or are transitioning most rapidly from acute to ambulatory settings. Layer on a holistic environmental analysis encompassing both institution-specific factors (eg, System of CARE strategy, clinical leadership, technology assets) and market factors (eg, comparative performance, growth relative to market trajectory, payment evolution).
- Redouble efforts to control variance and cost. Efforts to curtail cost and variance have underpinned performance initiatives for decades. Now, heightened payment pressure and evolving risk-based models bring new urgency and demand a more expansive view of these endeavors. Hospitals and health systems must move beyond traditional incremental approaches to system-wide strategies, including adoption of evidence-based protocols for high-volume conditions; maximization of procedural efficiencies for key surgeries; and reduction of unwarranted quality and cost discrepancies among physicians treating clinically comparable patients.
- Reduce unnecessary care. Redundant or avoidable care is another long-standing challenge, driven by misaligned incentives, historical patient perception that “more care is better care,” and physician propensity to practice defensive medicine. Organizations must empower, motivate and incentivize clinicians to foster a culture of optimal care. Educate patients about the importance of evidence-based clinical decisions, and the potential costs, benefits and risks of treatment options. Adopt segmentation strategies and predictive modeling to identify and support patients at highest risk of readmission and avoidable acute episodes.
- Restructure the clinical experience. Initiatives toward the more progressive end of the care redesign spectrum focus on the “who” and the “where” of care. Optimizing the site of care through enhanced access, novel patient engagement strategies, and strengthened relationships with post-acute and community providers plays a core role in drawing patients to the most cost-effective, clinically appropriate setting that meets their needs. Organizations seeking the broadest care continuum will offer virtual health options. Ensuring that advanced practitioners and other care team members work at the top of their licensure is fundamental to all clinical restructuring efforts.
- Optimize the System of CARE. System optimization—the most progressive region of the care redesign spectrum—encompasses efforts to transform the patient experience into a life-affirming journey for even the most complex conditions, and to refocus the enterprise on wellness, prevention and the health of communities and populations. Successful initiatives harness the full power of health information; enhance care coordination and collaboration across sites and providers; expand and strengthen palliative care and hospice services; and integrate behavioral health into the core of care.