Organizational Road Maps for Value-Driven Health Care
The value journey's destination is clear. As healthcare costs have begun to outpace improvements in the quality, a value gap has emerged. Healthcare provider organizations must work to close the value gap by improving quality while reducing the total cost of care to the purchaser.
As part of its Phase 2 Value Project research, HFMA has worked with a group of 35 hospitals and health systems to better understand their road maps to value. These organizations have been divided into five organizational cohorts: academic medical centers, aligned integrated systems, multihospital systems, rural hospitals, and stand-alone hospitals. HFMA's research has identified common challenges that all healthcare providers will face in the value journey, as well as common capabilities, strategies, and tactics that will help them on their way. It has also identified unique challenges and opportunities that define cohort-specific road maps to value.
Virtually all healthcare organizations are working to clarify and communicate their value proposition. They are trying to build more agile organizations to adapt to a rapidly changing payment environment and are seeking to build greater alignment with physicians. They are making these efforts against a backdrop of expected diminution of future revenues, uncertainty about future payment models, and concerns over patient engagement as health care transitions to care delivery models emphasizing population health and the prevention of illness.
This report provides a common road map for value, identifying action steps organizations should take to build competencies and skills within the four value-driving capabilities of people and culture, business intelligence, performance improvement, and contract and risk management identified in HFMA's Phase 1 Value Project research. The common road map in turn serves as a starting point for the cohort-specific road maps also presented in this report.
Cohort-specific Road Maps
This report offers separate discussions of challenges and opportunities, strategies and tactics, and key recommendations for each of the five organizational cohorts. These discussions are summarized in cohort-specific road maps provided throughout the report.
- Academic medical centers must work to align complex organizations around the goals of value-improvement, reducing overall cost structures while improving care processes.
- Aligned integrated systems must work to prove the value of integrated care delivery models, while aligning network providers to their systems and approaches to clinical practice.
- Multihospital systems must reevaluate the proper balance between centralized and decentralized elements within their systems, while continuing to add scale as they expand across a broader continuum of care.
- Rural hospitals must plan for potential reductions in revenue, while seeking the appropriate balance of primary care and specialty services to meet community needs.
- Stand-alone hospitals must pursue opportunities to improve scale and seek to differentiate themselves through superior clinical and financial performance.
Using This Report
We suggest you begin by reviewing this report's discussion of the common road map before turning to cohort-specific discussions. HFMA recognizes that many organizations have operations or facilities that extend across multiple cohorts. We encourage you to read across the different cohort discussions to gain a better understanding of the multiple road maps available to organizations as they undertake their value journeys.
Publication Date: Thursday, November 01, 2012