Transforming healthcare delivery to improve value for all is a difficult task made even more challenging by economic pressures, political polarization, lack of authentic dialogue between key constituents, public confusion, and more. During ANI: The 2013 HFMA National Institute, healthcare thought leaders offered the following strategies for driving value.


Be open to new ways of thinking and nontraditional approaches to care delivery. For example, Denver Health implemented Lean production practices to increase efficiency throughout its system—and saved $180 million in five to six years, with the lowest case-mix adjusted mortality rate in the University HealthSystem Consortium, according to Don Berwick, MD, former Centers for Medicare & Medicaid Services administrator and founding CEO for the Institute for Healthcare Improvement. Meanwhile, the “Nuka” care system, based in Anchorage, Alaska, encourages residents to take charge of their health—and has reduced emergency department utilization and inpatient admissions by more than 50 percent while increasing patient satisfaction, he said.

Pinpoint areas where waste can be removed throughout the continuum of care. “I want you to be interested in improvement,” Berwick told healthcare finance professionals at ANI, “and to do that, you really need to decide what you want to improve.” Berwick suggested finance professionals begin by finding areas of waste in their organizations—such as overtreatment, excesses in administrative costs, failures to coordinate care, and failures in care delivery—and concentrating on removing waste from these areas, one by one.

Empower consumers with information that enables them to make more informed healthcare choices—and make them accountable for their own actions in regard to their health. Providers and payers should work together in designing incentives for consumers that encourage them to make responsible decisions regarding health and wellness and utilization of healthcare services, said Robert Kolodgy, senior vice president, finance, and CFO for Blue Cross Blue Shield Association. “We need to give folks good information … that allows them to think through [their care options],” Kolodgy said.

Build scale through nontraditional methods. Innovative examples of nontraditional methods highlighted by Lisa Goldstein, associate managing director for Moody’s, include Walmart’s designation of six centers of excellence for associates; the BJC Collaborative, which brings together four sizable healthcare systems for shared savings through group purchasing and shared best practices; Aspen Valley Hospital’s participation in the Western Health Alliance, a network of rural hospitals to achieve savings through group purchasing; and Novant Health’s shared savings and services model with community hospitals.

Focus on the organization’s ability to respond quickly to change. For example, during a presentation on the role of stand-alone hospitals in today’s economic environment, Michael Allen, CFO for Winona Health in Minnesota, cited agility as one quality that enables stand-alone hospitals to compete with larger organizations. “We are able to do things faster than most organizations,” Allen said at ANI. The hospital also takes an innovative approach to patient interaction. For example, Winona is piloting a population health approach that enlists students who are working toward nursing and other healthcare degrees on care teams who visit patients in their homes. “This is close to a zero-cost program,” Allen said.

Jeni Williams is managing editor, content development, HFMA’s Westchester, Ill., office.

Publication Date: Sunday, September 01, 2013

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