Quality and price are on the table.


As we prepare to mark the end of 2013—a year that has been historic for health care in more ways than one—the shift toward value seems stronger than ever. Healthcare organizations realize that they must improve quality while reducing the total cost of care to the purchaser. Across the industry, folks are making encouraging moves in this direction. However, when it comes to promoting themselves as “high value” organizations to an external audience, many hospitals and health systems still hesitate. It’s time for that to change. Whether we like it or not, the immediate future will bring consumers who want to make value-based decisions about who provides their care.

HFMA members have always been quick to identify their organizations as “high quality,” but historically, some have been reluctant to identify as “high value.” Some members have told us that it seems to imply that the quality of service is not top-notch. They worry that consumers might think they are a “bargain” or “discount” organization that does not provide premium service. Even if this once might have been accurate in some cases, consumer thinking is now profoundly reoriented. Facing increasingly steep deductibles, today’s patients are more interested than ever about what exactly they are getting (or not getting) for their money. And if we’re unwilling to provide them with this information, someone else is standing by to do it for us.

In 2011, we saw the launch of private companies like Castlight Health Inc. that provide technology allowing consumers to compare quality and cost data at different medical providers. Last year, Castlight secured $100 million in investment funds. Clearly, someone believes the public has an appetite for this kind of value information.

We need to be ready to lead the way in a new, value-oriented marketplace. So what, practically speaking, should organizations do? I think an excellent first step is deciding internally on a “value strategy.” Formulate a way forward that stresses quality—as you always have—but also incorporate value, transparency, and clear pricing policies.

I realize this is easier said than done, and can involve a change in mindset and thinking. Organizations will need to continually drive efforts that improve quality while reducing the amount paid for care by the purchasers. They will need to create a culture of collaboration and accountability around value. They will need to maintain and continually analyze quality and business data, and then take real, meaningful steps to use these findings to improve their value propositions. And they will
also need to develop and manage effective care networks that predict and manage different forms of patient risk. All of this will require investment and dedication, but assets like HFMA’s Patient Financial Communications Best Practices and Value Project reports contain pathways and case studies that can make the transition easier.

Change is coming whether we like it or not. By taking steps now to emphasize value—not just quality—we can position ourselves to keep our organizations competitive, and to make a positive impact in the lives of our patients.

Publication Date: Monday, December 02, 2013

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