Robert FrombergEditor in Chief, HFMA
Some quick thoughts upon returning from the Non-Profit Health Care Investor Conference in New York:
“American health care gets it right 54.9 percent of the time…I wonder what we could achieve if we got it right 98 percent of the time.” That comment came from Brent James, MD, M.Stat Executive Director of the Institute for Health Care Delivery Research of Intermountain Health Care, in the conference’s keynote address. By “get it right,” he meant provide the right care at the right time in the right manner.
And he had some thoughts about how American health care can “get it right.” One is to apply to clinical care the techniques used to manage the business side. As James said, we need to manage our core business, and “the core business of the care delivery system is care delivery.” Those management techniques include capturing and analyzing data, communicating results, holding people accountable for achieving results, and managing change. This approach will, says James, help provide a “shared baseline” that will move health care from “craft-based practice” to “profession-based practice.”
“These are the markers for a successful healthcare organization,” he told the audience, a mix of investors and healthcare executives. He adds that the resulting cost reduction will be crucial to keeping Medicare fiscally viable.
The leading healthcare organizations that presented at the conference appear to have gotten the message, as one after another emphasized its investments and success in improving quality. Some presenters focused on patient safety. Others focused on quality of care more broadly. Some focused on meeting external benchmarks; some focused on internal benchmarks. Some focused on broader measures; some focused on specific conditions or treatments. But all had a compelling quality story to tell and all told that story in language that to some extent drew on business management.
(Another message this group seemed to get was the critical role of healthcare IT. James said that “in ten to fifteen years, if you haven’t implemented an electronic health record, you won’t be able to compete.”)
But an analysis released yesterday by Moody’s to coincide with the conference poses a significant challenge about the relationship between today’s quality improvement activities and future financial success. The analysis says that the ROI from a quality strategy will be demonstrated not only by the market benefit from national accolades, but by “more lasting and fundamental signs of improved quality that may not be so publicly recognized, such as improvements in market position and operating results. As the industry develops common metrics for measuing quality, our approach to hospital bond ratings will likely also evolve.” Moody’s goes on to indicate several “current measures or indicators that we believe can evidence initial success around quality,” including improved patient satisfaction scores, lower malpractice premiums, and limited physician turnover.
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