Improving Efficiency Scores While Maintaining Quality
Medicare’s Value-Based Purchasing (VBP) program steps on the accelerator, beginning Oct. 1, 2014, when it adds an efficiency score—a hospital’s spending per Medicare patient—to the formula that determines hospital pay. “In a way, this is a measure of how well we are coordinating care, which is something that we are working very hard to improve,” says Susan Dragoo, director of quality and innovation at INTEGRIS Health.

Melinda Hancock, CFO at Bon Secours Virginia Health System, shares Dragoo’s perspective. The efficiency score reinforces her health system’s current focus on cost reduction. “We were accepted into the Medicare Shared Savings Program as of January 1, so the timing couldn’t be better,” she says. “When we first saw the efficiency component show up on the Hospital Compare website, we quickly pulled all of our hospital scores and presented them to our CMOs, CNEs, CFOs, and CEOs from across the system,” says Hancock.

Social Services: Prescribing the Basics of Good Health
Rebecca Onie, a MacArthur genius grant award winner, is demonstrating the ROI to be gained from helping patients obtain needed social services, including food, utilities, and a job. She is the co-founder and CEO of Health Leads, a not-for-profit organization that connects patients and their families with needed social services.

In most communities in which Health Leads works, a health system pays part or all of the program costs because the system leaders recognize the need—and the benefit. For example, research has found that pediatric patients whose families cannot pay their utility bills are 30 percent more likely to be hospitalized. So every time Health Leads connects a patient to needed resources, it may be reducing utilization.

Moving the Dial with Employee and Executive Incentives
Setting clear goals and rewarding leaders and employees for meeting targets are common factors in the incentive plans developed by North Mississippi Health Services (NMHS) and North Shore-LIJ Health System.

“We created a clear and aligned connection between NMHS’s critical success factors—people, service, quality, finance, and growth—and employee behavior,” says Rodger Brown is vice president of human resources, North Mississippi Health Services. “To accomplish that, we identified ‘high-impact behaviors,’ which are specific actions our employees take to positively contribute to our goals. For example, a high-impact behavior for inpatient satisfaction is hourly rounding.”

North Shore-LIJ Health System first ensured that the health system’s goals were meaningful and reflected areas that would lead to success, says Joseph Cabral is senior vice president, chief human resources officer. “We suspected that same misalignment of goals among our staff employees. To repair the disconnect, we created a clear method for communicating goals across the organization.

Successful Physician-Hospital Alignment

Lee Memorial Hospital boasts that its joint replacement program ranks among the top 5 percent in the nation, according to HealthGrades. Kevin Newingham, the system’s vice president for strategic services, attributes much of that success to a three-year-old co-management agreement with 24 orthopedic surgeons from seven different practices.

Other hospitals and health systems are exploring pay for performance, clinically integrated networks, and more.

Publication Date: Thursday, June 13, 2013