Browse by Topic
More than 40,000 members value HFMA's thought leadership and practical strategies. HFMA is where you need to be.
Get acquainted with the
healthcare finance industry's leading professional association. Find out why our
members rely on HFMA as their go-to source for insight and
Members have many
options for helping them advance their careers. Conferences, seminars,
eLearning, certification, and more -- our education and events will keep you
Connect the dots on today's big issues, explore collaborations, get career-boosting tips, and network with colleagues nationwide at the leading finance conference. Save $100 off the full conference rate when you register by May 8.
Real-time presentations with nationally recognized experts, networking opportunities, and industry solutions—no travel required!
Get the latest, practical education in key areas of healthcare finance over 1, 2, or 3 days. Choose Essentials Programs or Master Sessions in DC or Seattle. Register early and save $100.
If you're a subscriber to any of our three newsletters, you have access to online education. Learn more or subscribe.
Get the perspectives of leading healthcare finance professionals on today's hottest issues.
Information about leading vendors helps your buying decisions.
Forum members can network during live webinars or access a library of past webinars on topics such as bundled payment, charity care, and ICD-10.
An ever-expanding collection of spreadsheets, policies, job
descriptions, checklists, and more that you can adopt and adapt.
Forum members can submit vexing questions to a panel of experts
using our Ask the Expert service.
Your source for employment solutions.
Find new employment opportunities or
reach out to qualified candidates.
Distinguish yourself as a
leader among your peers and advance your career by earning certification in our
healthcare finance programs.
Get an objective third-party evaluation of products and services used in the healthcare finance workplace.
MAP App is a web-based application that helps organizations improve revenue cycle performance based on industry-standard metrics called MAP Keys.
Find suppliers and products in this comprehensive vendor directory for healthcare finance professionals.
Guidance for understanding and communicating about the price of health care.
Guidelines on how to make it easier for consumers to get information about healthcare prices.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
Last week on this Blog, I wrote about three elements that are critically important for fostering organizationwide commitment to development of an effective accountable care organization (ACO). Briefly, these elements are:
I noted that these elements can help promote continued care accountability, clinical care quality improvement, and an overall environment of standardization that results in significant cost containment. These three elements warrant a more detailed discussion, including consideration of risks involved with not having these three elements well established.
The willingness of top management to actively enforce the strategic vision is essential to a successful ACO implementation. As I noted previously, executive-level commitment provides direction and sets specific outcome expectations across the organization, including among lower level managers. It also engages senior physician leaders in structuring and reviewing improvements in quality of care. The nature of a large scale ACO implementation naturally involves executive leadership within the operations of the enterprise because it necessarily touches most of their areas of control.
Risks. Without executive support and guidance, an ACO project can lose focus and stakeholder support, which can cause the project to fall short of expected outcomes. In the absence of highly visible C-suite project support over the course of the project, two considerable risks are likely to become strikingly apparent.
First, misalignment of strategies at the highest executive levels can result in dissonance over the need for an integrated corporate organizational structure versus autonomy for individual facilities.
Second, even if the executive sponsor remains laser-focused on the objective, a few project stakeholders may begin to question their role both in the project and in the transformed organization and, as a result, only partially uphold their commitments. The lack of, or limited, stakeholder participation can result in significant project friction and noncompliance. The role of stakeholder buy-in should not be underestimated.
It also should be noted that, although these risks may seem obvious and important to address, the need for strong executive-level support and guidance can be all-too-easily overlooked at the project’s start if there is a perception that the executive sponsor’s span of control is appropriate and sufficient.
Engaging a project manager suited to this type of large-scale, multisite, multistakeholder project is one of the most critical components a successful ACO implementation. The skill set for this position is fairly unique; in addition to broad hands-on experience as an absolute essential, this individual should demonstrate the following qualifications:
Risk. If a qualified project manager is not engaged to lead the project, or if the project manager who is engaged has only limited operational experience, the project will be at risk from a potential lack of foresight in making the sound decisions necessary for success on these types of projects.
It may seem odd to talk about organizational patience, but we all have witnessed this need—repeatedly. Organizational patience, in this sense, hinges on having a common definition of the goal and an understanding of the commitments and resources necessary to achieve that goal.
Risks. There are two specific areas of risk posed by a lack of organization patience. The first is the risk that of waning interest and energy over the project’s duration—a year or more in many cases—due to the constant need for intensely repetitive work at a highly detailed level (e.g., comparing clinical cohorts at the level of drug and device, by procedure, by type of specialty, etc.). The second risk stems from the potential for political infighting. Again, it is a common characteristic of human nature for people to be satisfied only if they see their idea “win.” However, they are much more likely to encounter the friction of different, competing, ideas. This risk is exacerbated if the executive sponsor is disconnected or the organization is being smothered by an overabundance of political “issues.”
Many predictable roadblocks also can get in the way of the commitment required to maintain organization patience, including the political tensions that can cause stakeholders and sponsors to question their level of commitment. In some instances, team members may become disengaged if they come to perceive that the projects end goal may result in reorganization and position eliminations (e.g., Does the organization truly need people at every facility managing the same single master files set?) Long-term project team members and stakeholders who are expected to act on an official recommendation or decision, but see it as posing a risk that their positions might be eliminated, may act in a way that does not support the primary goal.
As healthcare organizations pursue enterprisewide projects in 2014 to create an environment for continued care accountability and clinical care quality improvements, they should clearly understand the risks they face if their projects lack the three key elements highlighted here. It is also important that they not underestimate the challenges that piloting significant change inevitably presents. Special attention should be given to helping stakeholders, particularly at the project resource level, embrace the new unified approaches to care delivery.
Chris Miller, MT (ASCP), MSSM, is Senior Delivery Manager and EACOE Enterprise Architect, CTG Health Solutions, Buffalo, N.Y.
Publication Date: Monday, March 31, 2014
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
©2015 Copyright Healthcare Financial Management Association
HFMA.org is best viewed using IE9 or the latest versions of Chrome, Firefox, and Safari.
Join HFMA today and enjoy: