HFMA has identified the following subcompetencies that should be addressed in executing an effective integration strategy, based on discussions that took place at HFMA's most recent payment reform retreat. The September 2009 retreat, "Payment Reform: Leading the Way to Change," brought together 115 healthcare thought leaders and major stakeholders from around the country.
A clear view of the market position of each of the component organizations involved in the integration process will be essential.
Key questions include the following:
One key to success as an integrated organization is setting realistic goals based on organizational capabilities and an assessment of market and customer base. Key questions include the following:
Developing key physician leaders/champions who have a high level of credibility with physicians and other providers will be critical to producing the changes necessary to create a sustainable healthcare industry. Key questions include the following:
The development and sharing of credible data on utilization, cost, and quality will be essential to making informed decisions on system composition, process, and incentives. Key questions include the following:
Compensation policies and economic incentives are powerful tools that can be employed to align incentives and foster change. Key questions include the following:
One definition describes engagement as a heightened level of ownership wherein each employee does whatever he or she can for the benefit of internal and external customers and for the success of the organization as a whole. The complexity of integrated organizations and the importance of efficiency and cost effectiveness make it essential that the organization develop sound processes to heighten stakeholder engagement.
Cultural differences between the various component organizations proved to be a significant factor behind the failure of many organizations that attempted to integrate in the 1990s. Examples of these cultural differences are rural versus urban cultures, religious versus secular views, or simply the demographic differences among the customers an organization serves.
Key questions include the following:
Shared IT can serve as an important, unifying backbone to support an integrated organization by providing a common syntax and shared data that can be used to build knowledge of system performance. Key questions include the following:
Given the enormous challenges facing healthcare organizations, those that engage in continuous process improvement are likely to be more successful. This competency requires a well-trained staff, sound tools to measure processes, and a culture that encourages "outside-the-box" thinking and communication. Key questions include the following:
This article is excerpted from HFMA's payment reform paper, Healthcare Payment Reform: Accelerating Success Report, March 2010.
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