The emergence of value-based payment methodologies and the increased emphasis on transparency will have profound implications for academic medical centers (AMCs), according to the latest research report from HFMA's Value Project. AMCs have unique attributes that represent both opportunities to be leveraged in the emerging payment environment and challenges to be overcome as they move toward value-based business models.
One key challenge that emerged was the need for AMCs to develop a centralized governance structure. AMCs often have different boards, leadership structures, and mission statements governing each of their teaching, research, and care delivery functions. These distinct governance structures make it challenging for AMCs to make decisions nimbly and strategically. Furthermore, many AMCs report the absence of dialogue among academic departments, specialists, the hospital, and other potential elements of a coordinated, detailed approach to care management.
The CFO of one academic center noted, "We are using the possibility of a bundled payment project not because we think it will be a big winner for our system, but just to get an early dialogue going between the key elements of our system."
The goal should be a centralized leadership structure that can make critical decisions on behalf of the AMC.
UAB Hospital, part of UAB Health System in Birmingham, Ala., is taking a step in this direction: A centralized structure exists, but leaders need greater authority to make decisions on behalf of the system. In addition, UAB's system leaders require more agile decision-making capabilities. Like other academic medical centers, UAB is instituting a funds-flow model that combines all revenue from clinical practice and hospitals into one operation. Key benefits of this approach include the following:
Partners HealthCare in Boston operates within an active state governmental and legal environment and illustrates the following examples of how AMCs may need to change over time to form a more highly integrated organization.
The Partners strategy also envisions:
Additional mechanisms to bolster centralized leadership are to develop a common strategic plan and to determine management-level goals and incentives that help align the care delivery, research, and academic functions of the AMC.
This article is an excerpt from The Value Journey: Organizational Road Maps for Value-Driven Health Care, published by HFMA.
American Express: Streamlining Supplier Payments and Boosting Revenue
Deloitte: Realizing the Potential of Your CDI Program
Suzanne Whitworth, director at Deloitte & Touche LLP, and LaVerne Romberger, MSN, CCM, CCDS, clinical operations manager-Seton Healthcare, share leading practices for maximizing the potential of clinical documentation programs under value-based care.
RevSpring: Customizing a Technology Platform to Drive Patient Payment
Martin Callahan, Senior Vice President, Healthcare Solutions, RevSpring, describes key industry trends affecting how patients engage with the revenue cycle and ways payment processes are changing as a result.
KPMG: Readying for Healthcare Today and Tomorrow
Dion Sheidy, a partner in KPMG's Healthcare Advisory practice, discusses healthcare's changing landscape and how having the right advisor can help organizations navigate challenges and opportunities.
Huron Healthcare: Readying Your Organization for Transformation
Gordon Mountford, executive vice president, Huron Healthcare, discusses business imperatives for undertaking transformative change.
Xtend Healthcare: A Custom Approach to Optimizing Revenue Cycle Performance
Tom O'Neill, CEO of Xtend Healthcare Advanced Revenue Solutions, discusses key areas where organizations risk revenue leakage and ways they can use outsourcing to better protect cash flow and support accurate payment.
KeyBank: Helping You to Realize Your Strategic Vision in Changing Times
Victoria Terekhova, senior strategist for Enterprise Healthcare at KeyBank, discusses key challenges when developing long-term strategy in a rapidly changing industry, and the role the right banking partner can play in helping healthcare providers navigate the opportunities before them.
SSI: Preparing the Revenue Cycle for Changing Payer Roles
Availity: Connect to the Future of Healthcare Information
Deloitte: Leveraging IT for Value-Based Care Transformation