For healthcare organizations to be successful with their quality and cost improvement initiatives, physicians must be engaged with the proposed changes. But many physicians are not engaged because their morale is suffering. While some strategies to encourage buy-in for improvement initiatives don’t work, there are six strategies that have proven to be effective: (1) discover a common purpose, (2) adopt an engaging style, (3) turn physicians into partners, not customers, (4) segment the engagement plan, (5) use “engaging” improvement methods, and (6) provide them with backup—all the way to the board. Once the organization has their trust, physicians will gain enthusiasm to move forward with improvement efforts that will benefit everyone.
Learn more about Bryan Oshiro, MD
Bryan Oshiro, MD joined Health Catalyst in January 2014 as the Medical Director. He received his medical degree and completed his residency in Obstetrics and Gynecology at Loma Linda University School of Medicine and completed his fellowship in Maternal-Fetal Medicine at the University of Texas in Houston before moving to Salt Lake City to join Intermountain Health Care and served as the Medical Director of the Women and Newborn Service line. He also was a member of the department of Obstetrics and Gynecology at the University of Utah. He then joined Loma Linda University where he became the division director of Maternal-Fetal Medicine and the vice-chairman for the department of Obstetrics and Gynecology. He co-chairs the American College of Obstetricians and Gynecologists Patient Safety Committee for District IX and received the Elaine Whitelaw Service Award from the March of Dimes for his work on a 5 state initiative to eliminate elective deliveries less than 39 weeks gestation.
Read articles by Bryan Oshiro, MD
The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.
This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.
It’s a practical guide complete with next steps for strategic and tactical planning.
A big key to improving quality and patient care is engaging physicians and nurses. As many healthcare systems begin to implement improvement initiatives, they must ensure their clinicians are supportive and engaged in order to achieve success. Senior-level executives need to understand the challenges their clinical staff are facing in feeling overwhelmed, having too little time, as well as not really understanding new risk-based payment models. Knowing what motivates physicians and nurses to engage (and what doesn’t) ensures process improvements become tangible, sustainable, while at the same time building trust between clinicians and the healthcare organization.
This article, first published by in July 2016 by hfma, outlines how hospitals can get physicians to understand the financial impact of their clinical decisions and become actively engaged in improving the value of care. Texas Children’s Hospital was successful through recognizing the need for cultural transformation and ensuring quality came first. The organization engaged clinicians with financial data, including educating them on key financial principles, linking quality improvement training with financial accountability, and accompanying financial choices with clinical choices.
If all goes according to plan, the first performance period for the new Medicare Access and Chip Reauthorization Act (MACRA) is just around the calendar corner. It’s a complicated reimbursement structure with multiple tracks that are guaranteed to reward with bonuses or inflict pain through penalties in CMS’s new zero sum game. To the physicians and practices that adopt this new program early and position themselves for the best fiscal outcomes, go the spoils. But for many smaller practices and those that consistently underperform, the outlook may be glum regardless. Here are some highlights of the new program and the financial impact it will have on clinicians and practices.
Transitioning to outcomes-based healthcare is an industry wide goal. While some health systems, such as Texas Children’s Hospital, are in the process of making the switch (and doing it successfully), many systems don’t even know where to begin.
Despite the challenges of achieving outcomes-based healthcare, it is essential for surviving the transition from fee-for-service (FFS) to value-based care. Systems can overcome the top three challenges associated with making the switch (lack of analytics, lack of access to information, and inappropriate organizational structure) by focusing on the most important success factors:
Armed with an enterprise data warehouse (EDW) to make data-driven decisions about the best outcomes improvement goals to pursue, and permanent multidisciplinary teams responsible for continuously improving care, systems can start making the switch to outcomes-based healthcare.
The Affordable Care Act has changed the landscape for physicians. They are under pressure to care for patients more effectively and efficiently. However, the significant increase in diagnostic testing and treatments have made it challenging for physicians to decide on an optimal diagnosis and treatment plan. Meaningful, actionable data to measure the effectiveness of these treatments has only recently become available, delaying the adoption and use of analytics among physicians. Integration and use analytics in medical practices is critical to improve outcomes, shorten the timeline for translating best practices into clinical practice, and ultimately improve the overall health of individual and populations of patients.
Our current healthcare system is designed to provide “sick care”—care intended to help patients return to their previously healthy state after experiencing an illness or injury. But sick care is costly and introduces the risk of further patient harm. A new model of care, patient-centered care, aims to improve cost and quality by shifting the focus of care to preventative measures. Moving to patient-centered care requires organizations to provide the following for their patients: respect for preferences, values, and desire to stay informed; emotional support; physical comfort; information and education about conditions; continuity of care and transitional assistance after discharge; care coordination and integration care providers; access to care whenever care is needed; and the inclusion of family and friends as caregivers and decision makers.
Introducing the Accelerated Practices (AP) Program: An Innovative Way to Help Health Systems Accelerate and Sustain Outcomes Improvement
We are excited to announce the launch of Health Catalyst University’s Accelerated Practices (AP) Program. This program is a highly immersive, project-based learning experience that healthcare industry experts have spent a lot of time developing. The goal of the program is for participants to leave with the tools and knowledge they need to achieve significant improvements in a short amount of time for their organizations. They will also learn how to communicate the need for change in this new value-based care environment by using data and proven leadership principles.
Have you ever had one of those “wake up moments” where you literally learn a lesson that impacts and changes the trajectory of your life? Read this personal story by Dr. Bryan Oshiro of his “wake up” call where he learned the importance of data to save lives. He learned this first-hand when he saw rows of babies on ventilators in the neonatal unit and realized that they had all been electively delivered before 39 weeks. But he didn’t have the data compiled to make a compelling case to his physicians to stop elective pre-39 week deliveries. Working with his technology team, he gathered the data, analyzed it, and successfully engaged his physician team in a quality improvement project to reduce these elective deliveries.