The shift from fee-for-service to value-based reimbursements has good and bad consequences for healthcare. While the shift will ultimately help health systems provide higher quality lower cost care, the transition may be financially disastrous for some. In addition, the shifting revenue mix from commercial payers to Medicare and Medicaid is creating its own set of challenges. There are, however, three keys to surviving the transition: 1) Effectively manage shared savings programs to maximize reimbursement. 2) Improve operating costs. 3) Increase patient volumes. With an analytics foundation, health systems will be able to meet and survive today’s healthcare challenges.
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Healthcare leaders looking to establish and sustain a culture of large-scale outcomes improvement must communicate their health system’s values, beliefs, and norms throughout the entire organization. Effective communication spreads understanding of outcomes improvement, ensuring broad engagement and ongoing progress toward shared goals.
An eight-step strategy describes essential elements of organizational outcomes improvement communication plan:
- Include a communications specialist on the outcomes improvement leadership team.
- Analyze the stakeholders early and often.
- Craft the central message around shared values.
- Be a constant champion.
- Commit to regular times and mechanisms for communication.
- Make sure communication flows both ways.
- Be transparent.
- Be creative.
Every three seconds, someone in the United States will need a blood transfusion, which adds up to nearly 17 million blood components transfused annually. Yet, evidence shows that up to 60 percent of red cell transfusions may not be necessary. In 2011, Allina Health, a healthcare delivery system that serves Minnesota and western Wisconsin, had a wide variation in transfusion practices throughout the system and a transfusion rate that was 25 percent above national benchmarks. In an effort to improve outcomes of high-risk transfusions, Allina Health turned to its data to develop an evidence-based blood conservation program aimed at reducing costs and saving valuable blood resources.
- $3.2M decrease in annual blood product acquisition costs since 2011
- 30,283 units saved annually
- 111 units of red cells saved per 1000 inpatient admissions
Today’s healthcare industry, in which a lack of insight into clinical variation has contributed to increased expenses, has significant opportunities to use data and analytics to improve outcomes and reduce costs. As part of its ongoing commitment to improve clinical value, Allina Health has employed a systemwide process to identify, measure, and improve clinical value. The health system has been able to quantify the value of clinical change work to improve outcomes, while reducing costs and increasing revenue for reinvestment in care.
Allina Health achieved the following meaningful results with this collaborative, data-driven opportunity analysis process:
- Identified nearly $33 million in potential cost savings for the first three quarters of 2017.
- Achieved over $10 million of confirmed savings during the first three quarters of the year.
- Elevated discussions of cost concerns, leading to the development of standard processes, and significantly reducing unwarranted clinical variation.