Engaging Physicians to be Good Financial Stewards (HFMA)

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PROVIDING CLINICIANS WITH EASY ACCESS TO TIMELY COST AND PERFORMANCE DATA BROADENS THEIR PERSPECTIVES BY ENABLING THEM TO ACCOUNT FOR THE ECONOMIC IMPACT OF THEIR CARE DECISIONS.

Getting physicians to become actively engaged in improving value is a critical concern for the nation’s hospitals. In many cases, achieving that goal—where physicians are willing to share in the responsibility for the financial implications of their clinical decisions—is necessary to ensure a hospital’s future survival. Each success story, therefore, serves as a beacon to guide the efforts of organizations that are still finding their way.

For Texas Children’s Hospital in Houston, efforts to engage physicians in the pursuit of value have led to a profound cultural change, in which physicians, administrators, and the finance team are now working collaboratively to facilitate a joint vision and mission for delivering affordable high-quality care. This is the story of how Texas Children’s integrated financial considerations into its physician culture with measurable success, and of the lessons learned along the way.

The Need for a Paradigm Shift

Physicians always have focused on being good stewards of patient health. Delivering high-quality care is and has been their mission, as it should always be. However, in the current climate of skyrocketing costs and declining payments, a mission focused solely on quality of clinical care isn’t enough. A paradigm shift is required in which physicians come to embrace the concept of value in health care, which involves a consideration of both financial and clinical outcomes. This paradigm shift will bring about a cultural transformation predicated on a growing appreciation of the truth that without money, there is no mission, no expansion, and no innovation. Without money, there is no health care.
Recognizing the need for this fundamental paradigm shift, leaders at Texas Children’s Hospital worked diligently on integrating financial considerations into the organization’s physician culture and building physician and financial administrative partnerships. And they have met with measurable success by focusing first on quality.

Quality Comes First

Because many clinicians are as yet unaccustomed to tracking the cost of health care, applying financial metrics to the services that they deliver represents a sea change for them. One of the biggest cultural barriers encountered at Texas Children’s was the longstanding taboo in physician culture regarding discussions of cost. Although the reasons for this aversion are not entirely clear, it’s safe to say that clinicians often regard any push to reduce cost as tantamount to a push to reduce quality. Administrators can help clinicians understand—as burgeoning research on cost of care suggests—that reduced cost is not necessarily associated with lower quality.a

The first step leaders at Texas Children’s took … Click to Read More

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