Sustainable Cost Reduction of Healthcare Delivery Requires an Aligned System

Healthcare providers from all setting of care (ambulatory, acute and post-acute) are feeling the constraints and reduction of healthcare reimbursement year over year. Reimbursement rates will continue to decline while healthcare demand grows. This is a burning platform requiring healthcare providers from all disciplines to look at their delivery and range of services, costs, utilization (supplies and resources) and associated clinical outcomes. The acute healthcare provider needs to take a leading role coordinating patient care across all the settings and help the delivery points of care (ambulatory and post-acute) understand their contribution, value, and associated costs. The acute care provider has the informatics and sophistication to measure the performance of each delivery point of care, provide feedback on clinical outcomes and associated costs. This information helps each organization assess their own practice patterns to make the appropriate adjustments in care delivery. The goal is to provide clinically sound information of how these participating organizations can coordinate care across all of the settings to derive the best outcomes at the lowest possible cost.

For any delivery point of care, each organization requires some underlying motivation to look at their practices and determine which changes deliver the highest clinical outcomes at the lowest possible cost. This motivation arises through physician, acute and post-acute alignment strategies. Healthcare delivery systems need to redefine themselves and their relationship with the surrounding delivery points of care. Each participating organization must take a big picture perspective of what is in the best interest of the patient while controlling costs and preserving the profitability of all vested parties. There are various alignment strategies, though the most effective contain the following components:

  • Shared vision and commitment of high quality healthcare delivery
  • Shared financial incentives tied to the best quality outcomes at the lowest possible cost
  • Transparent and credible clinical data available to all participating organizations
  • Accountability to each other
  • Participation at the decision making table to influence business and clinical healthcare delivery

The alternative approach is:

  • Lack of cooperation and coordination or
  • Alienate all other delivery points of care through a dominating role

The outcome with the latter approach is high costs of care and financially losing business operations that underserve the community.

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