WASHINGTON, Nov. 13, 2017 /PRNewswire/ -- As more costs
shift to health care consumers, hospitals and health systems will
increasingly compete on care reliability, affordability, and
accessibility. These changes in the business of health care are
driving hospitals to address one of their most complex challenges,
working better with physicians to reduce unnecessary care
variation, Advisory Board's John
Johnston said on Monday.
"For a typical hospital, the costs of treatments that do not
improve patient outcomes can add up to millions of dollars—a major
impact on care affordability and reliability," said Johnston,
National Partner, Consulting at Advisory Board. Reducing variation
is also the biggest opportunity to improve performance under
value-based care models, he added, and that requires reigning in
variation at scale and successfully embedding standards in clinical
workflows.
The other potential patient-facing effects of improved care
reliability can also be outsized. One health system has found that
reducing unwarranted variation in hip and knee replacements alone
could save patients more than 1,000 bed days across the system
every year.
Need Grows for Improving Productivity, Lowering
Costs
The challenge is top of mind for hospital and health
system executives—and for good reason. The Congressional Budget
Office has projected that 60% of hospitals will have negative
profit margins by 2025 if they do not improve productivity or
reduce costs. According to an Advisory Board survey, health system
chief financial officers see clinical standardization as the
biggest single opportunity for cost savings in their own
systems.
"Many institutions addressed the obvious places to raise
productivity or cut costs long ago. The efforts that remain are
tough challenges," said Sean Angert,
National Partner, Consulting at Advisory Board. Nationally, in the
16 years since the Institute of Medicine issued its landmark
Crossing the Chasm report on care quality, 47% of effective
treatment measures have shown no signs of change or are worsening.
For example, inappropriate mammography use has resulted in 20%
overdiagnosis of breast cancer cases (i.e., false-positive results
where there is no breast cancer).
Build High-Performing Partnership with Physicians
The
challenge calls for a comprehensive approach, said Allison Shimooka, Executive Director, Research
at Advisory Board. "Physician leadership should create a
permanent care variation reduction 'engine' to address both
cross-cutting opportunities (such as documentation, clinical
supplies, laboratory, and post-acute care) and care for conditions
and disease states (such as cardiovascular services, pulmonology,
and critical care)." This strategy results in improved
physician engagement, reliable cross-continuum quality and
experience at scale, and sustainable reductions in costs, she
added.
Beyond these changes in organizational design and clinical
processes, hospitals and health systems should ensure they have the
foundational data needed to address unnecessary care variation,
according to Matt Cinque, National
Partner, Technology at Advisory Board. "You need reliable data to
make the case to physicians about why there might be a better way
to do things. By combining data from different systems, hospitals
and health systems can highlight the impact that variation in
practice has on patient outcomes," he said.
National Experts on Reducing Care Variation
Advisory
Board's new team of National Partners on reducing care variation
includes experts on these topics for hospitals and health
systems:
John
Johnston, CPA, MHA: Organizational strategy, operational
efficiency, and financial performance improvement
Sean Angert, MBA: Clinical
and operational performance improvement, workforce management,
revenue cycle management, supply chain and spend management,
reduction of cost per case and length of stay, and hospital
throughput
John Kontor, MD: EHR
optimization and workflows for risk-adjusted reimbursement and
value-based care
Matt Cinque: Care cost,
quality, and utilization performance; population health management;
and disease management
Beyond the National Partners, other Advisory Board experts on
reducing care variation include:
Steven
Berkow, JD, Principal and Executive Director,
Research: Change management, high-reliability care, staff
engagement, workforce strategy, and nursing
Jennifer Stewart, Executive
Director, Research: Leadership development, physician and employee
engagement, recruitment, retention, accountability and strategic
alignment, care models and top-of-license practice, and care
variation reduction.
Rodrigo Martinez, MD, Senior
Vice President, Consulting: Electronic health records
implementation and optimization, clinical decision support, EHR
strategy, and clinical workflow
Allison Shimooka, MBA,
Executive Director, Research: Health system strategy, clinical
performance improvement, oncology, service line strategy, clinical
research, academic medical centers, and quality improvement
Veena Lanka, MD, MPH, Senior
Director, Research: Reliable care delivery, minimizing
unwarranted care variation, clinical performance improvement,
physician engagement, cross-continuum care coordination, program
design, and population health management
Preston Raulerson, MBA,
Senior Vice President, Consulting: EHR strategy and implementation,
EHR optimization, Epic program directorship, and digital health
Daniel Clark, MBA, RN,
FHIMSS, Senior Vice President, Consulting: Ambulatory EHR
strategy, implementation, go-live management and optimization
About Advisory Board
Advisory Board is a best
practices firm that uses a combination of research, technology, and
consulting to improve the performance of 4,400+ health care
organizations. As the health care business of The Advisory Board
Company (NASDAQ: ABCO), Advisory Board forges and finds the best
new ideas and proven practices from its network of thousands of
leaders, then customizes and hardwires them into every level of
member organizations, creating enduring value. For more
information, visit www.advisory.com.
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