Building an Offensive Game Plan to Navigate Payment Reform
As America’s healthcare payment system is in a period of rapid evolution, savvy leaders are not waiting to find out what happens with U.S. healthcare reform. They are building the team, writing the playbook and creating the culture that will allow their organizations to win, regardless of which payment systems and delivery models gain traction. Richard P. Miller, CEO at Virtua, a multi-hospital system based in Marlton, N.J., is rapidly repositioning his organization to succeed in an uncertain environment. He said: “Frankly, I don’t think we’re in a wait-and-see mode anymore. We are in a preparation for change mode.” Executing that change presents a significant challenge for all healthcare systems. Research conducted by GE Healthcare shows that the transition to more value-based payment models, systems with more accountable care, require three distinct phases: Planning, Implementation and Operational. Before a health system can effectively begin a transition to accountable care delivery, its leaders must understand the specific tasks and capabilities necessary in the planning, implementation and operational phases. That allows them to identify the gaps between its current capabilities and those that will be needed for a successful transition. The research found that five broad categories of tasks are foundational to any new payment models: 1) Implement the strategy 2) Create a healthcare culture with accountability 3) Standardize the delivery of care 4) Enable information to aid in decision-making 5) Coordinate care delivery “If you start to think about these five core job functions, we are confident you are going to add value for your institution, regardless of where payment reform is going,” said Mark Dente, MD, Chief Medical Informatics Officer, GE Healthcare. Understanding the specific tasks that must occur in those phases is an important step in preparing for payment reform. “There will be those that will probably be extremely successful in the brave new world. And then there will be those that will struggle with it,” Dr. Dente said. “And the question is: What do you need to do to position yourselves to be on the winning side?”