What Organizations Need to Survive in a Value-Based World

by | Mar 2, 2017 | Healthcare

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value-based worldIn our previous blog post on value-based care, we examined the new value-based landscape. We also looked at some of the most common new reimbursement models. In this post, we will take a look at the new realities of survival.

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Fact is, the old ways of providing healthcare – in a pay-for-service world – no longer cut it. In order to survive, your organization will need to focus on 5 key areas that will enable you to reduce spending and improve margins. Learn more in our graphic and then read about each area in more detail.

What you should focus on in a value-based world

1. Accurately understand costs

Hospitals that do not have a complete understanding of costs expose their organizations to increased financial risk. First and foremost, it’s critical that you have a detailed understanding of what different procedures cost. This means having access to financial data to understand the cost of services and margins, as well as Electronic Health Records (EHR) data, which provides information on performance, variation among providers, and common complications. It also means tying these data sources together to gain insights from linking the information.

2. Better tracking and reporting of quality measures

In addition, your organization will need to perform well on various quality measures if you want to excel in the value-based world. For example, in Maryland, hospital reimbursement depends on how a facility performs on measures, such as hospital readmissions, deaths, and more. You will need to know exactly how you are performing on these measures so you can make informed decisions as to how to improve upon them.

3. Maximize use of staff resources

It’s hard for your organization to rein in costs when your team is not optimizing the use of available resources. For example, there are often times when too many nurses are on staff for the number of patients in their units. This results in extraneous staff costs. Conversely, units are also often understaffed, leading to costly overtime charges and gaps in patient care.

Another example of this is utilization of surgery units. There are some days that units are overbooked, whereas other days they are not being used at maximum capacity. In both of these instances, your organization would benefit from better understanding peak and off-times so you can maximize the use of your staff resources without incurring extra costs.

4. Monitor and improve patient experience

A key part to succeeding in the value-based world directly depends on the patient experience. Since many patients feel frustrated with the healthcare system, this often results in disengagement. A few reasons for this disengagement include patients not complying with medication protocols, not receiving appropriate follow-up care, or not taking ownership of their own health.

Because of this, your healthcare organization needs to find ways to better monitor and improve the patient experience so patients feel welcomed by your institution and your providers, and they feel empowered to take control of their own care decisions.

5. Provide long-term value to patients

Similar to improving the patient experience, your organization also needs to make sure that you are proving long-term value to your patients. By doing so, you will become a trusted partner in your patients’ healthcare journeys. In addition, you will be involved in more than just emergency care, which usually requires massive amounts of resources and is very costly.

By working more closely with patients, your providers will be able to deliver the right care at the right time. This results in better overall outcomes.

Learn more

If you want to read more about the value-based care landscape and how healthcare institutions are responding to the challenges, download our new eBook, “Navigating the World of Value-Based Care with Analytics”.

Ready for a test drive of our healthcare analytics software?

Kathy Sucich
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