In our final installment with Bob Wells, he discusses the questions healthcare leaders should ask when considering payment reform, shares some of his tips and resources, and gives examples of who is doing it right.
What questions should healthcare leaders ask (of themselves or others) when considering Payment reform?
How well does our organization understand the various models?
How accurate is our data?
What are the risks and how can they be managed?
How well do we understand both our internal and affiliates culture?
Can we put the models in place to align goals across the continuum of care to facilitate higher outcomes at a lower cost?
How much of an investment is required to start and support the process?
What are some tips for engaging physicians or staff in payment experiments?
The first step is to include physicians and staff into the discussion regarding the evaluation of payment models and the need to prepare proactively for a payment reform. The organization should then pull together cross-functional teams learning about the different models and engaging domain experts to provide an additional perspective. Lastly, the healthcare leadership team needs to ascertain how to integrate goal alignment across all points of care within their delivery system to ensure the cross-functional teams work well together delivering the highest quality of care at the lowest cost.
Any examples of who's doing it right?
There are numerous organizations in the market taking the right approach to prepare and implement new models of payment. There is no one universal answer due to the variation in organization's characteristics and business environment. I would recommend looking at those organizations that participate in various CMS initiatives, self-insured organizations that are testing out these models and organizations that are working with private payers today.
Any resources you'd like to share?
I would recommend organizations research what has worked and fell short of its objectives in the past. Delve deeper into the research data published from past payment reform models. Another area to research is those organizations that have structured goal alignment with physicians such as Gainsharing programs.
Any other comments?
This is an exciting time in healthcare and an opportunity to demonstrate to the world how we can bend the curve of healthcare costs without compromising quality. The changes and models underway allow the U.S. to demonstrate its ingenuity and create a culture of aligning financial optimization and healthcare quality across the continuum of care. I am confident that the healthcare cost and delivery challenges are solvable while ensuring our healthcare delivery system remains financially viable. Now is the time to take the best ideas across the world with the latest technology showing the country and the world how we rise to the challenge and solve complex problems.
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