I wrote "Navigating to Value-Based Outcomes" because leaders of healthcare delivery organizations are making the transition from volume- to value-based payment arrangements, and there is no comprehensive guide to them do that. While a few pioneering health systems are well into the transition, most organizations are not, and in order to survive in the new payment environment they will need to very soon.
Healthcare leaders are anxious because they are “flying blind.” They lack essential data on outcomes that matter to patients and the costs associated with achieving those outcomes. Where data already exist, they do not know how to find, retrieve and organize it, or leverage it for their needs. Meanwhile, a booming “big data” industry complicates the situation with promises to solve an organization’s data needs through the addition of costly infrastructure. The electronic records, registries, and servers produce voluminous data that quickly smother an organization with useless and confusing numbers if the leaders do not have a plan for turning the data to action.
My book is an antidote for this situation.
It is one thing to understand the concept of value; it is another to know what needs to change in an organization and how to get it done. This includes moving an organization to a place where all of its leaders are not only aware of clinical and administrative outcomes, but also aware of outcomes that matter to patients. Beyond awareness, leaders need new types of information, knowledge, and skills in order to act quickly and to successfully improve underperforming areas.
This type of organizational agility is necessary because there are many changes happening in healthcare payment reform and we should expect changes to continue. Recent examples include The Affordable Care Act, Accountable Care Organizations, Value-Based Payments and the Medicare Access and CHIP Reauthorization Act and its Merit-based Incentive Payment System (MIPS). In this book, I do not attempt to go into detail about the nuances of these emerging and evolving trends because I believe a book of that type will have a very short shelf life. Rather, I describe an approach to delivering healthcare that has been successfully used for over 25 years, during both democratic and republican administrations, in an academic medical center, numerous independent physician offices, and is now being implemented in a military medical facility.
Knowing what matters most to patients, and systematically trying to improve those outcomes, while maintaining or lowering the costs it takes to achieve those outcomes, is not only better value, it is better business. This is true no matter the political, regulatory, or payment environment.
Healthcare leaders are anxious because they are “flying blind.” They lack essential data on outcomes that matter to patients and the costs associated with achieving those outcomes. Where data already exist, they do not know how to find, retrieve and organize it, or leverage it for their needs. Meanwhile, a booming “big data” industry complicates the situation with promises to solve an organization’s data needs through the addition of costly infrastructure. The electronic records, registries, and servers produce voluminous data that quickly smother an organization with useless and confusing numbers if the leaders do not have a plan for turning the data to action.
My book is an antidote for this situation.
It is one thing to understand the concept of value; it is another to know what needs to change in an organization and how to get it done. This includes moving an organization to a place where all of its leaders are not only aware of clinical and administrative outcomes, but also aware of outcomes that matter to patients. Beyond awareness, leaders need new types of information, knowledge, and skills in order to act quickly and to successfully improve underperforming areas.
This type of organizational agility is necessary because there are many changes happening in healthcare payment reform and we should expect changes to continue. Recent examples include The Affordable Care Act, Accountable Care Organizations, Value-Based Payments and the Medicare Access and CHIP Reauthorization Act and its Merit-based Incentive Payment System (MIPS). In this book, I do not attempt to go into detail about the nuances of these emerging and evolving trends because I believe a book of that type will have a very short shelf life. Rather, I describe an approach to delivering healthcare that has been successfully used for over 25 years, during both democratic and republican administrations, in an academic medical center, numerous independent physician offices, and is now being implemented in a military medical facility.
Knowing what matters most to patients, and systematically trying to improve those outcomes, while maintaining or lowering the costs it takes to achieve those outcomes, is not only better value, it is better business. This is true no matter the political, regulatory, or payment environment.