Collaborative News

I entitled this post “Collaborative News” because of two articles that caught my attention.

Collaborative News: How Not to Cut Health Care Costs

This article by Harvard Business School faculty Robert S. Kaplan and Derek A. Haas (Harvard Business Review November 2014, Reprint R1411G) draws attention to missteps that add to the cost of treatment:

I entitled this post “Collaborative News” because of two articles that caught my attention.

Collaborative News: How Not to Cut Health Care Costs

This article by Harvard Business School faculty Robert S. Kaplan and Derek A. Haas (Harvard Business Review November 2014, Reprint R1411G) draws attention to missteps that add to the cost of treatment:

• Cutting back on support staff: specialists’ time averages 10 times the cost of their assistants’ time; effectively integrating assistants into patients’ care frees up senior clinicians to work at the top of their license, leading to higher quality care at a lower cost per patient
• Underinvesting in space and equipment: increased spending on relatively inexpensive equipment is paid for by the savings from reducing the idle time of more expensive staff members and improving responsiveness to patients’ conditions
• Focusing narrowly on procurement prices:focusing narrowly on negotiating price causes organizations to lose sight of how individual clinicians consume supplies and miss opportunities to lower spending even further
• Maximizing patient throughput: measuring physicians’ productivity by patients seen rather than quality delivered causes them to skimp on items like counseling and expectation-setting; organizations in the lowest quartile of costs spent more time educating patients and families about discharge planning than those in the highest quartile
• Failing to benchmark and standardize: actively engaging clinicians in cost-management allows them to learn the drivers of the entire cycle of care from diagnosis through treatment and recovery; sharing data between administrators and clinicians fosters innovations that simultaneously cut cost and improve quality

Collaborative News: Strategies for Physician Engagement and Alignment

This 26-page HFMA Value Project Report contains member surveys and suggestions to optimize engagement and alignment, for example, regarding physician employment (p.6) :

• Employment does not equal alignment. Physician employment is not a shortcut around the hard work and investments of time and resources required of both health systems and their physicians to align themselves around common organizational goals.
• Clear and consistent communication on expectations is critical. “It is extremely important to set expectations from the beginning and then follow up on a regular basis,” according to one respondent.
• Know your organization’s needs and have a strategy in place before you start. “It is far better to determine needs, identify positive attributes, and recruit physicians than to simply employ any physician who shows up at your door,” a respondent says.
• Consider employment needs beyond physicians. If acquiring a practice, consider who beyond the physicians has been important to the practice’s success: “It is a good idea to evaluate the staff to determine who else should be included in the employment,” according to a survey respondent.

Another example (p. 13) regarding key considerations for physician compensation plans recommends to:

• Create mechanisms to engage and encourage physician leadership
• Incorporate quality metrics
• Build flexibility to allow for gradual increases in the amount of compensation tied to quality
• Refocus incentives to include team goals
• Understand the legal parameters of structuring these plans

I recommend that you read this article in its entirety.

As always, I welcome your input to improve healthcare collaboration where you work.  Please send me your comments and suggestions for improvement.

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