To keep up with big changes in how healthcare is administered, financed, and organized, top leaders are finding a need for new talents and organizational structures.
Healthcare reform as a term has become so ubiquitous that it is almost indefinable. At first, and broadly, it meant removing the waste in an excessively expensive healthcare system that too often added to the problems of the people whose health it aimed to improve. Then it became legislative and regulatory, in the form of the Patient Protection and Affordable Care Act and its incentives aimed at improving the continuum of care and expanding the pool of those covered by health insurance.
Now, for many in the industry, healthcare reform has matured into a business imperative: the process of ingraining tactics, strategies, and reimbursement changes so that health systems improve quality and efficiency with the parallel goal of weaning us all off a system in which incentives have been so misaligned that neither quality nor efficiency was rewarded.
That leaders finally are able to translate healthcare reform into action is welcome, but to many health systems trying to survive and thrive in a rapidly changing business environment, the old maxim that all healthcare is local is being proved true. Making sense of healthcare reform is up to individual organizations and their unique local circumstances. Fortunately, there are some broad themes and organizational principles that are helpful for all that are trying to make this transition. What works in one place won’t necessarily work in another, but the innovation level is off the charts as healthcare organization leaders reshape what being a leading healthcare organization means as well as what it requires.
No blueprint to follow
In some ways, Methodist Le Bonheur Healthcare in Memphis is fortunate. As a health system with 2013 total revenue of $1.66 billion, it holds a dominant position in its market. But because that market remains “99% fee-for-service,” says Michael Ugwueke, MPH, DHA, FACHE, its president and chief operating officer, Methodist’s long-term position dominating its market may be in doubt.
Without value-based contracts, the benefit of the work Methodist does to reorganize care and improve outcomes currently accrues to the payer; yet without the work to reorient to risk-based contracts that are likely in the future, Methodist will be woefully underprepared, he says. For the full article click here
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