The New Metrics

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The business and clinical intelligence that are necessary for healthcare leaders to better manage their organizations are changing rapidly. Returns may be greatest for organizations that are able to measure outcomes and show value.

An old saying from Six Sigma and other process improvement regimes is that “what gets measured gets done.” That’s important for senior healthcare executives to remember. But that truth leaves out the critical question of what should be measured.

The options are literally endless, but determining the most important metrics to measure in an era in which healthcare is transforming is no trivial decision.

The move toward reimbursement based on the value the healthcare organization provides to the patient and the payer, which is happening at vastly different rates in some geographical areas compared to others, means that asking and answering that question at regular intervals is crucial.

If that’s the case, what are the metrics that leaders need to watch to ensure clinical, financial, and strategic success?

This special issue of HealthLeaders examines how high-performing organizations are instilling and adapting to new performance measures that healthcare leaders need to track to “get value done.”

Our editorial team talked with more than a dozen organizations in a variety of sectors, from leaders of hospital inpatient organizations to payer leaders, from leaders of postacute care organizations to information technology, nursing, and finance leaders; all have measurements they find useful to achieve value in a rapidly transforming healthcare business environment.

Some metrics may be familiar, such as admissions or readmissions per thousand patients. Other metrics may be unfamiliar, such as a “user resource metric,” part of which incorporates the speed with which patient calls are answered at a call center.

Many more important metrics are clinical in nature, but are often monitored and reported by the financial arms of the organization, as they provide a proxy for customer satisfaction, a growing component of the value equation.

Also critical is the latency of such measurements. For example, it’s less valuable to learn about line infection rates and sepsis diagnoses after the patient has been discharged, because little can be done to influence the statistics by that time.

Anatomy of a post-acute care partnership

http://www.beckershospitalreview.com/hospital-transactions-and-valuation/anatomy-of-a-post-acute-care-partnership-a-guide-to-finding-the-right-partner-and-forming-a-successful-joint-venture.html

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In communities across America — large and small — local hospitals serve a purpose that goes beyond being a center for on-demand emergency care. Our nation’s healthcare facilities have a legacy and responsibility as leaders and guardians for the health of individuals in the communities they serve.

As such, it is imperative that local hospitals continue to take the lead in community patient care and avoid being relegated to the position of bystander through managed care or government mandate.

In addition to providing quality patient care, hospitals also have a responsibility to remain financially healthy. And in today’s environment of uncertain and changing regulation, government-mandated penalties, and shifting payment models, hospital leaders are being reminded that financial health and quality patient outcomes go hand-in-hand.

Balancing these two responsibilities is an increasingly tough task. Avoidable readmissions are a cost no organization can afford to ignore, and many of America’s best healthcare facilities are struggling to find an effective solution to their patients’ post-acute needs.

For many hospitals and health systems seeking an answer, partnering with an experienced and proven post-acute care provider has been the solution.

In a value-based world, the ability to manage the total cost of care — from admittance, through acute care, to the post-acute environment — is a strategic advantage for sustaining organizational health and getting patients the right care at the right time, obtaining efficient outcome and attracting and retaining the best and brightest of professional caregivers.

But how do executives and hospital leaders find the right partner, and how can they determine competence and compatibility for their needs?

William F. “Bud” Barrow II, the recently retired president and CEO of Our Lady of Lourdes Regional Medical Center in Lafayette, La., developed what he calls his “Four-Way Test” for evaluating prospective  post-acute care partners.

“There are many players in the sub-acute space, and a lot of them are not in it for the right reasons,” Mr. Barrow says. “There are many small companies formed not to advance care AND make a profit, but to make a profit and flip the company for even more profit.”

“It’s important to partner with a large capital healthcare provider that has demonstrated long-term commitment to patients, to profitability and to doing the right thing at the right time — every time,” adds Mr. Barrow.

The four “C’s” in Mr. Barrow’s test include:

  • Character: Examine the cultural history of the organization and the character of key individuals.
  • Competence: Can they demonstrate long-term, systemic success and expertise in their field?
  • Capital: Is there a financial model in place that suggests sustainability in a profitable way?
  • Creativity: Does the organization demonstrate nimbleness and the ability to rethink and adjust on-the-go based on the uncertainties inherent in healthcare reimbursement and the overall healthcare landscape?

Once a suitable partner is found, Mr. Barrow further identifies three “must-haves” for forming a successful and sustainable joint venture.

  • Organization-wide support

    Support must come from all areas of the organization. Everyone — from board members to medical staff — must understand and support the goal of the enterprise and fully endorse what is a time-consuming process and significant investment.

  • A critical eye

    You must be willing and able to employ a critical eye when viewing your own organization and make a clear and unbiased assessment of what you do well versus what you wish you did well. “Most people are unable to make this critical internal evaluation,” Barrow says. “As a result, they continue to try and do things on their own, often times leading to long-term failure.”

  • Assemble the right team

    The right people must be in place to evaluate various alternatives and possible solutions as you go through the process and fill in the deficit gaps determined in the critical assessment.

Poor evaluation of organizational readiness, Mr. Barrow adds, is one of the most common pitfalls — particularly when it comes to the vital mutual commitment from administration and medical staff.

“There has to be alignment between the business of medicine and the practice of medicine — it’s paramount,” he says. “The prevailing attitude must be that failure is not an option. This is not something where you put your toe in the water, see what happens, and then back out the first time you hit a bump in the road. Everyone must be on board with an all-in focus on clinical networks, evidenced-based best practices, shared accountability and a singular focus on best patient outcomes.”

Nearly two decades ago, LHC Group pioneered a model of post-acute care partnership that has since earned a reputation for enhancing patient outcomes and financial performance in cities and towns across the country. Since then, the company has pursued a mission to build stronger healthcare delivery systems in the communities it serves.

Quality outcomes — for patients and partners — are the driving force behind everything LHC Group does. Quality metrics are now the preferred standard for evaluating post-acute providers, and with more than 60 percent of its home health locations named among the 2016 HomeCare Elite®, and with the highest CMS Star Ratings compared to home health national averages, LHC Group continues to enhance its reputation as one of the top quality home health providers in the country.

“I can think of no other post-acute provider that demonstrates all of the ‘Four C’s’ at the level of LHC Group,” says Mr. Barrow, who formed his first joint-venture partnership with the company in 2007. “Their overwhelming commitment to character, competence and creativity has allowed them to develop the strong capital to deliver on what they promise.”

LHC Group’s record of designing and growing successful post-acute care partnerships throughout the country is the result of years of dedication, tireless work and experience. Their team is accustomed to rising to the challenge of succeeding in the constantly shifting landscape that is the healthcare industry, and they know how to provide value for partners and improved outcomes for their patients.

The conclusion is clear: Choose the right partner. The health of your community and your organization is at stake.

Hospital Readmissions are Not the Enemy

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The Centers for Medicare & Medicaid Services has all but declared war on readmissions. But one researcher suggests that the relationship between readmission rates and quality is flawed.

Pay for performance worked this time, right? No?

Pay for performance worked this time, right? No?

Pay for Performance

Big data, analytics drive ACO quality more than value-based reimbursement, JAMA says

http://www.healthcarefinancenews.com/news/big-data-analytics-drive-aco-quality-more-value-based-reimbursement-jama-says?mkt_tok=3RkMMJWWfF9wsRonuqTNd%2B%2FhmjTEU5z16ukvX6%2B%2Fh4kz2EFye%2BLIHETpodcMTcBqMrzYDBceEJhqyQJxPr3MLtINwNlqRhPrCg%3D%3D

A combination of interventions, IT advancements and close contact support are responsible for greatest improvements in quality measures, study claims

Value-based compensation for physicians: Slow and steady wins the race?

http://www.healthcaredive.com/news/value-based-compensation-for-physicians-slow-and-steady-wins-the-race/342482/