Improving Value in Health Care Organizations

By Devin Partida, Editor-in-Chief,
Twitter: @rehackmagazine

People have ongoing conversations about improving value within health care organizations. But what that means differs across the respective groups.

Patients might link high-quality care to value, while providers may view value as synonymous with productivity. Similarly, administrators often tie value to staying under budget. Here are five actionable strategies for raising value in health care facilities.

1. Get Patient-Reported Outcomes

Patient experience feedback often comes from third parties, and it does not always include long-term outcomes. For example, getting a person discharged is only the first milestone. Patient-reported outcomes (PROs) assess whether the care received causes genuine improvements for recovery, prevention of chronic illness management.

Health care organizations can get those insights by encouraging patients to take satisfaction surveys and clarifying what went well and where room for improvement exists. Having a mix of score-based and open-ended questions provides ample opportunities for getting an accurate picture.

It’s also essential to link PROs to individuals’ medical records for easy access that guides decision-making. Perhaps a new mother complained of not getting enough lactation counseling three years ago when having her first baby. Then, hospital staff could ensure that doesn’t happen again when she uses the same hospital to deliver a second child.

2. Provide Telemedicine Options

Telemedicine has opened new possibilities for connecting people to care and removing boundaries. Work is even underway to let doctors operate on patients from hundreds of miles away by maneuvering remote-controlled surgical robots. That type of surgery is still out of reach for many facilities. Still, other types of telemedicine are more accessible, such as those that let providers see patients at home via an internet connection.

A study of gastroenterology and hepatology appointments delivered by telemedicine at Penn State during the COVID-19 pandemic showed that 67% of patients felt telemedicine was as good or better than in-person visits. Then, 88% of clinicians had that perspective.

Dr. Shivan Mehta, the study’s corresponding author, said, “Given the speed at which our practice ramped up telemedicine use and the external stressors faced by both patients and clinicians during this pandemic, it’s notable that the implementation of remote visits was so well-received.” More specifically, in one week, Penn Medicine went from doing approximately 5% of visits via telemedicine to 94%.

3. Look for Revenue-Driving Opportunities

Health care organizations may miss out on capitalizing on value by failing to optimize processes. Getting input from outside professionals who perform an extensive audit is one wise way to generate future value.

In one case, a four-campus health system discovered $5.56 million in recurring revenue opportunities via its pharmacies. The changes made to reach that outcome ranged from charge simplification to transitioning to charging on administration.

The pharmacy found chances to recover more revenue, while patients benefited from improved processes. The most effective value-unlocking efforts have the highest likelihood of helping everyone involved when they’re thorough and thoughtful.

4. Practice Patient-Centered Care

There was a time when a visit with a physician meant a patient always assumed the provider knew what was best and did it without question. However, the relationship has changed.

There’s now a larger emphasis on what’s important to patients and participation in shared decision-making, for example. These are elements of patient-centered care.

It can also extend beyond providers to the administrative side, including things like easier billing options and extended clinic hours. Putting patients at the heart of things often brings advantages to everyone at an organization.

5. Create Resources for the Unhoused Population

Improving health care value also means focusing on groups that may be the most likely to cause an oversized burden on the existing system. One real-life example of a recently passed New Jersey law will create permanent housing for the homeless and allow hospitals in the state to provide expanded care for the residents.

Senator Bob Smith, who co-sponsored the bill, said, “We hold ourselves to a high standard in helping the most vulnerable populations in the state. This law will ensure our homeless population has a safe place to turn to after they receive treatment without depleting hospital resources that could go towards helping other patients.”

Doctors often find homeless people are more likely to need hospital care and require more interventions after arriving. Putting resources into preventive care instead helps patients by reducing their need for emergency room visits and assists providers by getting people care sooner before their needs become more severe.

Creating Value Is a Balancing Act

Some efforts to bring more value to health care organizations do not equally benefit every involved party, and that’s okay. The key is to implement numerous value-driving measures to make the payoffs more evident to everyone involved.