Assuntos
Atenção à Saúde/organização & administração , Competição Econômica , Administração de Instituições de Saúde/métodos , Aquisição Baseada em Valor , Serviços Contratados , Humanos , Modelos Organizacionais , Cultura Organizacional , Qualidade da Assistência à Saúde , Reembolso de Incentivo , Estados UnidosRESUMO
The challenges health systems often face in aligning physicians with organizational cost and quality goals related to the delivery of value-based care differ between employed and independent physicians. With employed physicians, the focus should be on right-sizing the service delivery network and employed medical group, building a sustainable compensation program, enhancing the revenue cycle, increasing use of midlevel providers, and implementing a common technology platform. With independent physicians, the focus should be on understanding available contracting models, participating in shared-savings arrangements, considering alternative payment distribution models, choosing the right metrics, and exploring shared branding options.
Assuntos
Economia Hospitalar , Administração Hospitalar , Médicos/economia , Salários e Benefícios , Prática de Grupo , Relações Hospital-MédicoRESUMO
Developing a health insurance exchange strategy begins with: Understanding how both the public and private exchanges work. Conducting a thorough analysis to quantify how exchanges will affect the organization's current and future patient populations and revenue base. Determining when to participate in the exchanges, keeping in mind current market position as well as competitors' actions.
Assuntos
Administração Financeira de Hospitais/organização & administração , Trocas de Seguro de Saúde/organização & administração , Patient Protection and Affordable Care Act , Estados UnidosRESUMO
Numerous factors contribute to an organization's "risk tolerance" under performance-based risk arrangements, including its size, patient population, and the strength of its financial position. There are three types of risk inherent in value-based contracting: Financial risk. Actuarial risk. Strategic risk.
Assuntos
Contratos/economia , Gestão de Riscos/organização & administração , Aquisição Baseada em Valor , Economia Hospitalar , Mecanismo de Reembolso , Gestão de Riscos/economia , Estados UnidosRESUMO
Before embarking on a physician-integration strategy, hospitals and health systems should perform a detailed analysis of the following four critical areas to ensure that the strategy is competitive and sustainable: Strategic objectives; Financial resources; Requisite experience and functional capabilities; Organizational structure, culture, and commitment.
Assuntos
Comportamento Cooperativo , Convênios Hospital-Médico/economia , Convênios Hospital-Médico/organização & administração , Avaliação de Programas e Projetos de Saúde , Competição Econômica , Eficiência Organizacional , Convênios Hospital-Médico/tendências , Inovação Organizacional , Objetivos Organizacionais , Determinação do Valor Econômico de Organizações de Saúde/economia , Determinação do Valor Econômico de Organizações de Saúde/organização & administração , Reembolso de Incentivo , Estados Unidos , Aquisição Baseada em ValorRESUMO
Before taking on value-based care, hospitals must assess risk capacity.
Assuntos
Gestão de Riscos/organização & administração , Aquisição Baseada em Valor , Economia Hospitalar , Conselho Diretor , Estados UnidosRESUMO
Physician alignment will be essential to success under value-based care. Learn the six steps to building long-term, effective integration.
Assuntos
Administração Hospitalar/métodos , Relações Hospital-Médico , Objetivos Organizacionais , Estados UnidosRESUMO
Four primary hospital-physician models are per-click service agreements, management services agreements, gainsharing, and equity joint ventures. Four key attributes needed for successful joint ventures are clinical quality, customer satisfaction, operational effectiveness, and financial soundness. Hospitals and physicians need to approach joint ventures with expectations of high performance.