Healthcare is shifting toward a pay-for-performance future, and hospitals looking to succeed as healthcare trends toward value will have to place a large emphasis on population health.
At the Becker's Hospital Review 5th Annual CEO + CFO Roundtable Nov. 8, Accenture, a global professional services company, delved into how hospitals can propel their organizations forward into healthcare's value-based future and successfully utilize data analytics to drive meaningful change in their organization during an executive roundtable titled "An Uncharted Path to the Future of Healthcare."
To better gauge what healthcare organizations envision for the industry's future and steps they are taking in lieu of this transformation, Accenture previously conducted a research study and spoke to 50 leading health system CEOs who discussed their perspectives on the healthcare landscape and how their organizations are evolving to keep pace with these changes.
"Several CEOs said that 100 percent of what they do right now will be 100 percent different in the future," said Michael Main, managing director of Accenture Strategy. "Many said that to survive the next 10 years, they are going to need to be number one or number two in their market."
While organizations increasingly understand the need to allocate resources toward population health initiatives, many organizations and even leaders within an organization have contrasting definitions of population health. During the roundtable discussion, many hospital and health system executives reported their organizations are pursuing a population health strategy. However, the vice president of medical affairs of a 365-bed hospital on the East Coast said his facility has found it challenging to tell their independent physicians they need to spend money now on a population health initiative so they can reap financial success later down the line by improving the health of their population.
Many organizations spanning the United States, including the roundtable attendees' centers, are acute care facilities that operate under a fee-for-service payment model. Despite many organizations not yet fully shifting to pay-for-performance, healthcare's future will largely depend on outcomes and population health will be of exceeding importance.
"Most of you are dominantly operating under a FFS model. When CEOs say healthcare will be 180 degrees different in the future, they are saying they will focus on the whole care continuum and treat the entire population," Mr. Main said. "When we tie the fee to value, we have to extract the cost out of the system and shift it to the lowest cost, highest quality avenue possible."
Hospitals can work to improve patients' quality of care by employing technology. Mr. Main noted that if healthcare continues to exponentially improve providers' computing ability, healthcare will demand transparency and center around the consumer. Hospitals and other healthcare organizations that fail to shift to a patient-centered mentality will likely not be prepared for what is coming down the pipeline. Becoming patient-centric also entails understanding the most pressing challenges facing your organization.
"In the 1800s, if you told hospitals that we want you to improve the population's health and decrease the number of diarrhoeal diseases and deaths you are experiencing, they would say that is not their jobs," said the CEO of a Southern-based 250-bed hospital that provides services to Tricare beneficiaries. "Today, our biggest issues are lack of exercise, obesity and tobacco [use]. We often talk about managing the disease once we know about it, but we need to get in front of that."
When implementing population health initiatives and staying on the forefront of preventative medicine, the healthcare industry has a valuable, and often underutilized tool at its fingertips — data analytics. The issues related to data analytics are embedded in using these tools to effectively drive change in organizations.
"If our metrics are poorly defined and our definitions are askew, how do we bring clarity [to the healthcare system]?" Mr. Main said. "The problem is what you have been doing successfully now is not what will make you successful in the future. Your competencies have to be more related to data and science."
John Carew, senior manager of Accenture Analytics, said successful organizations follow a series of steps to obtain value from their data analytic systems. While the majority of organizations can implement data analytic systems and have endless amounts of data to dissect, the biggest failures organizations have is turning those data-driven insights into meaningful action.
"When I think of organizations that are getting their data analytics right, they look at data analytics as part of their overall organizational strategy, rather than thinking of data analytics separately," Mr. Carew said.
Healthcare is moving swiftly, but many organizations, despite their best efforts, are failing to drive insight from their data analytics. This failure is largely due to the fact that they don't make data analytics a top priority. Mr. Main cited an example of a surgeon who said the hospital should allocate its resources toward its cardiology service line as there was an influx of patients coming into the facility for these services. Another staff member probed the surgeon as to how he reached that conclusion, which created tension amongst the two staff members.
"It really came down to experience versus the science and data," Mr. Main said. "We told the hospital why don't we alleviate the tension by doing clinical segmentation so we can know where the revenue is really coming from?"
By using data, the hospital got a full picture of its services lines, allowing it to better understand how large those service lines should be. Without effectively using data analytics, hospitals run the risk of wasting valuable time and resources.
"Data analytics allows you to begin making decisions and if you decide to do population health, you can understand which mechanisms to put into place," Mr. Main added. "If big data is how we become better providers, we need to think of data analytics as part of our jobs."