5 Long Hauls for Hospitals and Health Systems

As much as healthcare has changed since the Patient Protection and Affordable Care Act passed in 2010, there is no doubt more change is coming in 2013. Hospitals and health systems will continue transitioning away from the fee-for-service world while attempting to lower the cost of care to survive and thrive in the developing healthcare environment.

With change comes new challenges. Huron Consulting Group recently released a briefing outlining and offering insights into five key challenges hospital and health systems will face throughout the year.

1. Aligning stakeholders. Getting all of the stakeholders, particularly physicians, to buy in to the mission of value-based care will be critical to its success. "We will continue to see changes in the way physicians are employed, compensated and managed," Andrew Ziskind, MD, managing director and clinical solutions leader, said in the briefing. Getting physicians to buy in from the beginning is important because many of the changes will fall on their shoulders.

2. Evaluating new care settings and models. There are many new or different options for how to provide primary care, including utilizing telemedicine, providing home health and virtual care monitoring or becoming a patient-centered medical home. "Ambulatory settings, virtual visits and home health are growing and access to care is becoming customized and more convenient," said Gordon Mountford, executive vice president of Huron Healthcare. "New primary care models are a key component for success in the healthcare landscape." Hospital and health system executives are beginning to experiment with the various approaches to find which works best for their organization and market.

3. Forging new payor relationships. Many new hospital-payor relationships have surfaced recently, including shared-risk programs or even direct contracting with employers. Some payors have been more receptive to new relationships than others, but Jeff Jones, managing director at Huron Healthcare, shared a tip to help make new types of partnerships work. "Transparency, communication and a true spirit of partnership will be crucial in making those relationships win-win," he said.

4. Leveraging size and scale. In today's healthcare landscape, size matters. Hospital executives are beginning to consider options, such as acquisitions, strategic partnerships and collaborations, to leverage their facilities' size and scale. Curt Whelan, managing director for Huron Healthcare, says each hospital needs to develop their own way of leveraging their size depending on their market and existing capabilities. "Organizations that already have an insurance plan and large physician group have very different approaches, opportunities and strategies than organizations with other variables."

5. Using advanced analytics. Utilizing advanced clinical analytics has become an essential part of providing efficient and effective clinical care. Advanced analytics can also help calculate risk accurately. "Providers are taking a look at opportunities to enhance accountability and the metrics they need to help sustain change. A major component will be advanced use of analytics to build new competencies as well as skills and tools required for fundamental changes to manage the cost of care and care delivery," Jim Gallas, managing director of performance solutions leader, explained.

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