Can Budgets Drive Healthcare Quality?

Operating under budget constraints has the potential to reinforce innovation, discipline and quality care encouraged under the Patient Protection and Affordable Care Act, according to a contributed Harvard Business Review post by the former Scottish National Health Service Head and Institute for Healthcare Improvement Executive Vice President Derek Feely.


Mr. Feely recounts the Scottish push toward quality through adoption of the IHI "Triple Aim" and the Improving Chronic Illness Care Program's Chronic Care Model. He shares the following lessons from Scotland's move to provide cost-effective, quality care:

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1. Balance investments in population health and treatment. Fixed resources leave the healthcare system with no choice but to improve population wellness through investment in community health.

2. Work with outside partners on the social determinants of health. Healthcare institutions cannot hope to address the entire continuum of health determinants alone. Rather, they would do well to partner with community institutions such as schools and faith-based groups to promote healthy living and wellness.

3. Build a strong system of primary care. Strong primary care, data tracking and data analysis are crucial to addressing the health of a subpopulation with the potential to be high-cost and high-utilization.

4. Get care right the first time. Preventing readmissions, errors and hospital-acquired conditions must be a priority. Getting care right the first time reduces costs, improves quality of care and builds confidence in the system.

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