Common misconceptions about balancing cost and quality initiatives — 3 executives weigh in

Balancing financial and quality initiatives requires fighting several misconceptions, including the ideas that cost and clinical outcomes are mutually exclusive, quality has a singular definition and quality protocols aren't everyone's responsibility.

The following panelists discussed these misconceptions at Becker's Hospital Review 7th Annual CEO + CFO Roundtable, Nov. 13 in Chicago:

  • Jeff Wakefield CFO, Marion (Ind.) General Hospital
  • Salman Naqvi, MD, MPH, associate chief medical information officer, Allscripts
  • Robert Rajalingam, senior vice president, enterprise corporate accounts and enterprise marketing, Cardinal Health

Here's what they shared:

Mr. Rajalingam: "One of the challenges everyone in this room faces is balancing extreme cost pressures with delivering clinical outcomes. The misperception is that those are at odds with each other, that optimizing supply chain metrics is inherently going to compromise the clinical outcomes. … They're really complementary goals if executed correctly. If you have an inefficient supply chain — if you don't have the right product at the right time — that can lead to adverse clinical events."

Mr. Wakefield: "When you talk about quality, what does that really mean? You'd think there weren't different definitions, but a lot of times the payers are dictating that. Anthem's scorecard dictates what quality is, and that's tied to part of what we can increase our charges by in the next year. CMS certainly [dictates quality] with bundled payments and many different things. It also means different things depending on what size you are. ... When I meet with folks, whether they're from the community or the payers, I say we have an obligation to provide the highest quality at the lowest cost. To me, we're trying to attain both of those things as we go forward."

Mr. Naqvi: "Sometimes, quality is seen as the police from a clinician point of view. … A lot of times, [clinicians] think quality is something they don't have to think about — someone else has to think about it. They're there because they need to take care of Mrs. Johnson who's 75 years old and is presenting with complications of stroke. Sometimes, they tend to forget that part of that stroke protocol is the six or seven nationally covered criteria that are going to make her outcomes better.

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