The American Hospital Association has outlined 10 of the top strategic questions hospitals and health systems should address to determine their plan for care transformation.
The AHA report "Your Hospital's Path to the Second Curve: Integration and Transformation" says hospitals are shifting from the "first curve" of volume-based care to the "second curve," where they begin creating value-based care systems and business models. But many hospitals today find themselves in an awkward spot, as timing the transition from the first to second curve takes some difficult decisions.
Addressing the following strategic questions will help hospital leaders determine whether it needs to take one or more or a combination of "paths," which are listed below.
1. What are the primary community health needs?
2. What are the long-term financial and clinical goals for this organization?
3. Would the organization be included in a health insurer's narrow/preferred network, based on cost and quality outcomes?
4. Is there a healthy physician-hospital organization (or business model that aligns physician in private practice with hospitals and hospital-employed physicians)?
5. How much financial risk is the organization willing or able to take on?
6. What sustainable factors differentiate the organization from current and future competitors?
7. Are the organization's data systems robust enough to provide actionable information for clinical decision making?
8. Does the organization have sufficient capital to test and implement new payment and care delivery models?
9. Does the organization have strong capabilities to deliver team-based, integrated care?
10. Is the organization proficient in program implementation and quality improvement?
Depending on the value an organization seeks to create, one or a combination of these paths can be pursued, according to the AHA.
• Redefine to a different care delivery system (such as more ambulatory or long-term care oriented).
• Partner with a care delivery system or health plan for greater horizontal or vertical reach, efficiency and resources for at-risk contracting.
• Integrate by developing a health insurance function or services across the continuum (such as behavioral health, home health, post-acute care, etc.)
• Experiment with new payment and care delivery models, such as bundled payments, accountable care organizations or patient-centered medical homes.
• Specialize to become a high-performing and essential provider.
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