Why Hospitals Are Redesigning Their Partnerships with Physicians for the Future

WASHINGTON, Nov. 13, 2017 /PRNewswire/ -- As more costs shift to health care consumers, hospitals and health systems will increasingly compete on care reliability, affordability, and accessibility. These changes in the business of health care are driving hospitals to address one of their most complex challenges, working better with physicians to reduce unnecessary care variation, Advisory Board's John Johnston said on Monday.

"For a typical hospital, the costs of treatments that do not improve patient outcomes can add up to millions of dollars—a major impact on care affordability and reliability," said Johnston, National Partner, Consulting at Advisory Board. Reducing variation is also the biggest opportunity to improve performance under value-based care models, he added, and that requires reigning in variation at scale and successfully embedding standards in clinical workflows.

The other potential patient-facing effects of improved care reliability can also be outsized. One health system has found that reducing unwarranted variation in hip and knee replacements alone could save patients more than 1,000 bed days across the system every year.

Need Grows for Improving Productivity, Lowering Costs
The challenge is top of mind for hospital and health system executives—and for good reason. The Congressional Budget Office has projected that 60% of hospitals will have negative profit margins by 2025 if they do not improve productivity or reduce costs. According to an Advisory Board survey, health system chief financial officers see clinical standardization as the biggest single opportunity for cost savings in their own systems.

"Many institutions addressed the obvious places to raise productivity or cut costs long ago. The efforts that remain are tough challenges," said Sean Angert, National Partner, Consulting at Advisory Board. Nationally, in the 16 years since the Institute of Medicine issued its landmark Crossing the Chasm report on care quality, 47% of effective treatment measures have shown no signs of change or are worsening. For example, inappropriate mammography use has resulted in 20% overdiagnosis of breast cancer cases (i.e., false-positive results where there is no breast cancer).

Build High-Performing Partnership with Physicians
The challenge calls for a comprehensive approach, said Allison Shimooka, Executive Director, Research at Advisory Board.  "Physician leadership should create a permanent care variation reduction 'engine' to address both cross-cutting opportunities (such as documentation, clinical supplies, laboratory, and post-acute care) and care for conditions and disease states (such as cardiovascular services, pulmonology, and critical care)."  This strategy results in improved physician engagement, reliable cross-continuum quality and experience at scale, and sustainable reductions in costs, she added.

Beyond these changes in organizational design and clinical processes, hospitals and health systems should ensure they have the foundational data needed to address unnecessary care variation, according to Matt Cinque, National Partner, Technology at Advisory Board. "You need reliable data to make the case to physicians about why there might be a better way to do things. By combining data from different systems, hospitals and health systems can highlight the impact that variation in practice has on patient outcomes," he said.

National Experts on Reducing Care Variation
Advisory Board's new team of National Partners on reducing care variation includes experts on these topics for hospitals and health systems:

John Johnston, CPA, MHA: Organizational strategy, operational efficiency, and financial performance improvement
Sean Angert, MBA: Clinical and operational performance improvement, workforce management, revenue cycle management, supply chain and spend management, reduction of cost per case and length of stay, and hospital throughput
John Kontor, MD: EHR optimization and workflows for risk-adjusted reimbursement and value-based care
Matt Cinque: Care cost, quality, and utilization performance; population health management; and disease management

Beyond the National Partners, other Advisory Board experts on reducing care variation include:

Steven Berkow, JD, Principal and Executive Director, Research: Change management, high-reliability care, staff engagement, workforce strategy, and nursing
Jennifer Stewart, Executive Director, Research: Leadership development, physician and employee engagement, recruitment, retention, accountability and strategic alignment, care models and top-of-license practice, and care variation reduction.
Rodrigo Martinez, MD, Senior Vice President, Consulting: Electronic health records implementation and optimization, clinical decision support, EHR strategy, and clinical workflow
Allison Shimooka, MBA, Executive Director, Research: Health system strategy, clinical performance improvement, oncology, service line strategy, clinical research, academic medical centers, and quality improvement
Veena Lanka, MD, MPH, Senior Director, Research: Reliable care delivery, minimizing unwarranted care variation, clinical performance improvement, physician engagement, cross-continuum care coordination, program design, and population health management
Preston Raulerson, MBA, Senior Vice President, Consulting: EHR strategy and implementation, EHR optimization, Epic program directorship, and digital health
Daniel Clark, MBA, RN, FHIMSS, Senior Vice President, Consulting: Ambulatory EHR strategy, implementation, go-live management and optimization

About Advisory Board
Advisory Board is a best practices firm that uses a combination of research, technology, and consulting to improve the performance of 4,400+ health care organizations. As the health care business of The Advisory Board Company (NASDAQ: ABCO), Advisory Board forges and finds the best new ideas and proven practices from its network of thousands of leaders, then customizes and hardwires them into every level of member organizations, creating enduring value. For more information, visit www.advisory.com.

SOURCE Advisory Board