A partnership between the American College of Surgeons and Harvard Business School aims to promote value-based care while reducing costs.
The American College of Surgeons (ACS) and Harvard Business School (HBS) announced a value-based care partnership aimed at improving quality care while reducing costs.
The duo’s primary goal is to help hospitals and surgical practices better measure the quality and costs of care delivery. In doing so, hospitals can more accurately assess the care they are administering, and reimbursement payments can be more reflective of the quality of care.
“Clearly defining the value of patient care is critical to our nation’s health care system,” said ACS Executive Director, David Hoyt, MD, in a public statement. “As the patient care model continues to evolve, we must place a premium on providing the utmost quality and efficiency in our hospitals. This program will help hospitals identify clear opportunities to do that.”
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Dubbed Transforming Health care Resource to Increase Value and Efficiency (THRIVE), the program will pilot the value-measurement process in ten to fifteen hospitals in the United States. After looking at a fully cycle of care for three surgical conditions, the method will risk-adjust benchmarks using surgical, medical, behavioral, and social elements. Hospitals will then be able to compare themselves to other institutions and learn best practices from high performers.
“We know quality improvement requires accurate and reliable data, with risk and case-mix adjustment,” stated the Director of the ACS’s Division of Research and Optimal Patient Care, Clifford Ko, MD, MS, MSHS. “Clinical data, not claims data, are routinely the best data to use. However, data alone are not sufficient. Appropriate and adequate resources, infrastructure and adherence to evidence-based standards are all likewise needed to provide high-value care. ACS has a long history of helping providers and hospitals achieve these aspects reliably.”
Results of the pilot study will lead to the development of an approach for all hospitals and surgical practices to use. Scalable solutions for all sites will support the healthcare industry shift in focus toward more value-based reimbursement strategies.
“We want to reduce the high costs incurred in the US health care sector but do this in ways that don’t compromise the quality of care or a patient’s access to it,” explained Robert Kaplan, MS, PhD, of HBS. “Cutting costs by arbitrary reduction in headcount is not a sustainable solution. True cost improvement requires that we first measure what it costs today to treat a patient’s medical condition, and then redesign the care model to deliver the same or, preferably, better outcomes with a lower-cost mix of resources, especially personnel, equipment, devices and drugs.”
Surgical practice is becoming more team based as bundled payment methods increase in adoption. Rather than reimburse the surgeon separately from the anesthesiologist separate from the internal medicine physician, a lump sum payment is being distributed to the entire team. ACS and HBS’s partnership plans to address this in their methodology as well.
“Surgical care is more than just the operative procedure,” said Medical Director of ACS Quality and Health Policy, Frank G. Opelka, MD. “Surgical care involves teams of clinicians who begin delivering care in the preoperative phase, include anesthesia, nursing care and medical specialties and continues through to postoperative rehabilitation. As a team, we need to optimize each phase of care to provide the best outcomes for patients and meet their goals.”
Measuring value correctly is becoming increasingly more important as value-based payment models rely heavily on these measurements.
“This is the next evolution of our nation’s health system,” stated Hoyt. “We know we can provide world-class care to all patients. Now we need to make that care affordable and accessible to all in a way that meets the patient’s goals.”
The new partnership is a part of HBS’s Institute for Strategy and Competitiveness known for creating business strategy and cost-measurement methods such as time-drive activity-based costing (TDABC), recognized for its ability to measure and improve and organization’s costs.
“We believe the value-based health care approach will expand the definition of quality and will improve transparency, both of which are essential to delivering truly patient-centered care,” explained Mary Witkowski, MD, MBA, of HBS. “With better understanding of their quality and costs, health systems, accountable care organizations and surgical practices to will then be able improve the value they deliver to patients and increase access to care.”
Date: July 26, 2019
Source: Health IT Analytics