Health care leaders can utilize data, reexamine pricing and manage risk to make health care more efficient and affordable, a panel of hospital and health system leaders said during a session at this month’s AHA Annual Membership Meeting.
[See a video of the session at the end of this article.]
Michelle Hood, AHA board member and president and CEO of Brewer-based Eastern Maine Healthcare Systems, said her organization uses analytic capabilities to drive population health initiatives; to uncover care variations and standardize them; and to enhance productivity.
“We have analytic capabilities today that we have not had in the past and that data — that rich source of data — really motivates and activates change,” Hood said.
Analytics also enable clinicians to identify high-risk patients early, Hood said, so they are able to intervene before patients reach “crisis levels.” Embedding behavioral health workers into organizations’ primary care practices helps them “get upstream from the risk factors and work on prevention,” she said.
Greg Poulsen, senior vice president and chief strategy officer for Intermountain Healthcare of Salt Lake City, UT, said that clinicians and health care leaders must play a bigger role in educating consumers on their clinical options to reduce overutilization and lower costs. “We can help get in the middle of those [clinical] decisions and help educate people on why those decisions are in their clinical as well as financial interest,” he said.
Part of this involves giving physicians a seat at the decision-making table to empower them to make financially informed choices, panelists said.
Speakers also emphasized the value of managing risk and owning health plans.
Jim Leonard, M.D., president and CEO of the Carle Health System in Urbana, IL, said his organization has “taken ownership of the delivery of care” through its health plan.
“Our view is the providers — us, all of you — should really be driving where [care delivery] is going,” said Leonard, a former AHA board member. “And a health plan offers us that opportunity to bring those lessons along at different levels.”
Brian Gragnolati, AHA chair-elect and president and CEO at Atlantic Health System in Morristown, NJ, raised the issue of retail providers and the difficulty of competing with “shoppable services.”
Rodney Hochman, M.D., president and CEO of Providence St. Joseph Health in Renton, WA, says his organization has shifted its reimbursement and pricing strategy — in which patients pay more for having 24/7 access to high-acuity services and less for ambulatory care — to contend with such services. Hospitals and health systems shouldn’t sell themselves short by pricing high-acuity services in the same league as retail ambulatory offerings, he said.
“We’ve been giving those services away at too low of a cost,” Hochman said. “We have to be sure that we’re getting paid well for those things that [consumers] are not going to get at [a retail clinic]. …And that then we also have to be much more price sensitive about the ambulatory [services we offer].”
Gragnolati, who had recently met with Health and Human Services Secretary Alex Azar, said there was a renewed sense of urgency from Washington around making health care more affordable. “I walked out of [my meeting with Azar] thinking that, at Atlantic [Health System], we’re going to need to continue to escalate our efforts into moving into value,” Gragnolati said. “We’ve got to push harder on transforming our cost structures and we’ve got to develop partnership in ways that we probably haven’t imagined.”
To help hospitals and health systems on these efforts, the AHA last year established The Value Initiative. It provides hospital and health system leaders with education, resources and tools that they need to advance affordable health care and promote value within their communities. For more on The Value Initiative, visit https://www.aha.org/value-initiative.