Recommendations for Monitoring Value in Healthcare at Asbury Medical Center

Overview of Asbury Medical Center's Need for Monitoring Value

You are a consulting team from a major regional healthcare consulting firm. You have been engaged by the CEO of a major healthcare provider in a competitive environment. The CEO of Asbury Medical Center informs you that the Board of Directors has asked that monthly reporting not be limited to financial projections and budget-to-actual reports. Rather, they are becoming concerned with evaluating the Medical Center’s performance on value.

The board still has a fiduciary responsibility to ensure the financial health of the organization and member are increasingly concerned with value provided, not just cost.  The CEO asks your team to advise her on what she should propose to the board for such monitoring of value.

1. Why might the Board of Directors want to monitor value and what accountability system would you recommend?

2. Describe your recommendations for how the Board and CEO might create an organizational unit to measure and monitor value. Who do you recommend lead the efforts?  What knowledge, skills and training might be helpful for that leader?  What department might have prime responsibility and who else in the organization must contribute/be involved?

3. What data, metrics and benchmarking does your team recommend and why?

4. Describe what you anticipate will be the short-term and long-term impacts on revenue and cash flow and why?

5. Analyze the roles and responsibilities of the medical staff leadership in value improvement.

6. What benefits do you forecast for the Asbury Medical Center, the community and patients?

7. Describe how Information Technology might contribute to this value improvement project.

I have written paper (added my paper from next page), but not able to write anything on question 4, please write two pages just for question 4.

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Asbury Medical Center is a major healthcare provider in a community where competition is prevalent. As a result, the Chief Executive Officer (CEO) and the board of directors, have realized the need to evaluate Asbury Medical Center’s performance not just from a financial perspective but rather on the value of care that is being provided. As the consulting team from a major regional healthcare consulting firm, the team was tasked to provide the CEO with recommendations on ways to monitor value. The CEO would eventually share and propose these recommendations to the board of directors.

Recommendations for an Accountability System

First it is important to understand value. Value in healthcare is defined by: Quality over Cost. Patients differ in their definition of value. For them, Value is, “How much did it cost? and did I get my dollar’s worth of care services?” According to Wegner, Value in healthcare is “health outcomes achieved which matter to patients relative to the cost of achieving those outcomes” (Wegner, 2016).  Improving value benefits patients, payers, providers, suppliers and the society while increasing economic sustainability of the healthcare organization (NEJM, 2019).

For Asbury Medical Center, monitoring “value” of care will allow the hospital to deliver high-value care directed towards patient’s well-being and to mitigate unnecessary services or those whose potential risk or costs supercede the likely benefits, maximize patient experience, reduce care variability, drive consistent quality, increase patient loyalty, and optimize revenue.

In order to set up AMC for success when measuring and monitoring value, the consulting team recommends the following accountability system:

1. Culture: AMC  must promote a culture of teamwork, multi-disciplinary integration, employee engagement and trustworthiness (HFMA, 2015). It must encourage shared accountability to bring value across the continuum of care. The staff and management must be prompt in addressing patient’s concerns to improve their experience of care.

2. Education and training: AMC must invest in training and cross-training staff and employees to develop skills and competencies necessary for efficient patient care. It must recognize creative and innovative thinking to optimize care delivery and change management. This will providers more compliant in monitoring, assessing and improving outcomes while controlling costs.

3. Analytical tools: AMC must mandate the use of Key Performance Indicators (KPIs) and make the dashboard accessible to other departments to deliver well-integrated high value care to patients (HFMA, 2015). Quality outcomes must be measured and reported.

4. Transparent Communication: AMC must encourage open communication to prevent missing out on vital information. Valid and genuine price information, authentic and transparent performance data must be available to consumers. People involved in measuring and monitoring value must send out periodic updates to leadership, staff and employees to keep everyone updated and engaged in efforts (HFMA, 2015).

5. Performance improvement: AMC must identify and develop ways to augment performance of care delivery to its patients. Incorporating evidence based practice  will further the objective of better care at lower cost bringing value to the hospital’s practices. Implementing the use of interoperable EHR system will facilitate seamless communication between providers and reduce waste, duplication and errors.

The Role of Organizational Units in Monitoring Value

6. Risk management: AMC must develop and manage care networks, assess patient related potential risks and closely monitor care episodes to amplify productivity (HFMA, 2015).

To measure and monitor value, we would recommend to the CEO and the Board of Directors of Asbury Medical Center to develop an organizational unit called the Population Health, Quality and Patient Safety department. This unit would lead efforts in identifying community needs, inefficiencies, waste, and address challenges that prolong AMC’s ability to successfully lean towards value-based care.

The Population Health, Quality, and Patient Safety Department would be led by a Chief Population Health and Quality Officer. This leader must be able to understand and align quality and value aims with Asbury Medical Center’s financial and strategic objectives (IHI, 2018). Due to the collaborative nature of this department, the leader must have experience in working in a team-based environment with information technology, be able to build relationships, and be passionate about quality (Becker’s Clinical Leadership and Infection Control, 2015).

To measure and monitor value, the recommended Population Health, Quality, and Patient Safety department would have the prime responsibility in measuring and monitoring value for AMC. However, the Finance department must closely work together (HFMA, 2015). The Finance department has valuable insight on care costs, the financial condition of AMC, and current contracts and risks. This knowledge is necessary to understand the value of care at AMC.

Besides Finance, this department would need to work with Information Technology, Compliance, Patient Care/Clinical Services (Especially the Chief Nursing Officer & Chief Medical Officer), and the Office of Medical Administration (Medical Staff). Working with these other departments within the hospital, would increase accountability when it comes to placing value on care.

Medical leadership is necessary for value improvement; medical leaders include physicians and other licensed practitioners. Medical leaders evaluate and establish direction for the clinical team. Also, medical leaders are responsible for providing clinical supervision and oversight of the clinical team’s care and performance.

Chief Medical Officers (CMO) perform many duties apart of their role. At Asbury Medical Center, the CMO will be responsible for: promoting safety, developing medical staff relationships, developing mechanisms to provide, track, and improve clinical care delivery, facilitating patient satisfaction, and serve as a liaison between administrative and clinical staff, etc

The meaning of value differs from person to person. More than being about the costs and efficiency, Value is about patient experience and what it holds for the community and individuals receiving it. For a receiver of the healthcare services, the value doesn’t limit to the kind of services provided but also to the quality of life resulting from the same (Marzorati et.al., 2017). 
Value based healthcare for Asbury Medical Center will be aimed at making the services patient- centered.

Apart from providing patient centered care, a value based model will aim at limiting the resources and amounts spent after healthcare. Not only will this affect the community, but it would be a small contribution to the economy. This would help transform the fragmented healthcare system to a unified one. An easy availability of care services, efficient usage of resources and reduced costs will be some of the benefits through the proposed value based model.

The use of Information Technology in healthcare aims at an overall advancement. HIT (Health Information Technology) can be used in all the departments, right from patient admission to discharge. Electronic Health Records (EHRs) can not only reduce time consumption, but can also make taking down patient information more precise (Po-Yin Yen et.al.,2017). In addition to that, EHRs offer an ease in transferring of patient data, thus improving patient experience.

Setting up an application for the medical center to provide information about the services offered as well as give updates regarding the upcoming activities, camps at the center. The app can also be used to provide information regarding the waiting times, thus improving patient experience.