Frontiers of Health Services Management - Summer 2013 - (Page 38)

and reliability; and (3) controlling the per capita cost of care. Both UnityPoint Health and Piedmont Heart had visions of developing, pursuing, and implementing triple-aimed strategies to achieve greater value. in 2008, UnityPoint Health changed its vision statement to “Best outcome for every patient every time.” the same vision was exhibited by Piedmont Healthcare/Piedmont Heart when aiming to move to “a new way of operating . . . [a] new model of success, based on value and integration that is patientand population-centric Most healthcare experts and driven by global or now agree that breaking bundled payments for the outcomes achieved.” down the clinical silos individuals, medical of complex healthcare practices, departments, organizations—known as service lines, and academic integration—is beneficial. units often perceive that triple-aimed strategies conflict with their interests. Providers need incentives to focus on efficiency and quality, and organizations must be restructured to align governance, management, and provision of care in support of achieving shared objectives. leadership must ensure that top leaders, board members, managers, and a select group of influential champion providers are engaged. Piedmont Heart facilitated cultural change by doing just that. it recruited administrative leaders and chiefs of centers of excellence (coes) as champions and held scripted pathway-development meetings with messages targeted to specific stakeholders. it’s not enough to find champions, however. the champions selected must have the training in population management, quality improvement, finance, and best practices needed to achieve the organization’s clinical integration goals. UnityPoint Health’s Physician leader- ship academy, initiated in collaboration with the american college of Physician executives, helps physicians learn and master leadership skills, which strengthen a collective sense of purpose. as leaver observes, “the importance of the academy in helping coalesce our physicians cannot be overstated.” efforts such as this, as well as online offerings, such as the open School certification program of the institute for Healthcare improvement (2013), can provide low-cost training to ensure that leadership, management-level providers, and staff share a common vision and have the skills to apply it. Participants in the integration effort must also have access to information and information support, with shared data reporting within and across clinical silos to ensure that responsibility for system outcomes is widely embraced and that metrics are used to drive value. clinical integration must be a strategic priority of leadership, and workflows must be assessed and redesigned at the macro (governance and management across facilities and sites) and micro (care delivery) levels. this process includes creating horizontal committees, work groups, and service line management structures to implement and advance clinical integration efforts system-wide. When applicable, the practice plan and health plan should be extensively involved in system operations. evidence shows that health plans that employ their own providers or are tightly affiliated with provider groups score significantly higher on clinical performance measures than do other types of provider delivery systems (gillies et al. 2006). Bifocal Vision leadership and management need bifocal vision. they must be forward-looking; be 38 • f ro ntier s o f h ea lth s e r vic e s ma na g e m e nt 29 :4

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2013

Frontiers of Health Services Management - Summer 2013
Contents
Editorial
At the Heart of Integration: Aligning Physicians and Administrators to Create New Value
Volume to Value
Physician-Led Models of Accountability and Value: Observations on Payment Policy and Culture
Collaboration Across Clinical Silos
Breaking Down Clinical Silos in Healthcare

Frontiers of Health Services Management - Summer 2013