Transitions in Healthcare

March 31, 2016 @ 1:25 pm by ACT

Change is everywhere right now. One of the industries experiencing the most change is the healthcare industry. The “fee-for-service” payment system that pays for “services” rendered, such as evaluations, diagnostic testing and surgeries is disappearing. This system has produced an increase in volume of services not necessarily concordant with improved quality, value or outcomes.  Consequently, it is not surprising to find higher paid services growing in volume compared to lower paid services. Simply put, a fee-for-service environment has promoted more service and higher costs, whether it is helpful to the patient or not.

To combat these problems, the healthcare system is moving toward a population management value based payment model that shifts incentives towards achieving cost and quality goals.  This seismic shift in the healthcare system has produced numerous challenges to providers, insurers, hospitals and health care organizations.

As is with most challenges associated with change, it can be a strategic opportunity as well as a strategic risk.  Amongst the challenges are anticipating and planning for market change, determining how quickly to transition from fee-for-service to value based payment, as well as the necessary structural and operational changes required to succeed in the new model of healthcare delivery.

The change is moving at a rapid pace.  “HHS (U.S. Department of Health & Human Services) has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.  HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.  This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.”   http://www.hhs.gov/about/news/2015/01/26/better-smarter-healthier-in-historic-announcement-hhs-sets-clear-goals-and-timeline-for-shifting-medicare-reimbursements-from-volume-to-value.html#

When dealing with massive change people tend to either flourish or flounder. Much of this has to do with how we psychologically process the change. Being proactive during times of change is key to success during challenging times. Here are three strategies we have seen in top performers during times of change:

• Get Creative – Top performers see change as an opportunity. While some may not like the change, they brainstorm and get creative to discover the opportunity that lies within the change itself.
• Display Grit – Top performers are full of grit. We define grit as, “a positive, cognitive and emotional trait based on a passion for a goal and coupled with actions to achieve that goal.” How can you display your grit during this time of change?
• Strengthen Relationships – Top performers seek out advice and coaching from others. They don’t try to go it alone. Rather, they seek support from co-workers, family, and friends while looking to support others as well. Top performers go through change with a team.

It is more important now than ever to be proactive in the healthcare industry. Get creative, develop grit, and strengthen your relationships to help navigate through the rough waters of change effectively.