With the first read of Pam Arlotto’s ”Rethinking Return on Investment: The Challenge of Accountable Meaningful Use,” healthcare providers are acquainted with what it will take to transform existing care delivery organizations to patient-centric, high quality, cost-efficient organizations to compete under the proposed Affordable Care Legislation. Managing value will require a realignment of organizational culture and operations to achieve success.
Management of care delivery will no longer be rewarded for providing services with the “let’s try this and see if it works” methodology of a fee for service payment structure. Heightened expectations will hold providers accountable to deliver care that is effective the first time it is delivered and do so without waste of time or money. New management disciplines will be required to make timely decisions based upon relevant information about each patient with evidence-based support to predict what works best in this situation to optimize the value of care. Value base purchasing of healthcare is a primary value lever driving this transformation.
Building a delivery system to exercise judgments and react quickly to variation from expectation are the requirements all healthcare providers must recognize and deploy to optimize value. Here lies the opportunity to operationalize meaningful use beyond simply qualifying for incentive dollars. Value levers control the factors that optimize care value. Leaders, managers, clinicians and patients must leverage their technology to improve value.
Patient care value must be planned for, realized and optimized. This is a new paradigm for rehabilitation providers and will require some education. Three stages of a successful value management process are identified to achieve the goals of meaningful use:
• Value Definition—Identify and understand the problems that need solving. Identifying the associated meaningful use value levers and developing a plan to realize value with key transformation strategies will require best practice research.
• Value Realization—This by far is the most complex and burdensome component of meaningful use success. It requires focusing on value delivery, designing standardized, “hard-wired” processes, creating adoption plans and implementing key health IT systems.
• Value Optimization— The use value metrics identified during the Value Definition phase, collecting key indicators during the Value Realization phase and analyzing results during the Value Optimization Phase provides an ongoing feedback loop for continuous improvement and transformation. Unfortunately, this phase of meaningful use is often overlooked; resulting in a failure to monitor and report performance leading to the erosion of value over time.
Meaningful use is foundational to high-value healthcare, not because of the technology, but because of the ability to inform providers as they increase care effectiveness, manage chronic diseases more efficiently and effectively, coordinate care across the continuum, create new models of care and incorporate the use of evidence-based health care. Managements identification and use of value levers provides the controls for system success.