美国医疗体系的未来将以持续的挑战为特征. 收入和成本压力将会增加. 经济和人口结构的变化将影响医疗保健的利用和付款人的组合. 行业混乱将继续. 利润率和现金流将受到影响,资本将变得稀缺. 毫无疑问,我们将看到进一步的呼吁, 可能在多个经济领域进行大规模改革, 包括卫生保健. 尽管未来很可能受制于这些不确定因素, 有一件事是肯定的:任其发展, 医疗保健提供者的经济状况仍将处于危急状态,甚至可能恶化.
当我们思考影响美国医疗保健系统的力量的含义时, 我们不能不承认,我们目前的模式太复杂了, too costly, 太分散了. Yet, 直到我们建立一个系统的解决方案, the pressures and challenges we face today will continue and quite likely escalate for the foreseeable future.
In the meantime, most hospitals and health systems must double down on several foundational business imperatives to be competitive in this new era of healthcare—one that places value on cost, access, and convenience.
以下是bet8网站备用重新定位的四项关键任务, 让他们的组织为未来做好准备, 改善他们的财务状况.
拥有消费者关系
Many health systems enjoy a level of consumer engagement that might be seen as favorable or even strong. 但很少有bet8网站备用能够做到这一点 own 消费者关系. 为什么这很重要?? 因为医疗的未来很大程度上是数字化的, 不仅仅是在远程医疗和远程监控等数字化医疗bet8娱乐方面, but ultimately in artificial intelligence (AI)–enabled health management and precision medicine in care delivery.
Health systems must appreciate that the rich data locked within their electronic health records (EHRs) can be used to strengthen the bond with consumers. The potential is huge to connect with larger segments of the population or even to expand the service area beyond traditional boundaries.
Health systems need a multifaceted consumer engagement strategy that encompasses the following considerations:
- Digital Healthbet8网站备用应制定明确的数字卫生战略, recognizing that digital health is not an IT function: it is a care delivery and consumer engagement capability enabled by technology.
- 客户关系管理(CRM) CRM is the process of establishing and managing personalized relationships with an organization’s customers and using data about their needs to strengthen those relationships. CRM策略是通过对医疗系统的患者记录进行广泛的数据挖掘来构建的, bet8网站备用转诊数据, 以及其他资源来分类并最终定制与独特个体的互动, 将其引导到bet8网站备用内适当的用户渠道.
重新设计交付网络以实现高性能
The adoption of technology will change all facets of healthcare delivery and care management through the use of web-based applications, 虚拟健康平台, 以及支持人工智能的健康管理. 未来的医疗系统将以其数字医疗平台为基础, 动态网络, and physician network as the front door to the system—with hospital services available when they are needed.
- Hospitals: 从历史上看,它是bet8网站备用的经济引擎, hospitals will come under great stress in the future as growth in ambulatory services continues and payment rates approach parity for ambulatory and ancillary services. 利润率压力持续增加, 医院必须更加关注其临床组合的表现.
- 门诊和bet8网站备用网络: 从长远来看, the economic engine for many regional delivery networks will shift from the hospital to the ambulatory and physician network. A health system’s 动态网络 and its aligned physician network are the metaphorical front door to the health system. 这就是为什么成本、可及性和便利性如此重要的原因.
- bet8网站备用企业: Many health systems operate their employed physician network as a loose federation of practices; few have created a fully functioning integrated medical group model. The institutional subsidy of these practices has become a financial burden for many health systems, with the aggregate investment amounting to tens of millions of dollars per year for some organizations.
Addressing the operating losses in a health system’s physician enterprise can be a sensitive undertaking, and leaders需要在设计持久力的解决方案时具有创造性.Fundamentally, 许多bet8网站备用将发现,它们需要重新考虑聘用bet8网站备用的策略, 高级实践提供者(APPs), and their staffs.
优化运营和成本结构
面对越来越多的政府资助的付款人组合, 继续朝着风险分担安排的方向发展, 进一步将bet8娱乐转移到门诊领域, health systems need to achieve greater levels of efficiency and cost management across their delivery networks. 优化组织的运营和成本结构可能是一个艰苦的过程, 但是,如果以可持续的方式处理,结果可能是显著的.
- Operating Costs: The solution for sustainable cost reduction is not a “slash and burn” reduction in force but a continuous process improvement business model that strives to reduce unit costs through greater efficiency, 低成本的资源, 以及医疗方面的创新.Organizations must focus on every aspect of their cost structure: fixed costs and asset management costs; labor and skill mix; high unit cost and variable cost items, such as blood products and pharmaceuticals; and of course, 吞吐量和容量管理.
- Fixed Costs: The COVID‑19 crisis forced hospitals and health systems to take a hard look at their cost structure. Any fixed expense not contributing to direct patient care or positively impacting quality or safety has been closely evaluated, 由于业务量减少,许多医院让大量员工休假, 其他公司则完全取消了某些固定成本——主要是支持功能. Going forward, hospitals and health systems must hone their focus on overhead and fixed costs.
- 高成本患者群体: 能够有效管理高成本的组织, frequent utilizers can have a significant impact on a provider’s ability to improve their financial health and sustain that improvement into the future. 管理这些种群是一项艰巨的任务, but one that can lead to long-term financial health for the organization through reduced cost.
优化收益结构
The pandemic has upended the assumptions and models that have historically served as the basis for establishing rates. As a result, health systems and payers have an opportunity to engage in collaborative discussions to reset payment rates going forward.
This new era of healthcare has the potential to create a further divide between health systems and payers. Commercial payers may be reluctant to negotiate with health systems—and in fact will push back harder if a system’s sole strategy is to negotiate for future rate increases that require commercial payers to cover shortfalls from government payers. Health systems cannot afford to be shortsighted and focus merely on rate relief associated with pandemic-related loss of volumes. 现在是bet8网站备用让支付者参与进来的时候了, 同意在续约周期之外重新签订合同, and explore creative solutions with payers that align with select customer-centric concepts and help reshape their revenue structure.
医疗保健的新时代需要加速变革
在缺乏迫在眉睫的系统性改革的情况下, bet8网站备用需要自我改造——现在就是采取行动的紧迫性. Organizations that make bold moves to address the above imperatives will be better positioned for the future. 那些做不到这一点的人可能会在市场上被其他供应商边缘化, 或者提供者和支付者的组合, 潜在的新进入者.
您的组织为医疗保健的新时代做好准备了吗?
这篇博文摘自我们的 We Believe series, a collection of strategic perspectives on the changing dynamics of the US healthcare system.
阅读白皮书2021年8月9日出版