The fusion of major changes in the U.S. health care delivery system carries the potential for organizational meltdown. If delivery system leaders can recognize the fundamental changes to assumptions, behaviors, and systems required of their organization, it is possible to transform the culture and organization, and move successfully into the next generation of profitable, patient-centric health care. If they fail to properly handle the caustic elements of the change at hand, the chain reactions may be fatal.
In March 2010, the U.S. health care delivery industry experienced a system-wide “wake up call” when decades of uncontrolled cost increases, advocacy for process over clinical outcomes, and too much focus on fixing sickness versus maintaining wellness culminated in the Affordable Care Act (ACA). Adherence to Medicare CMS’s “triple aim” definition of an exceptional patient experience while lowering the cost per episode of care and maintaining the health status of a defined population is the new strategic/operational focus.
This article examines how a fundamental change in clinical culture will be necessary to achieve a new normal of patient-centered care—integration of processes into episodes of care (outcomes) with exceptional patient experiences. Leadership needs to embrace this kind of transformation in order to remain sustainable and relevant. Proactive reform requires the clinical integration of the preventative, diagnostic, and treatment services to a given population via a lower cost model that enhances desired outcomes, e.g. the “right care” at the “right time” in the “right setting” at the “right cost” with the “right outcome.”
Length: 3 pages (PDF 80 kB)