Frontiers of Health Services Management最新文献

{"title":"UCI Health Acquisition: The Lasting Benefits of Transformative Integration.","authors":"Doug Niedzwiecki, Nate Shinagawa, Sherwin Rosario, Chad T Lefteris","doi":"10.1097/HAP.0000000000000225","DOIUrl":"10.1097/HAP.0000000000000225","url":null,"abstract":"<p><p>University of California (UCI) Health acquired an integrated healthcare delivery system from Tenet Healthcare in March 2024. The acquisition, which included four hospitals and added 858 beds to the system, was a pivotal move toward pursuing the organization's commitment to the long-term health needs of the region and progressing UCI Health's strategic priorities to improve health, increase sustainability, and transform healthcare. Following the acquisition, UCI Health embarked on a journey to integrate the system. This process strengthened the system's ability to deliver high-quality, patient-centered care across the region. From the beginning, UCI Health established three guiding principles to support a successful integration and inform the path toward systemness: 1. Quality and access 2. People and culture 3. Financial performance The integration of the acquired hospital facilities, referred to as the UCI Health Community Network, has been a dynamic process. UCI Health began by addressing challenges related to the format of a divestiture, identifying opportunities for synergies within this new structure, and then advancing transformative initiatives that can bring lasting benefits. UCI Health has also established an integrated mission and vision, as well as coworker values, ensuring that all these statements are representative of the broader system. The integration efforts demonstrate UCI Health's commitment to systemness and the positive impact it has had across the organization.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"42 1","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential Innovation: Thriving amid Significant Change.","authors":"David E Entwistle","doi":"10.1097/HAP.0000000000000217","DOIUrl":"10.1097/HAP.0000000000000217","url":null,"abstract":"<p><p>Healthcare systems worldwide are grappling with significant challenges, including rising costs, aging populations, and growing demands for care. The global pursuit of innovation has never been more critical to answering these challenges and ensuring that the mission of healthcare remains vital and strong. Prioritizing three areas for innovation, in particular, will be essential for systems navigating a rapidly changing industry: (1) ensuring access to timely care amid resource constraints, (2) fostering local innovation and knowledge sharing, and (3) strengthening support for healthcare workers globally. This article explores several approaches to driving progress in these domains. Artificial intelligence (AI) offers a unique opportunity to extend access to diagnostics and specialized care in low-resources settings. Effective collaborations can bridge persistent gaps in education, training, and infrastructure necessary for improving care quality and health outcomes for patients globally. And, amid a professional burnout crisis, the development of targeted \"copilots\" to support healthcare workers can help alleviate burdens that distract from what they do best. Ultimately, an ongoing commitment to innovation is vital for healthcare systems to not only sustain their missions but to meet the evolving needs of patients and clinicians everywhere.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"41 4","pages":"26-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodist Le Bonheur Healthcare: One Health System's Journey to Systemness.","authors":"Michael Ugwueke, Paula Jacobs","doi":"10.1097/HAP.0000000000000223","DOIUrl":"10.1097/HAP.0000000000000223","url":null,"abstract":"<p><p>In response to growing challenges in health care, such as regulatory changes, financial pressure, and physician and workforce shortages, Methodist Le Bonheur Healthcare (MLH) has embraced \"systemness,\" a concept emphasizing coordinated, unified operations with a shared focus on high quality and efficiency, to ensure sustainability. Drawing from foundational theories in systems thinking, MLH applies a systemness mindset to improve care quality, operational efficiency, and patient experience across its six hospitals and dozens of physician practices and outpatient services. MLH's strategic initiatives have included chartering a Systems Operational Improvement Team (SOIT) to achieve $73 million in savings in its first year, and the Methodist Associate Advancement Program (MAAP) to support workforce development. To actualize a branded commitment to enterprise-wide excellence, MLH implemented a transformational change in its accountability framework to boost Leapfrog Hospital Safety Grades and Centers for Medicare and Medicaid (CMS) star ratings with the Organizational Performance Tracker (OPT), an innovative dashboard aligning more than 90 performance goals to national benchmarks. Technology integration has been central to MLH's systemness journey with a transition to unified Epic electronic health record (EHR) and Workday platforms to streamline operations and enhance care coordination. The interprofessional care model supports important collaboration across disciplines and facilities to ensure consistent patient-centered care. Key to the systemness strategy is a balance between standardization with local innovation, recognizing unique needs of diverse patient populations. Programs like the Power of One Idea and Performance Excellence Award have encouraged staff-driven improvements to realize measurable gains. For MLH, systemness is an ongoing journey to deliver the exceptional care each patient deserves.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"42 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Management and Good Governance Support Organizational Value.","authors":"Sara U Gattie","doi":"10.1097/HAP.0000000000000212","DOIUrl":"10.1097/HAP.0000000000000212","url":null,"abstract":"<p><strong>Summary: </strong>As healthcare faces mounting financial challenges and an uncertain flow of resources, proactive risk officers are working to implement effective operating policies to handle those challenges and uncertainties. Clear governance structures that are fully integrated into the organization's strategic planning process can provide the framework for effective risk management. At Providence, a large not-for-profit health system, enterprise risk management practices serve to identify, assess, and manage the risks that can affect the entire organization. Armed with a complete view of risks (both taken and those avoided), system executives, core leaders, and board members work together to protect value and advance the corporate mission.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"41 3","pages":"14-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cedars-Sinai: Addressing Workforce Risks Through a New School.","authors":"Nicole Anderson","doi":"10.1097/HAP.0000000000000213","DOIUrl":"10.1097/HAP.0000000000000213","url":null,"abstract":"<p><strong>Summary: </strong>Located in Los Angeles, a diverse and expensive city of 3.8 million residents, Cedars-Sinai Health System seeks to hire and retain a qualified workforce that reflects its patient population. Research shows that concordance of a person's ethnicity with their clinical care team improves outcomes and reduces health disparities. Across the nation and at Cedars-Sinai, the pandemic exacerbated already existing workforce shortages and challenges to hiring, training, and retaining allied health workers. In September 2021, leaders at Cedars-Sinai began exploring ways to address these potential workforce risks to its operations. Through interviews with stakeholders and thorough analysis of Cedars-Sinai and local workforce and educational data, the decision was made to launch an allied health school. The goal of the program is to help fill the pipeline to meet the highest areas of need and provide opportunities for community members and existing Cedars staff to upgrade their skills and earning power.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"41 3","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning Capital with Care: Delivering Health Value Alongside Financial Returns.","authors":"Mark McClellan, Cheryl Pegus","doi":"10.1097/HAP.0000000000000234","DOIUrl":"10.1097/HAP.0000000000000234","url":null,"abstract":"<p><p>Private capital has been a powerful force in driving healthcare innovation, fueling digital tools, team-based care models, and many other modernizations of care. Yet skepticism remains about whether financial investment can align with improved outcomes, improved access, and lowering of costs based on negative examples. In a healthcare system that spent $4.9 trillion in 2023, with most of the supporting investment funded by nongovernmental sources, the role of private capital is not just influential but essential. Consequently, working to reduce negative implementations and increase transparency is worthwhile based on the needs for innovation in healthcare-digital and physical. This article provides approaches for private investment to analyze not only financial return on investment but also health value return on investment (HV-ROI). That means measuring how well capital deployment improves care outcomes, expands access, targets community needs, and supports providers while impacting healthcare costs. Investors should be true health partners. Adopting HV-ROI practices can help them and partnering healthcare executives align financial goals with value-driving both financial viability and improved outcomes for patients and communities. Key insights include: Blended funding is essential. Public programs, philanthropy, and private investment each play a role. Only together can they support the cost of care, scale proven solutions, and sustain innovation across all communities.Private investment must evolve. While it has enabled telehealth, diagnostics, and behavioral health platforms, instances of private for-profit investment with poorly aligned incentives have also led to staffing cuts, reduced services, and worse outcomes in areas like emergency medicine and nursing homes.HV-ROI offers a solution. This framework proposes embedding health value throughout the investment lifecycle:Evaluating clinical outcomes, access, affordability, and local needsAligning investment key performance indicators with patient, provider, and payer prioritiesBuilding governance structures that reward long-term health impactTransparency and accountability matter. Publishing impact analyses, engaging third-party evaluators, and sharing lessons learned will build trust and legitimacy.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"42 2","pages":"6-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Healthcare Systems Can Evolve and Thrive Through Value-Based Care.","authors":"Robert Millette","doi":"10.1097/HAP.0000000000000236","DOIUrl":"10.1097/HAP.0000000000000236","url":null,"abstract":"<p><p>The urgent need for healthcare transformation in the United States has long been evident. The traditional system of healthcare in a community has typically revolved around the acute care center, whether these communities are in large city neighborhoods or in remote rural areas, hundreds of miles from tertiary or quaternary services. One way in which healthcare leaders can transform systems of care is by considering local acute care centers as one aspect of a larger care ecosystem. Healthcare's most expensive work is in the acute care center. By most estimations, 25 percent of that work is waste (Bauchner and Fontanarosa 2019). According to the most recent data by the Centers for Medicare & Medicaid Services (CMS), national health expenses grew 7.5 percent in the year ending 2023, with hospital expenses experiencing double-digit increases (Centers for Medicare & Medicaid Services 2025). Building systems of care with the highest quality of service in the most coordinated and cost-efficient manner is needed more than ever. Despite limited resources, we must begin to invest capital dollars in value-based care and promote it in capital investment conversations as the leading strategy for healthcare systems.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"42 2","pages":"40-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One OSF: Building a Unified Health System for the Future of Care.","authors":"Michelle D Conger","doi":"10.1097/HAP.0000000000000222","DOIUrl":"10.1097/HAP.0000000000000222","url":null,"abstract":"<p><p>Over the past decade, OSF HealthCare has undergone a bold and deliberate transformation to evolve from a collection of hospitals and ambulatory sites into a unified, high-performing health system. In an era marked by rapid industry change, escalating costs, staff shortages, and technology transformation, along with the need for consistent, high-quality care models across diverse sites, OSF recognized that its operating model would not be sustainable for its future in healthcare. Without a consistent operating model, members of the same organization would operate in leadership silos, have inconsistent strategies, and struggle to achieve operating efficiency, all of which could create internal competition. With a renewed vision of One OSF, the organization embarked on a journey to systemness by prioritizing integration, cultural alignment, and innovation. Leadership restructured core functions, such as analytics, human resources, IT, legal, marketing, and communications, while establishing centralized roles and enterprise-wide analytics to drive performance. Through the creation of the Integration Management Office, OSF brought structure and consistency to growth efforts, ensuring that new acquisitions shared the same values and standards without losing their local relevance. Systemness proved especially vital during the COVID-19 pandemic, enabling OSF to dynamically reallocate resources and staff across its care sites. Today, with a focus on delivery system redesign, virtual care models, and artificial intelligence (AI)-driven tools, OSF is building a sustainable, scalable healthcare model tailored to the unique needs of the communities it serves, including those in rural settings. This article explores the OSF HealthCare journey to systemness, examining how a clear vision, aligned leadership, and strategic innovation enabled a seamless care experience, while driving efficiency, resilience, and long-term viability across a growing network.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"42 1","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing the Voice of the Patient in Value-Based Care Initiatives: Lessons from International Experiences.","authors":"Richard L Gundling","doi":"10.1097/HAP.0000000000000216","DOIUrl":"10.1097/HAP.0000000000000216","url":null,"abstract":"<p><p>Health outcomes that matter most to patients-those that affect their quality of life-are considered an integral yet underutilized element of value-based care and payment. These metrics, which are captured by reports that come directly from patients without clinician intervention, are known as patient-reported outcomes (PROs). Public and private payers in the US are increasingly calling for the use of PRO measures (PROMs), which will require hospitals, health systems, and physician practices to invest in developing new organizational capabilities. The first steps in adopting PROMs are determining what to measure and choosing the right instruments. Beyond that, common challenges of PROMs implementation-such as engaging patients and clinicians, mitigating barriers to data collection and analysis, and identifying and following best practices-transcend geographic boundaries. This article shares lessons learned about overcoming these challenges from hospitals that have implemented PROMs in clinical care in the Netherlands and Sweden, which are among the countries that have a long history with PROMs. Selected resources for healthcare organizations beginning their PROMs journey are also included in the article, which is intended as a brief introduction to the topic.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"41 4","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the Healthcare Industry Can Effectively Respond to the One Big Beautiful Bill Act.","authors":"Jon Burroughs","doi":"10.1097/HAP.0000000000000235","DOIUrl":"10.1097/HAP.0000000000000235","url":null,"abstract":"<p><p>The One Big Beautiful Bill Act (OBBBA) contains $1.3 trillion cuts in funding to federal healthcare programs-including $1 trillion cuts to Medicaid and $300 billion cuts to the Supplemental Nutrition Assistance Program (SNAP)-mandating a significant response from the US healthcare system. Important responses to this sweeping legislation include an update of strategic and capital planning, optimization of revenue cycle management, labor and the supply chain, and development of new sources of nonoperating revenue to support the organization's mission. The OBBBA represents a movement toward a market-based healthcare system in which healthcare organizations must become less dependent on third-party reimbursement and more reliant on disposable spending, nonoperating revenue, and market-based demand.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"42 2","pages":"20-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}