PRACTITIONER APPLICATION: Strategies for Delivering Value-Based Care: Do Care Management Practices Improve Hospital Performance?

Jain, Thorpe, Hockenberry, and Saltman address a critically important strategy for delivering value-based care: the relationship of care management processes with hospital performance. The value-based care payment structure affects not only the delivery and quality of care but also the future viability of healthcare organizations. As delivery and payment models continue to make the transition from a volume-driven structure to a more patient-centric care management model, organizations and individual care providers must raise the bar on their performance. The authors state that a hospital’s ability to perform well in value-based care has more to do with its internal organizational processes than the structure of the organization. As a hospital leader, I have also found this to be true. Yes, there are significant initial costs associated with implementation of foundational changes in care management and coordination. Over time, however, these changes can yield increasingly positive results for the patients’ well-being and the organization’s value-based care metrics. The initial, incremental changes accelerate as providers gain a deeper understanding of the new model of care delivery and their individual and team roles in the outcomes. Central to our successful implementation and positive outcomes was transparent and frequent communication among all team members in the organization. We achieved this success via multiple avenues of communication, and one of the most effective channels was the use of clear, concise dashboards that outlined results as compared to benchmarks and best performers. Healthcare providers are driven by evidence-based data, and information that is prominently displayed and shared across the organization advances adoption of the new strategies to better serve the patients. In addition, communication of vision and objectives for care delivery must be fully aligned throughout the organization, starting with the CEO and continuing through the chief medical officer and chief nursing officer. I further believe that focusing on financial metrics alone will not improve quality and lower costs to any meaningful degree. Internal processes also must be restructured, and the voices of the patient and providers must be considered. When value-based care initially began to make an impact on financial performance, the dollars at risk for any given organization were low. As the value-based care model has evolved, the dollars at risk have increased. My experience supports a slow start to learn