Hospital strategy puts sharper focus on care management instead of cost reduction needs

New York 23 March 1998 Health providers and managed care organisations prefer to invest more resources in case management, inpatient protocols, community education and other related items, because they believe all these elements of care management provide a higher potential for saving costs while at the same time optimising the quality of health care. As a result, cost reduction measures have dropped by nearly ten percent. This is the overall image as presented by the 1998 Environmental Assessment, which is based on a number of primary and secondary sources. This report on the major trends in the American health care industry, appears for the eleventh time under the title "Setting Foundations for the Millennium ".

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Health providers and managed care organisations prefer to invest more resources in case management, inpatient protocols, community education and other related items, because they believe all these elements of care management provide a higher potential for saving costs while at the same time optimising the quality of health care. As a result, cost reduction measures have dropped by nearly ten percent. This is the overall image as presented by the 1998 Environmental Assessment, which is based on a number of primary and secondary sources. This report on the major trends in the American health care industry, appears for the eleventh time under the title "Setting Foundations for the Millennium ".

The 1998 Environmental Assessment has been released by Deloitte & Touche, a worldwide accounting and management consulting services company, and VHA, a network of community-owned health care organisations. The general theme in this study forms the enhanced attention health care providers are paying to care management, information systems and outcomes improvement. On the other hand, findings show that cost reduction will decline in importance over the next three years to come. This strategic priorities shift highlights the future concerns of the health care community, such as the continued compromising between competing consumer demands, the physician's position towards the increasing managed care pressure, the realistic implementation of information technology, and the call for higher functionality of integrated delivery systems.

Health care consumers are likely to choose a hospital that offers customised services and appropriate programmes, corresponding to the specific needs of the community which it is serving. Hospitals need to emphasise on patient satisfaction and functional improvement. However, hospital clients consider the relationship between cost and quality of services to be hardly relevant as a differentiating factor among health care facilities. It remains difficult for providers though, to find a balance between service-conscious individuals on one side, and cost-conscious major purchasers of health care on the other. The successful health care organisation will have to juggle in order to satisfy both opposed needs.

The independent physician is challenged to find a positive answer to the managed care pressure. A great deal of them search for protection in group practices. Still, more practitioners than ever are working as employees in capitated organisations. The Environmental Assessment clearly shows that the majority of physicians practices, owned by health care organisations, are not making profit. Neither do companies supplying physician management services. Yet, the future looks promising as incomes are on the rise. In addition, opportunity knocks for most physicians to take on stronger strategic and governance roles since overall care management is gradually replacing individual disease management. Nonetheless, compensation undoubtedly will follow a major trend towards risk-based payments, according to the report researchers.

As for the integration of Information Technology (IT), health care providers have abandoned the idea of implementing futuristic technologies. They wish to rely on a basic infrastructure of hardware and software, which offers effective key applications and is able to exchange information among various entities. The concepts of data warehousing and voice recognition benefit from a growing interest, as well as telemedicine applications and local area networks (LANs). The general IT architecture comprises the older existing systems and primarily has to deliver timely and accurate patient information on the right spot.

The outcomes of integrated delivery systems have turned out less favourable as expected. Managers are starting to revise their philosophy of vertical integration. They now understand that the creation of a culturally meshed and highly efficient integrated delivery system will take the patience of an angel and the resources of a millionaire, embedded in a long-term strategy. Thus, the 1998 Environmental Assessment illustrates the future challenges in the health care industry and presents an elucidating view of the total health care landscape in the States.


Leslie Versweyveld

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