Meeting the Needs of an Aging Population
Source: Executive Insight – April 6, 2011
By: Ron Wince, Guidon Performance Solutions
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Healthcare leaders must recognize shifting realities and take the necessary steps to address the changes.
Some 3 million baby boomers became Medicare eligible this year alone. Efficient and fair Medicare reimbursement is becoming an even greater challenge. Add to that the uncertainty of the full impact of healthcare reform, and it may seem as though hospitals and healthcare facilities are staring into the perfect storm.
Doctors, administrators and others involved in healthcare know that an influx of older patients carries with it both health and financial issues that will further burden a struggling healthcare infrastructure. But this is one perfect storm that doesn’t have to be disastrous, provided that healthcare leaders recognize shifting realities and take the steps necessary to address those changes:
Step One: A Shift in Patient Population Means a Greater Focus on Outpatient Care. Several million new patients on the Medicare rolls represent a major change in demographics. Moreover, it’s a demographic whose care will be addressed in part through means other than a traditional inpatient model. An aging population, while still needing inpatient treatment for such chronic conditions as cancer and diabetes, will also require more intermittent outpatient care to manage arthritis and other less serious illnesses. That means hospitals need to shift their business model to place greater emphasis on varied forms of outpatient care programs, facilities and other types of ready access sources. This is particularly critical for facilities in warmer climates, which are attractive to retirees.
Step Two: Understand that “If You Build It, They May Come.” Merely setting up clinics, immediate care and other sorts of satellite facilities doesn’t guarantee an avalanche of patients. It’s important to recognize that, as you establish such facilities, you’re also taking on new competitors in Walgreens, Wal-Mart, competitive immediate care clinics and other options. Therefore, just don’t build something and wait for patients to arrive. Instead, determine why patients would choose your facilities over those competitors.
Step Three: Walk the Patient Path. Why do patients opt to go to a pharmacy for routine care in lieu of contacting their usual doctor? Speed and simplicity are two reasons. You don’t need to schedule an appointment for a flu shot; nor, for that matter, do you have to sit in a waiting room for a half an hour for what amounts to a 2-minute procedure. To consistently deliver superior patient experience in the most efficient manner possible, walk the patient path. Review every step involved in a patient’s experience to see what can be streamlined and improved, from the moment they walk in the door to the time they leave.
Step Four: Get Ahead of the IT Curve. Technology should mean more than compliance with meaningful use (although, of course, that is important in terms of financial incentives.) Rather, technology should be implemented to better the entire patient treatment process, from distribution and monitoring of prescriptions to the electronic exchange of critical health data. Moreover, don’t introduce technology that merely replicates an outdated system or is disconnected with the processes it’s designed to manage. Make certain the technology you choose works hand in hand with your processes to make them more efficient. Investing in the proper IT infrastructure can help build the outstanding service that’s central to all forms of patient care.
Step Five: Enlist “The Voice of The User.” Physicians and other healthcare professionals can listen to a technology consultant speak until he’s blue in the face without even coming close to being won over to the benefits of new technology. That takes a solid, proactive sponsor -- ideally, a physician. Once a prominent caregiver is convinced of the merits and efficiencies of any new technology, you have a powerful and persuasive point person who can encourage other members of the team to fully embrace new technology and new systems. This “voice of the user” is critical to making the most of the efficiencies that technology can provide.
Step Six: Revisit the Revenue Cycle. The issue of reimbursement is becoming increasingly complex and shows no signs of getting any more straightforward in the near future. The ability to efficiently and effectively navigate reimbursement landmines will prove critical to providers to avoid penalties or delays in getting paid. And, while many organizations have already made efforts to streamline and improve their claims processing, most will find it necessary to take another look within the context of newly emerging regulations.
As the American population -- and baby boomers in particular -- grow older, hospitals and other healthcare providers will continue to be caught in the quandary of providing superior patient care while remaining financially viable. Fresh business models that focus on a shift in how care is provided, coupled with a wholehearted commitment to technology to streamline patient care and billing and reimbursement procedures, are several critical steps toward that objective.
All contents © 2011 Executive Insight. All Rights Reserved.
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