Over the last few years, health care has continuously experienced dramatic shifts – in volume and acuity, care delivery, staffing, reimbursement, and public perceptions and expectations. The landscape will continue to change rapidly, creating an imperative for health care organizations to critically evaluate where to make changes and how to do so.
Health care will never again look like the pre-COVID norm, but there is a need to restore stability and sustainability amid market volatility. In order to continue delivering positive health outcomes, leaders must look for new ways to meet the needs of patients and clinicians, be able to continuously innovate as the environment evolves, and increase agility within their systems and structures. Consider these five strategies when evaluating your health system’s strategic plan amid market volatility:
1. Evaluate your program from a clinical quality and cost perspective, with a long-term lens
With the high rate of change in the industry and increasing strains on reimbursement, now is the time to look critically at the quality and cost of your current program. What worked for years is no longer enough and it’s time to ask yourself some tough questions.
- Is your program providing the level of care delivery and clinical quality needed to meet the needs of your patients?
- Are the acuity levels and delivered care accurately captured in documentation and represented in your reimbursement and revenue?
- Does your program provide the coaching, training, and development needed to effectively support clinicians?
- Will your program be able to survive in the current volatile market and is it sustainable in the long-term.
If the answer to any of these is ‘no’, consider that it may be time to make a change.
2. Better manage clinician relationships and clinician contracts
For many years, employing your physicians, nurse practitioners, and physician assistants, or outsourcing to a staffing-like company has successfully allowed organizations to manage their patient flow in the ED or hospital. This system did a reasonable to good job with quality of care and could generally at least break even. However, the significant changes in the workforce shortage and staffing environment have brought forth new challenges.
Volumes and acuity are all over the place, and the environment is seeing volatility in everything that once gave organizations any sense of consistency in their financials and how they work. Start-up companies are coming in to manage chronic care conditions, and payors are doing everything they can to keep patients out of hospitals.
As a result, organizations need to make changes in response to the decline in ED volume. Considering increased flexibility among your clinical team is key. Utilizing approaches such as dynamic scheduling to allow for more accurate coverage and converting emergency medicine resources to hospital medicine while still providing adequate staffing and surge plans in the ED are a few ways to address coverage challenges.
Additionally, with higher rates of burnout, there is an increased need to not just recruit clinicians, but to do it differently, and better, which isn’t easy. When recruiting, try looking beyond just filling the role and search for the right clinician. Once you find them, keep them with adequate support and development opportunities.
3. Expect employed physician groups to provide more financial, operational, and clinical output
Over the last couple of years, particularly with the No Surprises Act (NSA) and the payor response in place of the NSA, reimbursements have declined significantly in hospital and emergency medicine, making it harder to operate. Most importantly, it’s reasonable to expect things to get worse as the next layer of unforeseen consequences of the NSA rollout.
Work with a physician services program that is able provide a strong infrastructure and clear processes to help guide a comprehensive approach to care delivery, documentation, and billing. These foundations help to increase billing and reimbursement and allow your organization to operate at accurate acuity levels.
When it comes to staffing, utilizing a local only approach is becoming more challenging in today’s competitive market. Hiring emergency and hospital medicine clinicians can be difficult, consider partnering with a clinical company with the reach and support of a national network.
4. Connect clinicians to organizational goals and strategies
While staffing, particularly during this workforce shortage, remains a concern, it is no longer enough to just think about how to staff the emergency department (ED) or hospital medicine (HM) team. Identify how you can connect your clinicians and their performance to your organization’s strategies and goals.
For example, to reduce Length of Stay or Left Without Treatment rates, there needs to be an infrastructure in place that lays out how clinicians are trained, how they should work, and how emergency and hospital medicine teams can integrate to increase value. Such a system must include coaching and consistently teaching clinicians how to adjust their practice to provide better care and reduce those metrics.
Beyond improved care delivery and integration, it helps to programmatically approach connecting emergency medicine, hospital medicine, and billing. At times, you may find your approach necessitates a more robust infrastructure and well-utilized technology tools to achieve your strategic goals
5. Seek balance in all strategic areas
With razor thin margins and volatile changes in supply and demand, operating in today’s health care environment means organizations must create balance in their operations, requiring them to:
- Focus on patient care while intentionally leaning into a strong business foundation.
- Utilize integrated approaches and evidence-based systems to consistently deliver quality outcomes while retaining agility to meet changing needs.
- Develop talent by offering ongoing training and education to ensure high-quality care at the local level while requiring more regional and national support documentation and coding.
- Remain stable while embracing the future of health care through innovation and modernizing solutions.
- Work within the system while advocating for industry change.
Strategies need to remain flexible and agile to maintain balance throughout the market’s continuous shifts.
Collaboration and Change
Strategies such as the ones above may seem radical and hard to implement alone, but they are necessary to survive and certainly to thrive in today’s environment. If you’re struggling with how to take action and enact change, it might be time it to explore partnership options.
Led by clinical and operational experts, SCP Health collaborates with health care organizations to create scalable solutions to health care challenges. Contact our team to learn more about how we can accelerate your strategic goals while delivering exceptional patient care.