Health Care Providers Need a Value Management Office

Robert S. Kaplan; Catherine H. MacLean; Alexander  Dresner; Derek A. Haas; Thomas W. Feeley

Article | Harvard Business Review (website)

Health Care Providers Need a Value Management Office

by Robert S. Kaplan, Catherine H. MacLean, Alexander Dresner, Derek A. Haas and Thomas W. Feeley

Abstract

Many health care organizations are striving to implement a value agenda that delivers better patient outcomes at lower cost, medical condition by medical condition. To accelerate the dissemination and adoption of the value agenda, across many more medical conditions, leading institutions, such as MD Anderson Cancer Center and the Hospital for Special Surgery, have established a new central office to oversee the creation of all the capabilities and information for measuring and improving outcomes and cost, setting priorities for continuous improvement projects, facilitating the creation of value-based payment models with insurers and employers, and ensuring that new information technology platforms are aligned with the value agenda.

Keywords: Service Delivery; Value; Health Care and Treatment; Health Industry;

Format: Electronic

Citation:

Kaplan, Robert S., Catherine H. MacLean, Alexander Dresner, Derek A. Haas, and Thomas W. Feeley. "Health Care Providers Need a Value Management Office." Harvard Business Review (website) (December 2, 2015). (Part of the “Leading Change in Health Care” series, a collaboration of the editors of Harvard Business Review and NEJM Group.)

Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated specialists. The study used time-driven activity-based costing as a tool to measure and compare costs across the six sites. The results demonstrate that the four IPU sites improved clinical outcomes and had lower costs of care.

Value-based care models are becoming instrumental in structuring clinical care delivery in our healthcare climate. Our objective was to determine the value associated with implementation of a Family-Centered Care Coordination (FCCC) program for neonates undergoing tracheostomy.

Article | American Heart Journal

Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?

R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al

We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern management methods to achieve excellent patient outcomes. We use variance analysis to remove the effect of differential prices paid for personnel and space at the three hospitals. NH, even at U.S. price levels, retains a cost advantage over the two U.S. hospitals by shifting tasks to less-credentialed and/or less-experienced personnel, supervised by highly-skilled personnel, a practice facilitated by NH’s high annual CABG volume. NH offsets some of its task downshifting cost savings by having lower-skilled employees spend more time counseling patients and their families for in-hospital and home recovery. NH’s cost-saving practices could be captured by U.S. hospitals by relaxing hospital and health professional licensing regulations, encouraging greater family participation in inpatient care, and performing complex surgeries in high-volume regional centers of excellence.

Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Organizational Structure; Performance Efficiency; India; United States;

Citation:

Kaplan, R. S., F. Erhun, V.G. Narayanan, B. Mistry, and K. Brayton, et al. "Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?" American Heart Journal 224 (June 2020): 148–155. View Details

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Health Care Providers Need a Value Management Office

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