As we continue this Quintuple Aim series, we have discussed the need to improve the clinical professional experience to better support and enable our clinical workforce, the importance of serious investment in achieving health equity to ensure a population who is able to fully access care, and how using data to achieve those will organically drive better outcomes.? Working our way through the Aims, we arrive at lowering costs.? Can we, as an industry, invest in well-being, equity, and outcomes while simultaneously lowering costs??
It's no surprise to any of us that the rate of increase in the cost of care feels unstoppable.? Some key numbers to know from the
Centers for Medicare & Medicaid Services
National Health Expenditure (NHE) Survey [1] include:
It is safe to say that some of the efforts instilled to reduce the cost of care historically have not been successful.?? Notice on the above chart the accelerated increase in the cost of care starting in the late 1970’s.? The HMO Act of 1973 and the subsequent transformation of healthcare delivery from indemnity or fee for service to a managed care approach promised lower costs and better outcomes.
Unfortunately, the accelerated increase in the cost of care shown above indicates that this did not happen. While I am not claiming that managed care caused the increase in cost of care (we would need much more data to start making those assumptions) it is safe to say it did not keep costs managed. So, let’s focus on how we are going to leverage data to lower costs:
- AutomationWhere to automate so that it makes a difference while simultaneously improving experience? How to automate so that the predicted value is realized? Assess processes regularly, understand time to achieve a task, clicks required, value of each step, number of “hands” involved, and best use of technology. Don’t automate just to say you did, automate to reduce time spent, reduce workflow steps, minimize manual intervention, as well as improve accuracy and experience. If your automation isn’t reducing time/steps/interventions while improving accuracy and experience, it isn’t delivering value that will reduce costs. Revisit, revise, and retry. Mine your data, conduct time studies (use rapid assessment techniques so that this doesn’t become unnecessarily expensive), and talk to those doing the work. I assure you that they will have many specific suggestions about how to automate for the greatest impact. Imagine if your clinical workforce felt engaged in automation design. You would receive very informed input while also improving engagement and ownership from your workforce.?
- Artificial IntelligenceAt the risk of flooding LinkedIn with yet another POV about the recognition that AI will fundamentally transform our industry in the near and long term, a discussion about lowering the cost of care without sacrificing outcomes or experience, would be incomplete without acknowledging the need to embrace the use of AI as a key tool in our toolbelt. While healthcare is lagging behind other industries in the broad adoption and use of AI and we don’t have long to correct that, there is much to do to get there. Get your data in order, cleaned, and available. Curate large diverse datasets and build deep competency around responsible AI and unbiased data. Don’t let perfection be the barrier to progress and have a plan that you monitor and adjust continuously.? Small steps are progress, so start now.
- ActionThere cannot be enough emphasis on this point. The narratives around lowering costs, automation, data-driven, AI, and other topics are significant, where we see challenges in action and rigor around that action. Beware of "analysis paralysis", have a bias for action, and commit to real and measurable steps every day to achieve the desired results. This is done by using data to identify targeted and impactful interventions, creating a culture of willingness to try something new and adjust, and empowering small teams to decide and act. Overanalyzing, overthinking, and overengineering will ensure that your actions get delayed or have a reduced impact. Be agile, nimble, and decisive.??
Stay tuned for our final installment in this series, diving deeper into the Better Care Experience component of the Quintuple Aim.?
Still wondering what to do next or want some support from a team of experienced resources who have successfully helped other organizations? Reach out to us at Excell HCA and let our team help you achieve your cost-reduction goals.
