Nearly all children’s hospitals articulate their vision and mission as some variation of providing high- quality care, 进行创新研究, 培训下一代医疗保健提供者, 改善社区儿童的健康和福祉. 同时将自己打造成“儿童医院”,” their visions and missions require the efforts of physicians and healthcare professionals who work both in the hospital and across the broader healthcare delivery system.
Often the children’s hospital and the employed specialists in the pediatric physician organization (PO) are managed as separate business units, 通常会导致功能性的“孤岛”,即使他们相互依赖以取得共同的成功.e., 增长, 护理质量, 经营业绩)和财务稳定, 以及最终他们执行集体使命的能力.[1]This is a partly a result of corporate structure and the way revenues are directed by the fee-for-service reimbursement model.
These operational silos can result in transactional relationships that put excessive administrative burden on the management teams, 排除医师领导参与医院决策, 未能使医院和PO的战略和财务利益保持一致.
与POs合作的儿童医院有效地发挥作用 综合儿童bet8网站备用 有许多优点,例如:
- 创造战略优势.
- 促进bet8网站备用敬业度.
- 减少碎片.
- 更低的基础设施成本和重复.
- 是否处于共同设定和实现绩效目标的最佳位置.
儿童bet8网站备用的五大核心特征
一个综合的儿童保健系统具有这些特点.
授权bet8网站备用领导和共享责任
综合儿童保健系统包括高级医师管理人员(例如.g., 实践CEO, 的pediatrician-in-chief, 医疗系统行政领导团队的首席外科bet8网站备用, 通常在矩阵报告结构中. The executive team drives the development and adoption of a shared vision and strategy for the collective system.
医院和bet8网站备用领导共同制定和推行区域扩张战略, 招聘, 资本投资, 教育, 研究, 以及项目的发展, bet8娱乐线, 和研究机构. Physician leaders are empowered and share accountability for the 增长 and performance of services across ambulatory and hospital settings; they are not limited to the PO. This arrangement acknowledges that strategic initiatives have little chance of success without physician buy-in and engagement.
金融一体化
考虑到大多数组织仍然在按bet8娱乐收费的环境中运作的现实, 大部分病人护理费用由儿童医院支付. 我们知道在大多数组织中, bet8网站备用的收入本身不足以维持临床实践的运作, 更不用说剥离用于补贴研究和教育投资所需的资金了. 结果是, 大多数POs依靠医院的临床和学术支持来补充专业费用.
Financially 综合儿童bet8网站备用 are transparent on the financial performance of the hospital and the PO; they collectively develop budgets and manage financial performance. Many have transitioned to budget-based approaches for managing the finances of the PO without the need for hospital subsidies or contractual deficit funding (avoiding the expectation that the PO must break even or better).
他们采用了基于绩效的资金流模型,该模型使用了激励机制(例如.g., productivity targets and quality/safety metrics) to align the financial interests of the hospital and PO. An integrated financial model avoids perpetual internal negotiations about contracts and one-off deals, which draw attention and focus away from collaborating on outward-facing strategy and make the organization less agile.
与社区供应商的综合网络
虽然儿童医院历来都是围绕专科护理提供bet8娱乐, children’s health systems have expanded their focus to deliver primary care in the community setting through direct employment or network affiliations with private practice pediatricians. 初级保健协调是基于价值的模式取得成功的基础. 在竞争更激烈的市场中, 与儿科初级保健保持一致是保持或获得市场份额的关键战略.
Children’s health systems are increasingly exploring partnership models with community hospitals as a way to provide lower-complexity care closer to where patients live. Comprehensive care systems with the coordinated delivery of pediatric primary and specialty care improve patient experience and physician satisfaction on hand-offs and follow-ups—and these are core components of executing value-based care initiatives.
联合管理医疗合同
与付款人共同签订合同, 代表医院和检察院, ensures that reimbursement decisions are made in the best interest of the enterprise rather than to benefit an individual business unit. 财务整合通常是有效的联合管理医疗合同的先决条件.
POs that solely rely on professional fee reimbursement to fund the compensation pool or to support academic efforts will inevitably have little flexibility to think differently about managed care strategy and other key financial decisions. 出于这个原因,基于业绩的资金流模型通常与收入脱钩. Effective joint payer 承包 allows the children’s health system to optimize reimbursement and best positions the health system to succeed under value-based models.
共享基础设施
Performance improvement and sustainability depend on maximizing efficiency and streamlining administrative expense. 共享资源——企业级收入周期, IT, 承包, 法律, and HR platforms—are more efficiently deployed and provide for broader scale and higher-performing support services than duplicate and siloed services.
The buildup of duplicative support services and staff within the PO or at the department level is an inefficient use of resources that could be better directed toward 增长 initiatives or the academic mission.
成功没有单一的模式
虽然许多组织已经达到了上述的一些特征, opportunities exist at most children’s hospitals to grow into a more integrated children’s health system through the achievement of all five core features. 某些特征在不同的组织结构中或多或少可行,[2] but higher performance through greater integration can be achieved in any organizational construct. 最终,儿童bet8网站备用的整体运作能力, 不管公司结构如何, 会是竞争优势和业绩加速器吗.
While many highly regarded children’s hospitals are financially and often corporately integrated with their PO, 在他们如何构建这种关系方面存在差异. The unifying theme is that successful organizations have committed to a shared philosophy of functioning as an integrated children’s health system that allows them to perform at their highest level.
Well-综合儿童bet8网站备用 are able to reduce fragmentation within their organizations. 他们更有能力提供高质量的产品, family-centric care in a way that improves the patient experience and ensures continuity of care as patients move through the healthcare system. 最终, this empowers children’s health systems to best achieve their overarching purpose: enhancing the health and well-being of the children and families in the communities they serve.
获得儿科护理是不同的.
学习改善病人体验的策略.
了解更多脚注
- 1.
这取决于组织, 可通过医院聘用儿科专家, PO, 或者大学/医学院. 在许多不直接受雇于医院的例子中, 他们的专业bet8娱乐是租赁或承包的.
- 2.
儿童医院的公司结构, PO, 还有医学院, 以及bet8网站备用的雇佣模式, 在不同的组织中是不同的,并且可能对完全集成造成(实际的或感知的)障碍.
出版于2022年5月31日