Finding efficiencies in care delivery

New horizons - 2013 health care industry report

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EY - Cyndy Nayer - Value­based insurance design

Throughout the country, innovative health care organizations are redesigning care to lower costs and to improve the health of their patients and their communities.

Hospitals are finding ways to coordinate more closely with physicians, other providers and payers to facilitate global payments, the medical home and other ACA-related initiatives. Payers are differentiating their plans to excel in the retail market. Providers and payers are innovating together in cost-saving measures, driven by a rapidly changing payment environment and the ongoing quest to deliver value.

Considerations for your board and executive leaders

For providers

  • How is your organization reducing costly readmissions and ensuring that patient discharges and care transitions are made safely and effectively? Is appropriate information being shared with patients, their family members and their next care facilities before discharge?
  • What processes are in place in your organization to help eliminate waste and identify improvements for greater efficiency?

For payers

  • Is your organization collaborating with provider partners in new care management strategies? Are you sharing data analytics with contracted providers to aid them in developing specific strategies to achieve better value for the costs incurred?
  • How are you engaging plan members in chronic care management and preventive care?
  • Are you and the major health care providers in your marketplace collaborating on strategies to create more value from the care delivered and to share rewards from the savings achieved? Is this a basic tenet of your provider contract negotiations?