There’s a not so quiet revolution being fought in American healthcare today, and the victor will be determined by who is best at forming alliances.

Traditionally hospitals, physicians and ambulatory facilities have worked independently of one another. But, as value based care and population health management become the norm, that independence is rapidly becoming a luxury of the past.  To thrive in the emerging business environment, physicians, hospitals and benefits providers must learn to collaborate, with a shared focus on optimizing patient outcomes.

The fact is they really have no choice as illustrated by the new Comprehensive Joint Replacement or CJR model introduced by Medicare – and now mandatory in over 800 U.S. hospitals.

Under CJR, participant hospitals are responsible for the quality and cost of a patient’s knee or hip replacement.  That responsibility now extends beyond the hospital walls to include all of the treatment provided to a patient for 90 days following the procedure.  This means hospitals will need to work closely with physicians and post-acute care facilities to manage the cost and quality of post-discharge patient services.

Since Medicare will limit reimbursement for poor performance, noncompliant hospitals face substantial future financial downsides.

Adopting the new collaboration paradigm requires significant education for both physicians and hospitals as they learn to work together to provide patient care.  Hospitals must acquire the skills necessary to plan and deliver holistic patient care.  Physicians and ambulatory facilities must become experts at sharing patient responsibility across facilities.

The value-based healthcare revolution is real and its impacts are profound. How much better post-revolutionary life will be depends on how early and completely you embrace the changes it brings.


Call or click today to find out how KEUI’s experts can train you to face the healthcare challenges in 2016 and beyond.