Ruth Krystopolski

For too long, our system has focused on the volume of services provided, rather than the quality of care delivered. This approach has led to higher costs and inconsistent outcomes.     I recently participated in a CEO Panel at the AHIP Medicare, Medicaid, Duals & Commercial Markets Forum, where we discussed the future of health care delivery innovations. One of the key takeaways from our conversation was the importance of shifting toward rewarding quality over quantity to improve health outcomes, reduce unnecessary costs, and create a more sustainable health care system.      By incentivizing providers based on quality rather than quantity, we can create a more sustainable and effective health care system. This approach, which we've implemented through strong partnerships in our provider networks, has led to improved health outcomes and reduced costs for our members.     For example, the value-based Sanitas care model at our Florida Blue | Sanitas Medical Centers creates more seamless and coordinated care for our members that prioritizes prevention and early intervention. As a result, we've seen measurable reductions in avoidable hospitalizations and improvements in chronic disease management.      I'm proud of the work we're doing at GuideWell to create a more sustainable and effective health care system. By working together with providers and prioritizing the needs of our members, we can create a better future for health care.     #HealthCare #HealthCareOnLinkedIn #Innovation #Sustainability 

298

11 Comments

Every day, hospitals and health systems generate enormous volumes of data. Too often, that information is underutilized or not translated into action that improves patient care, reduces clinician burden, or drives efficiency.   Joint Commission recognizes that if we want to support healthcare organizations navigating today’s unprecedented challenges, we need to tap into the full power of our data. That’s why we’re introducing the Joint Commission Research Center, which consolidates our research capabilities into a single structure and will be led by Austin Frakt, former principal research scientist in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and co-founder of The Incidental Economist. The Center will give us a shaper lens into where quality and safety are making a real difference, and where they aren’t. That kind of data can help us refine our standards, improve survey design, and most importantly, give healthcare professionals actionable, real-time guidance.   Coming from a background in health IT and hospital operations, I’ve seen firsthand how actionable insights can transform performance. I believe the same is possible here as we continue to support healthcare organizations’ improvement journeys. Find out more about the Research Center here: https://lnkd.in/diw2BKRv   #PatientSafety #HealthcareQuality #Accreditation #HealthcareResearch

82

3 Comments

My Friday post about the continued struggles of VBC struck a chord and led to an excellent discussion. Pointing out flaws and shortcoming is one thing (and something we have plenty of in healthcare). Ultimately, offering solutions is more helpful. CMMI's struggles suggest that value doesn’t reliably emerge from controlling disparate portions of the care continuum. Taken independently, reducing postop acute care, avoiding unnecessary procedures and imaging, and nudging primary care toward risk leads to some gains -- but the whole isn't always greater than the sum of its parts. These mechanisms help, but they're rarely transformative. Rather than stacking up small wins, we should be figuring out how to re-wire the system. That's how to get the big wins that have been elusive. True value emerges when the full care pathway is redesigned from end to end. Not to avoid or gatekeep care, but to incentivize detection and early intervention while making sure patients get the right care, earlier, more precisely, and with better feedback loops. Start with prevention, risk profiling, and early diagnosis. Build pathways that encourage—not delay—high-quality, efficient specialist care. Create small, focused centers of excellence that do a few things incredibly well. Then loop the patient back to a central hub for long-term maintenance and proactive management. Create a coordinated cycle of care that prevents problems, identifies them early when they arise, and delivers the highest quality, most specialized care when needed. Closing the loop means cycling patients back to the central healthcare hub of maintenance and prevention. This isn’t vertical integration for financial ends or carrot-and-stick value mechanisms. It’s ownership of the entire care process for better outcomes. Call it VBC or something else. Either way, its broad systemic redesign, not another confusing, cumbersome, bloated program. #healthcare #valuebasedcare #innovation

58

20 Comments