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Healthcare Systems & Services

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The post-reform health
system: Meeting the
challenges ahead
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This series of articles provides an overview of core concepts and approaches that have successfully advanced the strategic positioning and performance of US health systems. The insights are drawn from our extensive research and experience over the past 24 months with stakeholders across the value chain.

Articles in this compendium

Engaging physicians

Engaging physicians to transform operational and clinical performance

Health systems (and health plans) that are serious about transforming themselves must harness the energy of their physicians. To do so, they must develop a true ability to engage physicians effectively.

Creating and sustaining change

Clinical operations excellence: Unlocking a hospital's true potential

A multiprong approach that puts physicians—and clinical care—at the heart of performance transformation efforts can help hospitals and health systems deliver more financially sustainable, patient-oriented, and physician-friendly care.

Clinical operations excellence

Creating and sustaining change in nursing care delivery

By giving nurses more control over their work environment and more opportunities for professional advancement, hospitals and health systems can reduce nurse turnover, lower costs, and improve patient care.

Academic medical centers

Academic medical centers: Transformational imperatives to succeed in the new era

Operating margins at AMCs are under severe pressure, placing their tripartite mission at risk. To survive, AMCs need significant structural and cultural changes. Five steps are imperative if they are to navigate the challenges ahead.

The smarter scale equation

Hospital revenue cycle operations: Opportunities created by the ACA

Although the ACA will make revenue cycle operations more complex, it also presents an opportunity for providers to improve, excel, and differentiate. By adapting their RCM operations and acquiring new capabilities, providers could open up opportunities to win.

Hospital revenue cycle operations

The smarter scale equation

Given today’s realities, health systems must look beyond the traditional  economies of scale if they want to reap the full benefits of M&A. They must consider other economies that M&A can offer, commit themselves fully to the effort, and execute flawlessly.

The impact of coverage shifts

The impact of coverage shifts on hospital utilization

For most health systems, the one-time impact of expanded insurance coverage on utilization will be small but significant (nearly 100 basis points in margin for the average provider). Systems that can capture a substantial share of the increase in utilization may gain a competitive advantage.

Winning strategies

Winning strategies for participating in narrow-network exchange offerings

In the post-reform era, payors will attempt to capture savings by creating limited networks with reduced reimbursement rates. To respond, health systems need a clear understanding—market by market—of their competitive advantages and of when, if, and how to trade price for volume.

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