Staffing Model Innovation in the NICU

Like all healthcare organizations, children’s hospitals face mounting pressure to reduce costs. Hospital leaders face the challenge of hitting ambitious new financial targets without compromising the quality of care. This is an especially delicate balancing act in the neonatal intensive care unit (NICU), where many of their sickest and most vulnerable patients are located.

In their article Needing More From Your NICU, ECG consultants Shelby Jergens and Clark Bosslet urge NICU leaders to turn a critical eye to their unit processes. They identify three areas that present the greatest opportunity for impactful change—staffing models, compensation methodology, and care coordination—and offer actionable plans based on what they’ve seen work with their clients. Here, Shelby and Clark talk about the work they’ve done with pediatric organizations around staffing model innovation in particular. Continue reading

Collaboration is Critical in Care Model Transformation

Organizations that want to transform the way they deliver care must have their physicians engaged in the effort – from the planning stages through implementation and beyond. Physicians are among the most influential stakeholders in a healthcare organization, and without their buy-in, organizations will struggle to meet the requirements of any new care model.

In a previous blog post, we watched an integrated health system pilot a patient-centered medical home (PCMH) model to great success, only to lose momentum when the model was scaled up across the broader system. Because physicians weren’t engaged in the process, the system failed to achieve true transformation.

In today’s blog post, we’ll see what happens when physicians are empowered to drive care model transformation. Continue reading

CMMI Remains Bullish on Bundled Payments

On April 18, as anticipated, the Center for Medicare & Medicaid Innovation (CMMI) announced it would be extending one of the few healthcare programs that has actually saved the government money. The Bundled Payments for Care Improvement (BPCI) initiative was originally scheduled to be a 3-year pilot ending in the fall of 2016. But now CMMI is offering current participants the opportunity to extend their participation in Models 2, 3, and 4 for an additional 2 years, through September 30, 2018. Continue reading

Oncology Medical Homes: Patient-Centered Care in the Specialty Realm

One of the foremost objectives of a patient-centered medical home (PCMH) is to reduce unnecessary specialty visits through effective management of acute and chronic illnesses. Invariably, though, some conditions require more costly specialty care. Among these conditions, cancer is notable for the extent to which it becomes the primary medical focus immediately upon diagnosis and establishes the context in which all other conditions must be managed. In that sense, PCMHs face particular challenges in managing patients with cancer, because much of their care transitions to specialists and settings that do not share the PCMH’s incentives for coordination, integration, and cost containment. Continue reading

Making Room for Specialists in the Medical Neighborhood

The patient-centered medical home (PCMH) model has historically focused on primary care medicine. The model was designed to promote comprehensive care – managing acute and chronic conditions, providing preventive services – by improving patient access to a care team. Coordination and integration are the hallmarks of such a team, which may include clinicians (PCP, APC), nurses (RN, LPN), medical assistants, administrative assistants, care managers, social workers, and others. One of the key objectives of such proactive care coordination and management is to keep patients out of more costly care settings, such as hospitals and specialists’ offices. Continue reading