Medical Construction & Design

MAR-APR 2017

Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.

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48 Medical Construction & Design | M A RCH /A PR IL 2017 | MCDM AG.COM Healthcare networks and their facilities are facing multiple pressures including legislation, population health, the rise of consumerism and changing technology. These forces press healthcare institutions to adapt to remain competitive and profi table in a value-based system. Healthcare leaders are evaluating new strategies and design models to build a consumer relationship platform with new types of facilities/sites of care and to improve clinical quality and access. Bending the cost curve of healthcare is a major goal of health networks, consumers, insurers and legislators, alike. And since 2009, the healthcare law has required networks to adopt pay-for-performance measures, improved patient care and increased access. Even before the healthcare law, healthcare networks had begun to optimize overall performance by pursuing each dimension of the Institute for Healthcare Improvement's Triple Aim (2007): > Improving the health of populations > Improving the patient ex- perience of care (including quality and satisfaction) > Reducing the per capita cost of health Looking forward, the Triple Aim needs to consider the importance of place in creating a continuum of care, as no one size fi ts all. When considering the Triple Aim, it is important to acknowledge that patient care outcomes are not always synonymous with patient sat- isfaction and loyalty. Beyond legislative changes and pay- for-performance measures, patient outcomes and experi- ence should be the focus. Some may argue that place is covered within the Triple Aim's dimension of "improving population health," but with today's expansive continuum of care — from telemedicine to outpatient centers, regional hospitals and major academic medical centers — there is a need to introduce the impor- tance of place as a dimension all its own. Legislative changes The healthcare law tightened the reins on reimbursements through value-based pur- chasing, bundled payments and HCAPHS scores, eff ec- tively determining payments. According to the American Journal of Public Health's January 2016 analysis, 63 per- cent of healthcare payments are supported by governmen- tal programs. Any new social contract de- veloped by the new adminis- tration will continue to impact healthcare delivery, and it is unlikely that reimbursements will rise in the future. Many health networks continue to move forward in a value-based direction and see it as the right way to drive quality and af- fordability. Population health Population health research attempts to understand the root causes of disease, and ways to mitigate risk factors. According to David Kindig (2014), population health de- terminants are broken down into four categories: > Health behaviors (30 percent): Includes diet and exercise, along with tobacco and alcohol use > Clinical care (20 percent): Focused on access and The fourth dimension in patient care continuum m Aim A A A Aim Aim Ai AN D THE Im p ortance of P l ace Aim Quadruple Quadruple Ai Ai Ai Ai i i i i A i i i BY LOUIS A. MEILINK JR. & CHRISTINA GRIMES

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