ACO & Finance
Posted by Edward Bleacher, II, MBA, CHFP, CRCR, FHFMA on July 24, 2018
When less business is better business.
In the shifting paradigm of healthcare business is an inflection point governing the law of diminishing returns. Historically, the more patients you saw, the more you got paid and the more income you generated. It was all variable reimbursement and straight fee for service. Currently a growing percentage of the business is paid based on the healthcare consumption of identified “attributed” populations.
Providers can earn additional dollars if they lower the overall longitudinal cost of their attributed population. The good news is that good comprehensive care is actually less expensive than sporadic and poorly coordinated care. Providers are able to lower the annual cost to care by being proactive and following optimal, high value, evidence-based care pathways to provide appropriate care in the appropriate setting.
As Cooper grows its population health footprint, the financial value of managing the total cost of the patients in the Cooper population becomes more important. As Cooper provides high quality, longitudinal services at a lower cost than other providers, it will be rewarded by sharing in those cost savings. High quality and lower cost is the definition of high value healthcare. This ultimately allows Cooper to prosper while our patients thrive. Avoiding waste and decreasing unwarranted variability in care allows capacity to be provided to other patients who may gather greater benefit. Ultimately, a high value model of evidence based quality care delivery results in less business per case, however, better health outcomes.
