This paper explores opportunities states could consider to improve their Medicaid programs, both to control spending and improve the program's performance.
In private health insurance, a focus on technical excellence in product development, pricing, underwriting, and claims handling can improve insurers’ bottom line—while easing their dependence on investment returns.
This new framework can help states improve their ability to design and contract for managed Medicaid programs for these individuals—and maximize the programs’ likelihood of success.
Beating the odds: Hiring and retaining an RN workforce to optimize patient outcomes and minimize unnecessary expense
Effective workforce management can increase RN retention, reduce absenteeism, and improve patient outcomes and experience. Here's how to get ahead of emerging challenges.
Two steps—increasing healthcare-sector productivity and improving healthcare-market functioning to better balance the supply of and demand for health services—would likely produce sufficient savings to lower medical cost inflation to the rate of GDP growth.
Traditional arguments for EHR implementation such as efficiency gains and meaningful-use incentives are insufficient to maximize a health system’s returns on its technology investments. However, clinically and operationally oriented sources of value can generate an additional $10,000 to $20,000 per bed in annual margin.
Digital technologies and applications have the potential to markedly enhance a payor’s profits. Leadership from the top is necessary to overcome the organizational resistance to change that can make a digital transformation difficult.
Our experience with clinical operations transformations in more than 200 hospitals across the US and overseas has shown that high performers tend to execute five things well.
An evolved approach to RN staffing, optimizing the nursing skill mix leads to lower costs, improved RN satisfaction and better patient outcomes. Here's how to get from 'here' to 'there.'
This series of articles examines transformational imperatives specific to health systems in the post-reform era, drawing on extensive work with healthcare stakeholders across the value chain.
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.
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.
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.
Although the ACA may 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.
Care pathways enable health systems (and other healthcare organizations) to make evidence-based decisions about where to focus improvement efforts.
Mandated upgrades to healthcare IT will demand heavy investments by providers but will help them minimize waste and standardize best medical practice.
Innovators—some from developing nations—have found ways to deliver care effectively at significantly lower cost while increasing access and quality.
Better procurement practices can help hospitals achieve rapid supply cost reductions of 20 percent or more and keep future cost escalations under control.