As healthcare evolves, key customers will also have to evolve. Cleveland Clinic is among those organizations who are leading the way. Through a wide array of different ventures--some of them involving futuristic devices while others are simply new business models--they are fighting to stay profitable amidst the turmoil in our healthcare market.
Dr. Delos M. Cosgrove, a 74-year-old former heart surgeon who took over as chief executive about a decade ago, likens what is happening in health care to the upheaval decades ago in the steel industry, where companies disappeared when they were unable to respond to change and new competition. “The disruption is going to happen,” he said. As an inevitable shakeout takes place among health care institutions, a look at how the clinic is responding underscores the industry’s challenges and the flurry of activity taking place as institutions try to adapt.
Here are some of the ways that they are changing the way they operate in one low-income neighborhood:
We are doing things differently,” said Dr. Nana Kobaivanova, the medical director for the Stephanie Tubbs Jones Health Center, the facility that was built to replace Huron, which was demolished.
The Huron location has been designated as green space, with grass planted where the building stood. The health center’s doctors have shifted their emphasis to preventing disease and managing chronic conditions, with primary care consisting of about 40 percent of what they do.
A patient with diabetes could take a cooking class to learn how to eat healthful foods and work with a diabetes educator on how to better manage the disease.
The facility recently expanded the hours of its separate walk-in clinic, where patients with sprained ankles or sore throats can come in without appointments, and it is trying to persuade people who go to the emergency room for their basic medical care to visit the walk-in clinic instead.
They are also looking to provide more efficient care:
The clinic cut expenses by roughly $500 million last year. The system is avoiding unnecessary lab tests, for example, and performing a hip replacement for $1,500 less than it did two years ago by standardizing the devices used and using less blood and other supplies, all, it says, without sacrificing quality. Its doctors are typically on salary, making it much easier for the clinic to work with them to figure out how to better care for patients.
“Our biggest challenge is managing all the change,” said Mr. Glass, who is also trying to handicap the odds of whether the Supreme Court will rule against allowing subsidies for people enrolled in the federal health insurance exchange in states like Ohio.
There is also tremendous uncertainty as systems prepare for payment systems that have not yet been fully developed. But systems cannot afford to wait, said Jeff Hoffman, a consultant at Kurt Salmon. “You have to move forward,” he said. “This is something you cannot flip a switch on.”
They are tracking patients more closely to follow outcomes and changing the way they deliver care:
To prepare for these changes, the system has invested heavily in the computer systems that allow it to track patients in different settings and look closely at how they are managing their care. Systems like Kaiser Permanente in California have long used clinical information to better manage the patients they insure under their own health plans.
Under Dr. Cosgrove, the clinic has emphasized the need to measure patient outcomes and other information to better judge how well it is delivering care. “We should have the very best shot at figuring out what is optimal care,” said Ms. Huston, the chief strategy officer.
The question for many health systems is whether they need to add a health plan to their portfolios. While Dr. Cosgrove says he thinks the clinic will be soon assuming the risk of providing care under the new arrangements, potentially losing money if care is too expensive or ineffective, he is reluctant to take the plunge into insurance. “That’s a tough dilemma,” he said.
Read more about the many changes here: http://www.nytimes.com/2015/03/18/business/cleveland-clinic-grapples-with-changes-in-health-care.html?mabReward=R1
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