Biomedical subjects
Publications and source records attributed to D J Brailer.
Managing care in integrated settings requires new frames of reference for assessing the cost and quality of care delivered. One approach, tracking episodes of care, has been discussed for decades, but it's been stymied by insufficient data. Now, the authors argue, the time has come for providers to develop episode-based protocols and outcomes measures that compensate for data liabilities.
Market shifts in health care reimbursement have made the improvement of clinical performance a key strategic goal for health care delivery systems, including hospitals, physician groups, and integrated delivery systems. This process requires a clinical management infrastructure, advanced clinical information technology, engaged physicians, and alterations to the strategic plan for the delivery system. Because the change to a clinical efficiency orientation takes several years for organizations to achieve, adoption of this approach must begin before markets become fully mature for managed care and most practicing physicians are aware of the change. This article outlines how to evaluate the costs and benefits of improving clinical performance and how to determine when an organization should begin making this change. It advises delivery systems executives to raise the priority of clinical performance improvement and to measure both the near-term and long-term impact of this approach on revenue, cost, quality, and market share.