All developed health care systems in the world are facing the same challenge: The demand for qualified medical service is increasing due to the phenomenon of an aging society and the cost-intensive progress in medical technologies leading to more precise diagnostic and innovative surgical procedures. On the other hand the health care sector suffers from strong financial limitations.
In order to overcome this conflicting situation hospitals and regional health care systems in the USA are striving to achieve the “Triple Aim”: Enhancing the patient experience of care, improving the health of populations and reducing the per capita cost of health care.
Hospitals and health care systems are challenged to develop innovative care delivery models focused on the whole person while improving the health of the communities they serve. All this must be done in the context of a payment and financing system that rewards high-quality outcomes and individual and population health (value-based care).
Kernel of this new approach of designing a health care system is a switch from a fee-for-service payment mechanism to bundled-based and population-based payment models.
Fig. 1: The “Magic Triangle” combines “Pay-for-Performance” with “Population-based Prevention” and “Informed Consent” decision-making.
In order to learn more about how to manage the “Triple Aim” and to figure out opportunities to transfer management experiences from U.S. hospitals to the German health care system a cohort of seven HHL part-time MBA students guided by the HHL health care expert Prof. Dr. Dr. Wilfried von Eiff visited the famous Institute for Health Care Improvement (IHI) and the Massachusetts General Hospital (MGH), which is ranked number 3 in the actual American Best Hospitals list, on September 15-16, 2016.
Fig. 2: Visiting the old medical theatre in the Massachusetts General Hospital (from left: PD. Dr. Torsten Prietzel, Clinic Blankenhain; Jan-Hendrik Unger, Mühlenkreis-Kliniken; Anna-Katharina Poppe, University Clinic Bonn; Prof. Dr. Dr. Wilfried von Eiff, HHL; Prof. Serguei Melnitchouk MD, MGH; Wilhelm Schleibach, CKM London).
At IHI the HHL students were made familiar with
- patient safety issues along the continuum of care,
- population-based health care service strategies,
- value-based payment models and
- person-and-family-centered care.
At the Massachusetts General Hospital (MGH) (see figure 4 on the right) the students got a deep insight in theatre management by “pooled open blocks” in order to shorten waiting times for non elective surgical cases and on the occasion of an emergency room visit (110.000 admissions p.a.) they were given the opportunity to learn about the basic design factors of an optimal emergency patient flow.
Finally, the HHL cohort attended a case study seminar on change management and behavioral economics (“How Micro-Moves can drive major health care change”) at Boston University Questrom School of Business and had the opportunity to site-visit CONTINUUM a world-wide operating design company that developed an innovative concept for a “Patient Room of the Future”.
„The purpose of this Boston site-visit program is to learn from best management practices and to discuss the transferability of innovative health service initiatives and reimbursement mechanisms to the German health care system“, says Academic Director Prof. Dr. Dr. Wilfried von Eiff.
The Boston site-visit program demonstrated the added-value of an international exchange of best management practices and innovative approaches in health services design as well. One of the most important take home messages the cohort got was the finding that the “Triple Aim” as a health care design strategy is transferable to the German system. Especially in combination with the “Boundaryless Hospital” approach, created by HHL health care experts, the “Triple Aim” is focused on “patient centeredness”, “healing environment”, “process optimization” and “integrated services contracts”.
The next Global Immersion Seminar in Boston including site-visits to important health care players is planned to take place in Sept. 2017.
- The site trip is also open for German health care managers interested in the US health care system.
- von Eiff will chair the session „The Triple Aim and the Role of the Boundaryless Hospital“ on the occasion of the EHMA (European Healthcare Management Association) congress, 13-15 June 2017, Bocconi University, Milan.