Quality and finance should be friends
By John Whittlesey
More and more, hospitals are finding themselves trying to figure out how to improve quality, not only for quality’s sake, but to minimize financial exposure. The U.S. Centers for Medicare and Medicaid Services (CMS) has laid the path by denying reimbursement for a host of Present On Admission (POA) conditions. If private insurers haven’t already followed suit, then shame on them.
One of the glaring holes that I see lies between a typical hospital’s quality management department and the finance department. Aside from setting the annual budget, very few managers in either area even speak to each other outside of the cafeteria line. Periodically, I ask either manager if one knows about the other’s annual performance improvement plans and goals. I also ask how these goals and plans may relate to the overall facility strategic plan. Then I get the proverbial deer-in-the-headlights stare. Intuitively, the different managers know their departments should be more integrated, but in the absence of a higher plan set by the senior team, it just doesn’t happen.
So I encourage hospitals with large cost, quality, and utilization issues to establish an annual – I’d love quarterly! – strategic summit with quality management and finance staff present to review individual strategic plans and see how they support each other. They can also look at ways to integrate their plans with initiatives meant to overcome the financial and clinical challenges facing the hospital.
Here’s a “top secret” tip: the HMC Benchmark gives you the answers, and we’d be happy to discuss it.
John Whittlesey is a principal at HMC.
