Got Value?

It is typical for the healthcare industry to have not one but several movements going on at once, with less than a handful ever gaining enough traction to make a noticeable difference in the way providers deliver care to patients. But unlike many other attempts to change the system, the drumbeat for better healthcare value only gets louder and louder.

Since value sits at that precise intersection where cost meets quality, I suppose I wasn't surprised to hear so much talk about healthcare value last month at the Institute for Healthcare Improvement's National Forum on Quality Improvement; indeed, value took the center stage, spoken about most prominently and passionately during IHI President and CEO Don Berwick's opening remarks.

In essence, Berwick urged healthcare providers—from bedside caregivers to system CEOs—to reform healthcare at the community level and in the absence of real health reform legislation from Washington. He pointed to a few specific examples of communities—in Cedar Rapids, IA; Everett, WA; Tallahassee, FL; and La Crosse, WI—that were doing just that by providing above-average healthcare value.

Being a skeptical magazine editor, I asked Berwick whether it was, in fact, realistic to expect healthcare leaders to reform themselves in a transformative way, as he had suggested, without the cover of mandates from the government. He told me the communities that are providing the best value tend to have strong synergies between physicians and hospitals, and sometimes employers are highly engaged in working with providers to continually improve the community's healthcare value.

Even though we are not likely to see sweeping reform from the federal government, the realization that reimbursement will continue to shrink and the push for bundled payments will cause progressive healthcare organizations to react in ways that create better value for care delivery. Moreover, Berwick said, those physicians and hospitals that are already taking steps to work toward consistently providing healthcare value hoped that government reform efforts will not impose regulations that could negatively impact collaboration by confusing it with collusion.

Here at HealthLeaders Media we have had similar findings. Most recently these efforts to "reform without reform," as Berwick coined it, are reported in granular detail in Breakthroughs: Aligning Hospitals and Physicians Toward Value (www. healthleadersmedia.com/breakthroughs). In this free digital report, you not only can read about how four progressive health systems answer the call to bring value back to healthcare, but you can also see and hear directly from the senior administrative and physician leaders from Gundersen Lutheran Health System, Sanford Health-MeritCare, SSM Health Care, and Virginia Mason Medical Center.

As our digital report provides you with lessons on value, the editors of HealthLeaders magazine discuss in this month's cover story whether there's growth left if healthcare. We focus on five areas and list another dozen opportunities to improve reimbursements, decrease costs, and enhance services. Growth as it relates to organizational development does not have to come at the expense of value, and that will be a challenging message for health leaders to get across to physicians, employees, and communities in the face of demands to lower costs.

Rick Johnson
Editorial Director
rjohnson@HealthLeadersMedia.com