Skip to main content

How to Motivate Clinical Staff for Value-Based Purchasing

 |  By kminich-pourshadi@healthleadersmedia.com  
   September 26, 2011

As a healthcare financial leader, you’re probably well aware of the performance-based penalties and rewards that accompany value-based purchasing (VBP). But is your clinical staff? How do you motivate healthcare professionals to drive down costs and improve quality to meet the directives of VBP? I can think of three possible approaches:

  1. The big picture – Explain the potential penalties and rewards and show how these could impact your organization’s financial future
  2. The pocketbook approach – Add incentive bonuses tied to specific quality and patient satisfaction metrics
  3.  Moral obligation – Depend on your staff’s desire to “do the right thing”

What’s the answer? Well, if you and your organization are anything like the panel of five CFOs I interviewed at the recent HealthLeaders Media CFO Exchange, then the answer is likely a combination of incentives and moral obligation.

Frankly, I would have thought an explanation of penalties and rewards would have been the first step. But this group of CFOs agreed that people at the director level already knew exactly how much their organizations stood to gain or lose from VBP. Staff at the clinical level, however, weren’t using VBP financial information.

Now, using hard numbers with the clinical staff isn’t an implausible approach, and it’s been done before with some success. Think of the many hospitals nationwide that launched campaigns encouraging staff at every level to cut costs, setting visible savings goals for each department. After all, margins are thin for most hospitals and health systems these days, and employees know it.

When it comes to VBP, aren’t clinicians really the ones tasked with putting the “value” back into care? Hard numbers should help enlighten staff on the potential financial affect—not just the quality impact—of VBP, right? Wrong.

Charlie Hall, executive vice president and CFO of the five-hospital system Piedmont Healthcare in Atlanta explains that clinical staff aren’t as concerned with the hospital’s financials; although Piedmont’s physicians are well aware of the quality metrics used for VBP because these are used in their bonus incentive plans.

“There are financial implications if the physicians don’t meet the metrics. It does put some attention on [VBP] as it affects them personally,” Hall says. Nurses, on the other hand, aren’t as focused on the financial outcomes of value-based purchasing as they are with care-giving.

It makes sense to align your physicians’ incentives to the core measures being used for value-based purchasing, because where they lead, others follow. But what is the non-physician clinical staffs’ impetus to achieve the end goal?

“When you identify and communicate to the masses what the right thing to do is, rather than how it is financially beneficial, they respond,” says Ann Pumpian, senior vice president and CFO at Sharp HealthCare, an eight-hospital system in San Diego.

“We just try to approach [VBP] as the right thing to do, quite frankly,” says James Moylan, vice president of finance and CFO at Griffin Hospital in Derby, CT. “We’re a hospital; we’re supposed to be doing this. It’s the right thing to do, and here’s all the literature about cutting down on infections.”

Moylan acknowledges that challenges come with the moral obligation approach, such as trying to educate the staff on what value-based purchasing is about. “That’s why we’re doing audits. It’s a kind of peer pressure if you’re not doing what you’re supposed to be doing,” he says.

So to sum up, to get your staff on board with VBP, moral obligation and peer pressure can be a successful carrot and stick, while still saving money. 

Pumpian says the key to this approach is for healthcare leaders to “identify the clear connection of cost savings with an act, and then implement that act in a manner in which everybody understands it to be the ‘right thing to do.’”

Perhaps one of the best lessons learned from these CFOs is that, for healthcare workers, value-based purchasing is not primarily a financial or clinical initiative. Instead, you must understand and harness the moral nature of your team.

Karen Minich-Pourshadi is a Senior Editor with HealthLeaders Media.
Twitter

Tagged Under:


Get the latest on healthcare leadership in your inbox.