BEYOND THE FACILITY MASTER PLAN: How to Develop a System-Wide Access Strategy Create access points around emerging patient needs Understand the individual patient journey Design sustainable economic viability AN EXECUTIVE STRATEGY WHITE PAPER FROM HAMMES COMPANY
A NEW PARADIGM FOR HEALTHCARE STRATEGY Powerful trends are driving rapid evolution in the healthcare industry. Changes in reimbursement and consumer expectations are forcing providers to increase quality and improve the patient experience while simultaneously lowering costs. As a result, the focus of healthcare facility strategy is shifting. Historically, the master planning process focused on hospital campus expansions. Today, advanced healthcare strategy focuses on designing an entire network that delivers quality, efficiency, and convenience for unprecedented growth in insured populations. The objective of a healthcare access strategy is to connect patients to the right care in the right setting at the right cost. This white paper presents three broad steps for developing a system-wide access strategy. Healthcare leaders can use these steps to launch internal discussions about access and begin developing a powerful strategy for the coming decades as baby boomers progress through their peak healthcare consumption years. OUR EXPERT PANEL This white paper was developed with input from a panel of leading national healthcare strategists: Meta Dooley, Senior VP of Strategy Development, Catholic Health Initiatives Jeff Kraut, Executive VP of Strategy and Analytics, Northwell Health John Pierro, Chief Operating Officer, Steward Health Care Holly Sullivan, Director of Strategic Partnerships, Spectrum Health Rex Holloway, Regional VP, Hammes Company 2
1. UNDERSTAND THE INDIVIDUAL PATIENT JOURNEY With the rise of healthcare consumerism, patients increasingly expect providers to deliver care quickly and conveniently. As such, healthcare strategic planning must begin with an understanding of the patient experience. Healthcare is a personal journey, and we need to evaluate individual preferences and design delivery methods around those preferences, says Meta Dooley, senior vice president of strategy development at Catholic Health Initiatives. Access strategy is about creating a network that is tailored to the individual. Presence Health-Healing Arts Pavilion, Romeoville, Illinois WHAT DOES THAT MEAN FOR HEALTHCARE STRATEGISTS? Strategy must put convenience front and center. Network design should ensure patients receive services quickly and easily. Patients follow the path of least resistance, and once you introduce any level of hassle, they are gone, Dooley says. With proper design, patient access call centers can improve appointment scheduling, recovery issues, and care follow-ups. More valuable data is essential. Analyzing your market by neighborhood is no longer enough. Leading strategists are now using advanced predictive analytics to understand patient choices and design total networks that optimize patient access at the neighborhood level, Rex Holloway says. Cost efficiency is key. Because of the rise of highdeductible health plans, healthcare consumers increasingly demand cost transparency, says Jeff Kraut, executive vice president of strategy and analytics at Northwell Health. Healthcare strategy must focus on providing these consumers with affordable alternatives. 2. CREATE ACCESS POINTS AROUND EMERGING PATIENT NEEDS Once the patient journey is analyzed, a clinical network must be designed to optimize patient access. This implies a strong foundation of ambulatory care sites, including strategically sited physician offices, diagnostic centers, surgery centers, retail clinics, and urgent care centers. Lobby at Presence Health-Healing Arts Pavilion, Romeoville, Illinois According to Jeff Kraut, today s strategists also need to think beyond facilities. Access cannot be reduced to bricks and mortar, he says. It also means delivering a level of convenience, cost control, and quality that patients typically associate with other industries. My nightmare is Wal-Mart, Amazon, and the Ritz-Carlton coming together to deliver healthcare. HOW CAN HEALTHCARE STRATEGISTS APPLY THIS PRINCIPLE? Improve access without breaking new ground. Better access does not necessarily require a new building. Health systems can improve access through less complex changes, such as establishing extended clinic hours to accommodate working families, or streamlining lab processes to enable rapid delivery of test results. 3
Aim for personalization. According to Holly Sullivan, director of strategic partnerships at Spectrum Health, same-day scheduling is just the starting point of a strong access strategy. Leading health systems are accommodating patient preferences regarding how they make appointments, where they receive services, and which channels they use to communicate with caregivers. Develop a digital platform for patient engagement. Digital access is becoming an important dimension of patient access. A strong digital platform might include enhanced telehealth capabilities for both primary care and specialty services, smartphone apps that give patients and providers new tools for managing chronic conditions, and an online portal that lets patients manage the full range of their health services. Incorporate care coordination into your strategic plan. As healthcare organizations shift their focus from inpatient care to the patient experience as a whole, they should provide care coordination across the continuum of access points to optimize the goals of treatment and care. 3. DESIGN SUSTAINABLE ECONOMIC VIABILITY Access strategy faces two financial obstacles, both of which call for creativity and flexibility from healthcare leaders. Cost control. To get this access paradigm to work, you need to decrease the cost of care, says John Pierro, senior vice president of facilities and operations at Brigham & Women s Hospital. And the way to do that is to reduce the costs of the physical manifestations of care by increasing clinical density. As Americans become more and more tied to at-yourfingertips access, as research and new technologies yield new care and treatment options, and as changes in consumer behavior and technological advances lead to underutilized facilities, costs can be controlled by rethinking the who, what, where, when, and how aspects of space usage. One promising cost control solution rooted in creativity and flexibility is virtual health. Telehealth can reduce the need for clinical space and repurpose underutilized buildings. This technology is mainstream and offers reimbursement opportunities amongst other cost savings benefits. Modern design strategies must look at cost control and cost effectiveness from both short- and long-term perspectives to ensure facilities can adapt and change to evolving processes and care methodologies over time. Cost-control strategies must also meld creativity and flexibility to divide care and treatment spaces in ways that optimize utilization, workflow, and patient care. Incentive alignment. To optimize patient access, the entire system must work together to provide patients with the right care in the most convenient settings in the most cost-efficient manners. Under a completely value-based payment system, it would be possible to reimburse all entities according to their contribution to this outcome. However, under the current mixed payment system, there can still be winners and losers within an otherwise successful network. For example, a medical office building may not be profitable, but it houses services that are critical to the success of the entire ambulatory network. The same could be said of service lines with individual profit and loss accountabilities. To address alignment challenges, healthcare leaders need to establish internal systems for orchestrating goals and success metrics. They also explore options for selectively partnering with outside organizations. Well-designed mergers and affiliations offer the opportunity to create financial win-win opportunities for multiple parties while filling gaps within the continuum of care. REQUIRED: NEW VISION + NEW TOOLS In today s rapidly changing healthcare environment, facility development strategy needs to look beyond the master plan. Healthcare leaders must focus on access strategy: a new approach to development that brings together facility planning, financial management, and healthcare strategy. The key to creating a strong healthcare access strategy is leveraging new tools that help visualize gaps in service and pursue new opportunities for delivering high-value patient care. 4
THE AUTHORS Chris Kay is the President and Chief Operating Officer of Hammes Company. Chris is responsible for directing the Company s service line META divisions DOOLEY and regional locations. Chris has over 30 years Senior of project VP of Strategy management, Development, operations and business development Catholic experience Health Initiatives in the building industry, spending the last 17 years of his career exclusively focused in the healthcare and life sciences markets. Chris is often quoted in national publications and speaks regularly at various industry associations and trade groups. Mr. Kay can be reached at ckay@hammesco.com. REX HOLLOWAY Regional VP, Hammes Company JEFF KRAUT Executive VP of Strategy and Analytics, Northwell Health HAMMES: YOUR VALUABLE RESOURCE Hammes Company has been ranked by Modern Healthcare as the No. 1 healthcare facility developer for 16 years. Hammes has managed in excess of 57 million square feet of complex new, expansion, renovation, replacement, ambulatory care, and acute care projects with a value of over $23 billion for hospitals and health systems nationwide. Hammes represents extensive experience managing the planning, financing, development, construction, leasing, and management of non-acute and acute healthcare facilities. Hammes has helped many of the nation s leading healthcare organizations plan, implement, and manage facility strategies and solutions for more than a quarter of a century. The company delivers measurable results that help healthcare providers grow while meeting the unique health and wellness needs of their communities. Hammes is headquartered in greater Milwaukee, Wisconsin, and provides services through a network of regional offices strategically located across the country. JOHN PIERRO Chief Operating Officer, Steward Health Care HOLLY SULLIVAN Director of Strategic Partnerships, Spectrum Health For more information on access strategy, please visit, www.hammesco.com 5