When health systems consolidate and specialize, emergent transfers increase

When health systems consolidate and specialize, emergent transfers increase

November 25, 2019
Health IT
By Angie Franks

Healthcare merger and acquisition (M&A) activity increased 14.4 percent in 2018 over the previous year, led by agreements between hospitals, physician groups, home health agencies and long-term care facilities. Likewise, a quarterly healthcare M&A report from consulting firm PwC notes that these agreements are continuing at a brisk pace in 2019, increasing by 24 percent among hospitals, while physician groups’ and other services’ M&A grew by 17 percent and 14 percent respectively. The firm notes that “[h]orizontal integration (e.g., health system mergers) is likely to continue due to its potential to strengthen service lines or mitigate volume pressure and high costs.”

As health systems consolidate and specialize as predicted, maximizing patient volume and retention will be essential for long-term financial success.

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With much of a large health system’s higher revenue-generating patients coming from referrals to its specialty centers, organizations need to ensure the transfer process is as easy and simple for the referring physicians. Such transfers need to be managed by more than a call center, but rather a centralized care orchestration hub, staffed by highly skilled clinicians that ensures patients receive the right care, at the right location, without delay. Having the right processes in place can create operational efficiencies and cost savings, while meeting the broader mission of health systems to drive growth, stem leakage, increase revenue and ensure comprehensive access to all services.

The end goal is visibility throughout the enterprise, systems integration, and actionable insight. Such comprehensive awareness can avoid situations such as a patient being admitted to a specialty center when they could have been treated in a more general setting; or another patient who may be sent home to wait for an open bed when another hospital within the system has availability.

This capability is even more crucial when organizations are spread over large geographic areas. Limited and siloed data lead to cumbersome transfer processes, resulting in multiple wasted phone calls to the wrong physicians, waiting, and ultimately, extended care delays, which are unacceptable in emergent situations. Instead, agents working within a health system’s transfer center should have a real-time view of the enterprise’s facility capacity and provider availability across a broad range of specialties.

Evolving to a health system focused on improving care access should be about making it easier for patients and physicians to work with health systems. When a health system makes care access easier, referral bases expand and leakage to competitors decreases, even in consolidating markets.

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