Value Project Identifies Strategies for Value Transformation Part Two

Last week we presented the Healthcare Financial Management Association’s (HFMA) Value Project strategies for value transformation. To make the strategies actionable, we now present the tactics identified by the Value Project. These tactics provide a roadmap that enables boards and executives to plot their organizations’ course to value transformation.


To recap, organizations cross four major “summits” to achieve the ACA’s Triple Aim of improving the patient experience, advancing population health and lowering the total cost of care, according to HFMA. The summits are people and culture, business intelligence, performance improvement and contract and risk management.


The four “summits” are:


  • People and culture: The ability to collaborate, effectively manage change, communicate a value message and create accountability to value-driven goals


  • Business intelligence: The ability to collect, analyze and connect quality and financial data to support organizational decision making


  • Performance improvement: The ability to eliminate clinical variation, unsafe practices and waste


  • Contract and risk management: The ability to predict and manage different forms of patient-related risk under different payment methodologies.


Specific strategies and tactics for each of these “summits” appear below. Please note that the four summits, as well as the strategies and tactics, are not necessarily in sequential order.


People and Culture


Determine strategy for achieving value


  • Evaluate needs of key patient populations
  • Assess mergers, acquisitions, and affiliations
  • Optimize cost structure while ensuring quality


Align executive leaders


  • Translate strategic plans into common goals
  • Monitor key metrics and tie to incentives
  • Adjust resources, as needed, to ensure success


Strengthen governing board


  • Adjust composition to ensure needed expertise
  • Educate leaders on changing marketplace
  • Improve decision-making processes


Integrate and incentivize physicians


  • Elevate physicians into executive positions
  • Educate and develop physician leaders
  • Tie incentives to quality/cost performance


Strategically transition staff


  • Assess future staffing and skill needs
  • Add staff strategically


Develop a flexible culture


  • Articulate the organization’s value message
  • Educate and engage all staff
  • Encourage risk-taking and innovation



Business Intelligence


Invest in clinical IT


  • Implement EHRs in all settings
  • Establish alerts
  • Establish disease registries
  • Develop capability to exchange data and information


Invest in data warehouse and analytics


  • Review data governance (e.g., data definitions)
  • Integrate clinical and financial data
  • Invest in decision-support capabilities


Improve costing capabilities


  • Move from identifying trends to pinpointing specific costs
  • Understand costs across settings and time
  • Develop per-member, per-month costing capabilities


Track performance


  • Track outcome and process metrics
  • Develop population-level reporting capabilities



Performance Improvement


Develop process improvement capabilities


  • Identify methodologies (e.g., Lean)
  • Establish cross-functional team/department to guide efforts
  • Use clinical/cost data to prioritize opportunities
  • Expand efforts across departments and continuum


Adopt evidence-based medicine


  • Begin with patient safety concerns
  • Adopt standardized orders and protocols
  • Manage high-risk and chronic care patients


Partner for population health management


  • Measure, expand, and/or leverage primary care access
  • Assess and right-size the scope of services
  • Partner strategically for population management capabilities


Engage patients and community


  • Create transparency around performance
  • Engage patients through shared decision making and other tactics
  • Strengthen ties to the community



Contract & Risk Management


Plan for value-based initiatives


  • Develop rolling calendar of cost-containment plans
  • Update cash flow models and capital budgets
  • Quantify and allocate initiatives


Understand your costs


  • Move from identifying trends to pinpointing specific costs
  • Understand costs across settings and time
  • Develop per-member, per-month costing capabilities


Mitigate insurance risks


  • Forecast utilization and cost patterns among patient sub-populations
  • Identify successful interventions for high-risk patients that hold down costs
  • Negotiate “risk corridors” with payers to cap potential losses under risk-based contracts


Pursue value-based payment contracts


  • Partner with payers
  • Experiment with shared savings, bundled payment, and other approaches
  • Prepare for higher levels of financial risk



(We thank HFMA and its Value Project for this information. It appeared in: “The Mountain Range of Healthcare Value,” HFMA Weekly News, December 18, 2014)


To see the Value Project infographic on the four summits, please contact Carlin Lockee at for a copy.



iProtean subscribers, the new advanced Quality course, Board Mindsets to Drive Value, featuring Stephen Beeson, M.D., and Larry McEvoy, M.D. is now in your library. Dr. Beeson and Dr. McEvoy offer suggestions about working with physicians to build a different kind of organization where collaboration, innovation and change will become the norm.



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