Health systems, integrated delivery networks (IDNs) and academic medical centers (AMCs) are significant players in the U.S. health care delivery system. Yet despite their strength and market power, they face the same pressure as a small physician practice to drive more value from the services they provide. 

Eight new reports, surveys and published research articles identify the challenges and opportunities for health systems, IDNs and AMCs as they strive to improve their clinical results, reduce their operating expenses and create more value for patients and payers.

Care Coordination

10% of U.S. patients experienced poor primary care coordination

40 percent of U.S. patients experienced at least one care coordination gap with 10 percent experiencing three or more, according to a study in the journal Annals of Family Medicine. In the study, researchers queried nearly 14,000 patients in 11 countries about how well providers coordinated their primary care services. They defined a gap in care coordination using one of five measures: diagnostic test results or medical records not being available; receiving conflicting medical information; receiving orders for a medical test they felt was unnecessary; their specialist not having basic medical information or test results from their regular doctor; or their regular doctor not seeming informed and up to date about the care they received from the specialist. The study defined poor care coordination across a health system as experiencing three or more of those five measures. Some 10 percent of U.S. patients experienced poor care coordination—the highest rate in any of the 11 countries.

Improving access to outpatient care top health systems concern

57 percent of 183 health system executives surveyed by the Advisory Board cited improving patient access to care in ambulatory or outpatient settings as their top concern. In its survey, the consulting firm ranked improving ambulatory care access as high or ahead of: innovative approaches to expense reduction (57 percent); boosting outpatient procedural market share (55 percent); minimizing unwarranted clinical variation (54 percent); and controlling avoidable utilization (49 percent).

Hospital Consolidation

90 hospital merger or acquisition transactions recorded in 2016

That’s down from 102 hospital merger or acquisition transactions recorded in 2015, according to Irving Levin Associates, the Norwalk, Conn.-based health care market research firm. In its most recent annual report, Levin said a total of 942 health care merger or acquisition transactions happened across all health industry sectors last year worth $72 billion. That’s compared with 935 transactions in 2015 worth $140 billion. The number of physician medical group mergers and acquisitions rose to 119 last year from 100 in 2015, Levin reported.

Merging hospitals reduced operating expense by 2.5% per admission

That’s according to a report by Charles River Associates commissioned by the American Hospital Association. In its report, the Chicago-based consulting firm reported the results of its study of the financial and clinical impact of hospital mergers from 2009 through 2014. The 2.5 percent reduction in operating cost per admission translated into an average annual savings of $5.8 million at each hospital, the report said. The mergers, though, did not translate into statistically significant improvements in outcomes like readmission and mortality rates for heart attack, heart failure or pneumonia patients, the report said.

Supply Chain

More than 90% of health system execs said precision medicine will increase their supply chain costs

That’s according to a survey of 91 health system executives conducted by Premier, the Charlotte, N.C.-based health care group purchasing organization.  Virtually all of the executives said pharmaceutical prices “pose a challenge” for their health systems with more than 90 percent adding that drug shortages will continue to be a challenge for them over the next three years. In response, nearly 70 percent of the executives said it may be necessary for their health systems to operate their own specialty pharmacy.

Predictive analytics top supply chain priority for health systems in 2017

That’s according to a survey of supply chain executives from 50 health systems conducted by Global Healthcare Exchange. In its survey, GHX said health systems’ second and third supply chain priorities, respectively, were optimizing value-based reimbursement and integration following mergers and acquisitions. Asked what their top supply chain initiatives were to achieve those objectives, the executives cited standardization of physician preference items and across all clinical areas, reduction in manual processes and paper transactions, and process excellence for operational management.

Value-Based Reimbursement

47% of health care C-suite executives said value-based care will have biggest transformative impact

That’s according to a survey of 213 health care c-suite executives, including 82 working at health systems, conducted by Lazard, the New York-based financial management firm. In its survey results, the executives cited “adoption of value-based/risk-sharing pricing models” as the development that will have the most transformative impact on the health care industry. Second in the executives’ opinion were scientific breakthroughs (38 percent) followed by the emergence of new care delivery models (31 percent) and increasing health care price and quality transparency (31 percent).

Drive for value will continue to top health systems agenda despite regulatory uncertainty

That’s according to a report from BDC Advisors, which interviewed C-suite executives from 12 leading health systems and academic medical centers in nine states. The Miami-based health care consulting firm published the key takeaways from the interviews in an article in Leadership, an online publication from the Healthcare Financial Management Association. BDC Advisors said the health system executives they interviewed said their provider organizations will continue their push for value. Their three leading tactics to get there are clinical integration, care coordination and high-quality care.

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