{"id":112,"date":"2014-11-07T19:22:41","date_gmt":"2014-11-07T19:22:41","guid":{"rendered":"http:\/\/leadingachildrenshospital.com\/?p=112"},"modified":"2015-02-28T12:49:10","modified_gmt":"2015-02-28T12:49:10","slug":"what-not-to-do-to-cut-health-care-costs","status":"publish","type":"post","link":"https:\/\/leadingachildrenshospital.com\/?p=112","title":{"rendered":"What not to do to cut health care costs"},"content":{"rendered":"<p>In this month\u2019s Harvard Business Review (November 2014) there\u2019s an article by Robert Kaplan and Derek Haas entitled <em>How Not to Cut Health Care Costs<\/em>. The authors list 5 common mistakes that health care systems and teams make when trying to lower costs:<\/p>\n<ul>\n<li>Cutting back on support staff,<\/li>\n<li>Underinvesting in space and equipment,<\/li>\n<li>Focusing narrowly on procurement prices,<\/li>\n<li>Maximizing patient throughput,<\/li>\n<li>Failing to benchmark and standardize.<\/li>\n<\/ul>\n<p>I can only imagine that some must have been scratching their head while reading this article.<\/p>\n<p>Here is my summary:<\/p>\n<p>#1 Cutting back on staff: \u00a0 It turns out that support staff aren\u2019t the expense problem and cutting them creates bottlenecks and more work for clinical staff who could instead be directly helping patients instead of doing clerical work, managing schedules, and solving operational problems.<\/p>\n<p>#2 Underinvesting in space and equipment: \u00a0 Space and equipment can drive up costs if not managed prudently, however, too often these items are cut to the point of creating bottlenecks and wasting more expensive resources (like doctors).<\/p>\n<p>#3 Too much focus on small procurement prices: \u00a0It turns out that saving $0.10 on every 100 gauze may be a victory for the supply chain manager, but it does very little for the bottom line. It would be better to reduce the waste of relatively expensive supplies that are common in health care. This is especially true in procedure oriented areas. \u00a0And it turns out that the variability in use of these expensive supplies is considerable, suggesting room for improvement.<\/p>\n<p>#4 Maximizing patient throughput: \u00a0This is my favorite. \u00a0The article asserts that pushing doctors to see more patients, or incentivizing them to see more patients (same thing), leads to increased health care costs , and not just because they will tend to do more than they really need to, but because they aren\u2019t making long-term investments in their patients. An example is talking about advanced directives for people with terminal illnesses, or counseling patients with end stage renal disease who are likely to need dialysis.<\/p>\n<p>#5 Failing to standardize: \u00a0Need I say anything further \u2013 not taking the time to standardize the processes of care and of doing business (operations) sets a system up for unnecessary variability, confusion, reworks, poor communication, etc.<\/p>\n<p>There is an interesting paragraph towards the end of the article that states: \u201cHigh health care costs are the result of mismatched capacity, fragmented delivery, suboptimal outcomes and inefficient use of highly skilled clinical and technical staff. The current practice of managing and cutting costs does nothing to address those problems.\u201d<\/p>\n<p>Articles that make you go ummmm\u2026<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this month\u2019s Harvard Business Review (November 2014) there\u2019s an article by Robert Kaplan and Derek Haas entitled How Not to Cut Health Care Costs. The authors list 5 common mistakes that health care systems and teams make when trying to lower costs: Cutting back on support staff, Underinvesting in space and equipment, Focusing narrowly [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[5],"tags":[],"_links":{"self":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/112"}],"collection":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=112"}],"version-history":[{"count":4,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/112\/revisions"}],"predecessor-version":[{"id":136,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/112\/revisions\/136"}],"wp:attachment":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=112"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=112"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}