Becker's Hospital Review

30 Executive Briefing Sponsored by: W ith more access to information about the cost and quality of their care than ever before, healthcare consumers are becoming more conscious of value. This rise in consumerism, as well as the growing prevalence of value-based, alternative payment models, has pushed hospitals and health systems to more strategically integrate into high-value networks by pursuing mergers and acquisitions. In this environment, achieving clinical integration is no longer an option for providers that want to keep a competitive edge — it's a necessity. Clinical integration is the facilitation of coordinated patient care across all care settings and is characterized by increased communication between clinicians, health system leaders and frontline staff, with the aim of improving patient outcomes. The need for clinical integration is one of the driving forces behind providers' mad dash toward consolidation. Consolidation is one of the defining trends of healthcare in the 21st century. If providers have not made proper investments in clinical integration, they often look for potential partners who have. In a recent Premier survey of health system leaders conducted in April and May, 48 percent of respondents said they completed a merger or acquisition in the last 24 months. Seventy-seven percent said they plan to complete one in the next 24 months. Twenty-four percent of survey respondents said their strongest motivation for consolidation is to integrate care across the continuum, thanks in large part to payment models that reward value. Sixteen percent of respondents cited consumerism as their primary motivation for mergers and acquisitions, making it the second most selected answer. This article will examine the positive benefits of clinical integration and explore best practices for how healthcare leaders can ensure mergers and acquisitions maximize their organization's ability to coordinate care. The importance of quality, reaffirmed Healthcare's siloed nature makes it possible for patients to fall between cracks at various points in their care journey. Successful clinical integration can bridge the communication gap between acute care clinicians and those involved with pre- and post-hospital encounters, which can contribute to better outcomes and costs. For a 2016 study on care coordination and patient outcomes, researchers with Baltimore-based Johns Hopkins University Bloomberg School of Public Health analyzed data from three large commercial insurers on 1.7 million lives. The team found patients with the highest levels of care density, which is the amount of information shared about a patient between clinicians, experienced significantly lower rates of adverse events. Care coordinators and care navigators are critical players who help close gaps patients may otherwise experience in their care journey. They help guide patients and their families through their care episode, communicating with different clinicians to ensure the patient receives top quality treatment. These vital members of the care team don't just ensure patients receive the most effective care, but also help improve the overall patient experience and satisfaction — a growing determinant of reimbursement. "Care coordinators and navigators have more facetime with patients and their family members and can have a significant impact in terms of helping to direct and guide the patient to the appropriate care," said Beth Anctil, principal at Premier, an industry-leading healthcare improvement company. "As you know, you've got pre-hospital, hospital, post-hospital, back to the doctor; there's a lot of different points of contact, so having someone take that accountability is really critical." Clinical integration not only helps improve communication between clinicians, but also facilitates the creation of longitudinal care plans, which can help improve care efficiency. These plans consider a patient's entire episode of care across settings as opposed to traditional care plans, which are generally more site-specific. It is healthcare organizations' fundamental mission to provide patients with the best possible care. However, as patient outcomes are increasingly linked to reimbursement, the all-important nature of care quality has been reaffirmed to hospitals' financial and operational teams. Industry leaders now understand that the promotion of clinical integration is one of the most instrumental steps they can take in service of their quality goals. Imagine your health system but better: The clinical integration makeover we all need

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