Strategies to Control Healthcare Costs

Healthcare Cost Management Strategies

Many healthcare organizations struggle to control costs. The good news is that there are a variety of strategies that can help. These include optimizing operations and workflows, updating and optimizing technology systems, and implementing predictive analytics tools.

One of the first steps is to recognize the cost problem. Then, you can start the journey toward solving it.

Health insurance

Health insurance is a type of coverage that helps pay for some or all of your medical costs. It can include hospitalization, surgery, and prescriptions. Health insurance can be provided by an employer or purchased individually. It can also cover health events such as accidents and critical illnesses.

Many employers are concerned about rising health care costs and want to reduce their rate of increase. Some take on significant risk through self-insurance, while others impose wage-price controls or use other methods to limit employee cost increases. While such strategies can help reduce health costs, they may have unintended consequences. In addition, they often fail to address underlying cost drivers. Employers can better manage their cost growth through continual monitoring and action planning that focuses on leading indicators. This approach can enable actuarial, clinical/quality, finance, and provider network teams to work together more effectively. It can also ensure that the best resources are allocated to achieving the desired results.

Hospitals

Hospitals play a critical role in modern healthcare. They provide vital services such as medical treatment, diagnostics, and emergency care. However, the increasing costs of hospitals can be a serious problem for healthcare systems. Hospitals should focus on reducing unnecessary costs, optimizing staffing and scheduling, and streamlining patient flow to avoid costly mistakes and inefficiencies.

In the US, hospitals are primarily funded by government revenues and social insurance payments. This means that patients are often insulated from the full cost of their hospital visits. Moreover, many hospitals use price information very infrequently when setting their charges. This lack of transparency has drawn the attention of regulators and the popular media.

Research has shown that more transparent prices can lead to a better understanding of hospital costs and promote competition. However, a number of obstacles prevent this from happening. For example, doctors may resist efforts to implement more sophisticated pricing systems because they fear that the system could undermine their professional judgement.

Physicians

Physicians must work to deliver patient-centered care while also aligning incentives to reduce system costs. This requires a shift in mindset for physicians, and an adjustment by companies throughout the healthcare value chain.

Physicians are increasingly willing to adjust clinical practices to accommodate cost considerations. They are more likely to agree with strategies to encourage preventive care, decrease utilization, limit the practice of defensive medicine and implement generally accepted clinical treatment protocols.

In addition, physicians appear to be less resistant to implementing a variety of structural solutions such as accountable care organizations and medical homes. These initiatives align physician payments with measurable performance improvement and create opportunities to reward physician participation in bundled payment models. They can also help entice physicians to join hospitals and health systems with captive referral networks or with arrangements such as reference pricing. These arrangements, along with a more holistic approach to quality and outcomes, are helping to drive cost control.

Technology

Technology is a crucial part of healthcare cost management. It can improve patient outcomes and help medical practices streamline their operations. Reduced costs allow them to invest in new equipment and staff. This helps them provide quality care to their patients and build trust.

Moreover, technological advancements can save patients and clinicians from medical errors that can be caused by miscommunication. These technologies include e-prescription and telemedicine. Additionally, they allow clinicians to access unlimited peer-reviewed medical information.

Health systems can leverage data analytics to identify instances of overutilization and optimize protocols. For example, a health system can use predictive modeling to identify high-cost patients and implement effective management strategies. It can also use this software to track changes in staffing, supplies, and drug usage. This will ensure that the institution is prepared for financial pitfalls. It can also encourage employees to shop for more affordable healthcare plans.

Click for additional reading