Can We Harness the Business Paradigm of Value Creation to Support Quality Improvement Projects? [31G

Abstract

INTRODUCTION: Quality improvement projects are generally not reimbursed by payers and often rely on engaged staff and physician volunteers. Physicians typically receive no training in business strategy. We hypothesized that adopting a paradigm of value creation has the potential to support QI projects and thereby enhance patient outcomes in a financially sustainable way. METHODS: Childbirth is the most common indication for hospital admission in the US. We identified pain points for insurance companies and hospitals that coincided with existing quality improvement initiatives. A decrease in the cesarean rate was chosen as a potentially modifiable target that would create a compelling value proposition for payers. A labor support app was then designed with content curated to support a QI initiative to decrease the NTSV cesarean rate. A business plan was built around the app and tested for viability in the investor community, with hospital administrators, insurance- and employer representatives. RESULTS: We partnered with Penny Simkin, to provide labor support content. Labor support has been shown to decrease cesarean birth. The app format allows for easy access by patients and their care team. Every cesarean avoided results in cost savings for payers, favoring payment of the app. This was highly acceptable to hospitals administrators, insurance and employer representatives. The business plan won first place in the business plan competition, indicating a high level of support of the local business community. CONCLUSION: Approaching clinical problems with a perspective of value creation to payers has the potential to create financially viable solutions and improve care for our patients.