Remaining Financially Viable in a Time of Healthcare Transition.

Abstract

In an unstable healthcare environment, Western Maryland Health System has been demonstrating stability. We have responded to the many challenges that hospitals face and managed to thrive in the new, value-based world.We made the transition to value-based payment and care delivery models through innovations in Maryland's payment system. In 2010, we recognized that becoming a demonstration project for value-based care would benefit our health system as we dealt with an aging and shrinking regional population. By moving care away from the acute setting to other settings across the care continuum, we now treat patients in the most appropriate setting (e.g., the home, physician office, clinic, and even senior centers, churches, and homeless shelters).As we have transitioned care, we have also transitioned our workforce. With fewer acute care patients, we need fewer staff members at the bedside. Many of our staff have shifted to delivering care in pre- and post-acute care settings.To improve our financial performance, we formed an alliance of three health systems. This new alliance has found increased savings by consolidating services, managing regionwide population health initiatives, and benchmarking clinical quality through best practices. Through the alliance, each individual health system is stronger and well augmented by the savings that it could not achieve separately.The transition has not been easy, but we have shown that it is achievable. We have identified a number of solutions to reduce costs and generate savings while enhancing quality and patient safety. These solutions may present a pathway to success for other organizations seeking to move to value-based care delivery and new payment models.