Optimizing Our Operations in 2021

An update on several initiatives already under way

By Cliff Megerian, MD, FACS, Chief Executive Officer

UH Clinical Update | February 2021

Almost exactly five years ago, in my capacity as the president of UH Physician Services, I was very keen on being involved in Clinical Update and began writing this monthly blog.

Now, as I have stepped into the role of UH CEO, I am intensely aware that I am still a practicing physician, and my interest in clinical matters as the CEO has only been heightened. So I will continue to publish this monthly blog, which addresses all of our clinical operations.

In the ever-changing health landscape, it is imperative that in 2021 we optimize University Hospitals so that we can effectively compete as one system. Over the past several years, we have put in place the parts that build a strong foundation, and now we need to maximize our operating model to ensure our success.

Here a few ways that will get us there.

First, we are leveraging what we learned during the pandemic. We’ve replicated the incident command structure that was so effective for critical and time-sensitive decision- making by establishing operations centers throughout the system.

Second, we know that in this competitive healthcare market – in addition to improving our patients’ health outcomes and the affordability of care, which are always a priority – we must take into account the continuing growth of the Medicare population. It’s time to position UH as the preferred provider for Medicare patients and to partner with health plans on Medicare Advantage solutions.

This should occur naturally on the heels of our success with our UH ACO. Through it, we’ve already shown that by using a framework that eliminated specific “defects in value” we save money and improve value for our patients. By providing better continuity of care to help prevent illness in healthy patients, manage chronically ill patients and treat acutely ill patients, we realized a 9 percent decline in cost per patient over 12 months. Maximizing our continuum of care also allows us to provide our patients with effective population health management – and prevention is the ideal.

Some other initiatives that are under way:

• We will lower costs by understanding that we do not need to offer all services at all locations; rather, we need to be intentional in our approach. If a specific market doesn’t have the volume to support a particular service line, we need to re-evaluate which services are needed in that community, and focus on providing those. That makes medical sense, too. As clinicians, we know that locations with high volumes of particular procedures have better patient outcomes.
• On another front, we will increase our marketing budget to promote UH and increase our market share, especially with commercial patients. UH Ventures will also continue to be a catalyst to help us grow alternative revenue streams through commercialization and investments and “systemness” innovation.
• We will continue our “keepage” initiatives – retaining the patients we have and meeting all their care needs within UH. You as clinicians are the crucial component of this endeavor.
• As you know, we will be switching to a new EMR system. This helps us aggregate patient data, and keeping our patients entirely in the UH system allows us to have the most current and comprehensive picture of their health.

In addition, we have initiatives under way to open more patient appointments and expand our Schedule Me Now platform so that patients can get in to see us when they need to, not several weeks later.

One initiative has already been a resounding success – that of discharging hospitalized patients directly to their homes rather than to skilled nursing facilities. Patients are happier because they can heal in the comfort of their own surroundings. The possibility of them enduring health complications is greatly reduced, as is the cost of care.

Our recent joint venture with ValueHealth (learn more on the UH Community Network) also emphasizes affordability. We will create Centers of Excellence for value-based surgical care – and by that I mean Centers that meet objective criteria, not, as is often the case elsewhere, centers that bestow this terminology on themselves. We will start with orthopedics, targeting hip and knee replacement, and then add other specialties. This joint venture also will expand our geographic footprint in Northern Ohio for surgical care – the facilities will be multi-specialty and may eventually include services such as cardiac care, otolaryngology, urology, general surgery and pain management.

Of course, UH and all healthcare systems are dealing with cost pressures connected to the pandemic, and uncertainties that come with healthcare reform.

To me, this accelerates the imperative to be at our best, and to provide the highest-value care. We will compete effectively as a fully unified system, one that is the most reliable and trusted partner in healthcare in Ohio, and beyond.

As I said, our foundation is solid. With these strategies and methods in place, and more to be announced in upcoming months, we will thrive beyond even our highest hopes and expectations.