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    • Key Attributes in Obtaining Better Outcomes and Reduced Costs in the Healthcare System

      Cowdell, Colt; The University of Arizona College of Medicine - Phoenix; Cortese, Denis MD (The University of Arizona., 2014-04)
      Objective/Hypothesis: The United States does not universally produce optimal levels of healthcare delivery, however, there are pockets throughout the country where organizations have utilized innovative strategies to produce high-value healthcare (better outcomes at lower costs). Our project aimed to identify factors that result in, or impede, the delivery of high-value healthcare. We hypothesized that there are common factors assisting or inhibiting organizations from producing high-value healthcare. Methods: We performed an analysis of innovative delivery models utilized at 10 different healthcare organizations throughout the country. The analysis included a literature search pertinent to each innovation we selected, a telephone interview with executives at the organization, integration of information we obtained into a pre-established template, a follow-up questionnaire, and finally an integration of new data from the questionnaire. Results: 10 different enablers were found to be common among the organizations. These included: shared vision, provider leadership, front-line empowerment, defined population, patient centeredness, co-creation with customer, information technology, culture of learning, presence of a willing payer, and a clear business case. The organizations ranked provider leadership and shared vision to be the two most important enablers. Three common barriers to success were found among the organizations and included government regulations, provider culture, and reimbursement. Provider culture was assessed as the most important barrier to overcome in the follow up questionnaire. Significance: The United States spends more overall and more per capita than any other country on healthcare, yet we are ranked 37th in the world for healthcare performance on average.1 Moreover, there is significant variability in mortality rates, access, safety, and patient satisfaction throughout the country.2 The information from this study provides a better understanding of how effective organizations are producing higher value healthcare and may act as a roadmap for organizations actively looking to produce better outcomes while lowering their costs.