Around the world, physicians are increasingly diagnosing patients with long-term chronic diseases, not just episodic health problems. Meanwhile, the treatments for other diseases and health conditions have become more complex — and more expensive. Patients want high-quality care at the lowest cost. Health systems want to serve these patients’ needs … while also staying afloat financially.
The result is a massive global shift from volume-based care toward a model that emphasizes value.
As many of our global affiliates work to navigate this sea change, Johns Hopkins Medicine International is providing leader-to-leader support to increase options for local, efficient and high-quality care.
Here are some recent examples of how we are working with our colleagues at Johns Hopkins Aramco Healthcare (JHAH) to optimize systems and processes to decrease cost burdens, improve efficiencies and increase patient satisfaction:
Highest-Value Health Care
Health systems like JHAH are increasingly turning to utilization management (UM) to ensure patients receive the right care using the right resources. In the health care context, UM is an approach to protect patients from the unnecessary or inefficient use of medical services and facilities.
As part of a two-year program, Johns Hopkins HealthCare is working with JHAH to create and implement a thorough UM program.
Recently, three leaders who are guiding JHAH’s UM efforts completed a five-day observership at Johns Hopkins. The focus of the visit was to help them develop the processes and skillsets needed to contain the costs of providing safe, high-quality care at JHAH. They met with managers, clinicians and staff members from Johns Hopkins Medicine (JHM) and delved into practical considerations necessary for creating a patient-centered UM unit at JHAH, including case management, billing and coding, finance and data management.
Beyond Balancing the Books
Mohammed Al Dhubaib, JHAH’s new CFO, recently met with JHM colleagues, who helped deepen his understanding of ambulatory and hospital operations to ensure JHAH clinicians have the tools and technologies they need to provide the best care possible.
Discussions included major capital expenditures for medical equipment — purchasing, maintaining and servicing it, and replacing it safely. Just one MRI machine can cost up to $3 million, so these considerations are critical in health care finance.
Al Dhubaib also got insights from JHM leaders on how moving to a value-based care model is changing costs related to procedure, disease, specialty and many other factors. This fundamental shift in how health systems are providing care has an enormous impact on business planning, financial forecasting and patient outcomes.
Chief Auditor Salim Bennis must evaluate the policies, procedures and controls JHAH has in place and in the pipeline and employ them to ensure regulatory compliance, operational efficiencies and patient satisfaction.
Bennis recently visited the Office of Hopkins Internal Audits (OHIA) to observe how it conducts audits in the clinical setting. During this visit, OHIA experts shared information on how they developed the office's charter and mission/vision statement and how they determined staffing, training and other needs prior to opening. Bennis’ JHM colleagues also detailed their highly vetted processes for conducting internal audits of clinical and operational areas and following up on potential threats.
The conversation included auditing risks in clinical areas, as well as in ancillary services such as pharmacy, radiology and pathology. They also discussed technology risks such as gathering and sourcing data in Epic and protecting against cybersecurity threats.
These are just some of the many ways we are sharing our operational expertise with JHAH and other global affiliates as they enhance and expand their efforts for providing patients with convenient access to the high-quality, high-value health care they demand and deserve.