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Health Systems

By design health, systems are extraordinarily complex sprawling organizations. Yet physicians are poorly trained (if at all) in the necessary management tools associated with managing divisions, sections, departments, and health systems.

Health Systems
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Valid for: 1 Year
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The health system curriculum is designed to leverage MDContent’s unique clinical and economic insights to the bedside. This competency based curriculum is designed to achieve the following:

  • Typical academic competencies – understanding the basics of finance, economics, operations management, strategy, and others. ‘
  • Managing work flows and optimizing human resources.
  • Encouraging teamwork and individual opportunities.
  • Managing and grooming intellectual capital and professional development.
  • Building collaboration on problem solving.
  • Developing meaningful strategies to retain and recruit faculty.
  • Leveraging financial tools for programmatic success.
  • Developing personnel to work across the institution.
  • Honestly assessing the competitive landscape and shaping future inflection points.
Curriculum Contents Hours
Introductions

The Basic Business Model of a Health System
  • In this session, we introduce the concept that health care is a “high-fixed cost” industry, and we describe some of the clinical and financial implications. To convey this concept, we describe the many ways to gauge costs – total, average, fixed/variable/marginal, avoidable/sunk, opportunity costs, and variable direct/fixed direct/indirect. We parse costs for specific diagnoses and principle procedures to show how costs accrue over the course of a patient’s hospital stay, and how activities such as pharmacy and lab contribute to costs.
Cost Accounting and Reimbursement
  • We continue with costs. We describe “overhead,” and explain how cost accountants allocate overhead to specific clinical activities. We explain the difference between total margin and contribution margin, and the applicability of each; and we use examples from specific clinical domains. We then describe inpatient payment and profit margins under traditional fee-for-service insurance, DRG-based payments, per diem, and “capitated” reimbursement – while showing the risks inherent in each arrangement, the incentives created (good and bad), and some repercussions for physicians.
Operations Management
  • We explain how hospitals and physicians can leverage their fixed assets to better serve their patients and themselves. We discuss the importance of throughput in settings with high fixed costs, and we discuss conventional mechanisms for improving operational performance: reducing flow time, attacking bottlenecks, and eliminating unnecessary buffers. We then discuss the adverse impact that variability has on operations, and we identify tools that providers can use to manage variability.
Integrating Business Principles into the Delivery of Care
  • This session provides a physician perspective on the lessons learned to this point, elaborating on how a different mindset for clinicians can both improve the quality of care and markedly reduce costs. To manage and lead a well-functioning clinical operation, physicians need straightforward managerial principles, along with good data. We discuss simple and inexpensive measures that well-informed clinicians can take even under the status quo to achieve win-win changes. Specific examples include “flexing” the ICU and improving operating room throughput.
Introduction to Corporate Finance
  • This is the first of two sessions designed to familiarize participants with the elements of corporate finance. Here we introduce the time value of money, present value, and return on investment. We set the stage for the advanced course by introducing risk, but the details are left for the second day.
Physician Leadership
  • This session introduces participants to the underlying business principles of health systems and invites them to look very differently at how their institution functions and what their roles should be as health system leaders. We suggest ways for physicians to lead their institutions to counter those forces – both real and contrived – that contribute to “silo” effects; and how, through their leadership, they might help to establish a true health system. This session examines physicians’ needs, both in advocating for their patients and in pursuing their own professional goals. It asks the physicians present to consider their needs strategically, and to articulate where they perceive that their strategic interests are well aligned with the larger health system, and where they perceive that their interests are in conflict. This session addresses a key question in the minds of physicians – “What is in it for me?”
Roundtable discussion
  • This forum provides an opportunity for the health system leadership to address questions from the course participants.
 
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