Shared decision-making, long-term goals essential to hospital success

Hospitals that shifted their operations to value-based care systems are about to enter the "second curve" of healthcare and are poised to thrive, writes Paul Keckley, managing director at the Navigant Center for Healthcare Research and Policy Analysis, in an opinion piece for Hospitals & Health Networks.

Futurist Ian Morrison coined the idea of the second curve in his 1996 book of the same name. Once an organization has seen a period of success, Morrison wrote, they plateau and must make decisions about their future. Organization leaders who do not allow this uncertainty to paralyze them are in the "second curve."

In a turbulent period for the healthcare industry, with Medicare, Medicaid and other insurers reimbursing less, demand on the rise and patients getting sicker, Keckley writes that hospitals are near the end of the first curve, which focused on a volume-based environment.

"Second Curve hospitals see the future differently," Keckley writes. "Their clinical model is holistic and individualized. Technology is digital and shared, and the preferences and values of individuals are just as important as their signs and symptoms. They focus on persons, not patients."

In addition to the difference in their long-term focus, there are several other distinctions between the two curves:

  • While first-curve hospitals emphasize care for the injured and sick, second-curve hospitals emphasize services, programs and products for individuals in all states of health

  • In contrast to the physician-centric, first-curve decision model, second-curve model shares in the decision-making

  • Second-curve hospitals place far more emphasis on care value rather than lower costs

Healthcare leaders discussed second-curve strategies in a 2014 American Hospital Association report, FierceHealthcare previously reported. For example, Jim Hinton, president and CEO of Presbyterian Healthcare Services in Albuquerque, New Mexico, described the organization's use of strategies such as bringing equipment, monitors and treatment into patient homes, achieving better results than inpatient settings.

To learn more:
- read Keckley's piece

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