4 ways tight budgets can improve quality of care

Working with fixed budgets can improve healthcare quality, argues a blog post from the Harvard Business Review.

Derek Feeley, former head of Scotland's National Health Service (NHS), writes that working with a cost ceiling can "unleash innovations that will lead to better care--and better health--for communities." Scotland's NHS provides healthcare for 5 million people with a fixed $18 billion budget, Feeley writes, and that limit created an incentive to improve the quality of care, focus on patient health and come up with creative solutions, since simply increasing revenues is not an option.

The budget constraints also enabled the NHS to implement a plan that centers on the "Triple Aim," that is, improving the healthcare experience, improving overall patient population health and cutting per capita costs. Working with fixed budgets requires skill in four areas, according to Feeley:

Investing in population health: An organization on a strict budget will become overwhelmed unless healthcare providers work to proactively reduce demand for healthcare for causes like obesity and multiple morbidities, Feeley writes. For example, he said the NHS invested in early cancer-detection and heart disease programs, as well as national behavioral health initiatives.

Working outside the healthcare sector when necessary: A patient's health, Feeley writes, is only 20 percent healthcare. The other 80 percent is the result of social, behavioral and environmental factors. Healthcare providers, he writes, "need to stop thinking that they can do all of this heroically on their own." The NHS instead implemented the Early Years Collaborative, which involved cooperation between healthcare providers, educators, police and social workers to combat infant mortality, according to Feeley.

Strengthening primary care: With so many healthcare resources devoted to management of chronic conditions, it's up to primary care providers to keep those patients out of hospitals whenever possible, Feeley writes. In addition to strengthening primary care, organizations must improve team-based and coordinated care, he says, echoing sentiments expressed by U.S. healthcare leaders.

Getting it right the first time: With readmission prevention on healthcare providers' minds already, Feeley calls for providers to focus on efficient care that keeps patients from coming back to the hospital, for the sake of both patients and reducing bed utilization and length of stay.

To learn more:
- read the blog post