From Reactive Treatment to Proactive Health Management
The FTI Consulting View
FTI Consulting believes that a successful transition from traditional delivery of medical services to proactively promoting the maintenance and optimization of long-term healthcare starts with an objective assessment of the community being served:
- What does the community look like currently?
- How is it likely to change going forward?
- What does that imply about community patient needs today and over the long run?
- What are the levers (and associated incentive structures) that can be used to reduce the demand over time for healthcare services by the patient community;
- What are the options to supply healthcare resources to the patient community more efficiently; and
- What are the potential effects of exogenous changes that might realistically occur in the marketplace (such as Medicaid reform).
Armed with this information, health systems – in collaboration with the broader community in which it operates – can now make intelligent tactical decisions that will move them meaningfully toward that goal:
- Narrow the organization’s focus to focus on areas in which it has a comparative advantage
- Expand or realign the organization’s footprint to address all aspects of healthcare in these areas of focus
- Think beyond acute and post-acute care by focusing on preventable healthcare management, in collaboration with other healthcare players in the community
Making the Case for Change
As a first step in this transition, FTI Consulting recommends a Transformational Demand Assessment to help identify opportunities and risks. This assessment looks at more than just past history of providing healthcare to that community but instead, it identifies demographic, socio-economic, mental health and social behavior factors, among others, predicts future disease patterns before they occur in a community, and provides a detailed profile of the resources that will be needed, based on empirical and statistical analysis.
The ability to predict expected disease patterns is critical in risk stratification, and it provide a detailed picture of vulnerabilities, along with the level of medical or healthcare services that are likely to be needed in the community. Using this Transformational Demand Assessment, FTI assists communities and providers in designing and structuring ACOs and integrated care systems that better meet the present and future needs of its diverse patient populations.
Senior Managing Director – Chief Operating Officer, Center for Healthcare Economics and Policy