Healthcare Transformation Reform Model
FTI Consulting’s healthcare advisory services rely extensively on evidence-based analytics and statistical modeling tools to predict and transform population health, costs of care, utilization of healthcare resources, quality of care delivered, disparities in health needs and variations in the delivery of healthcare services.
FTI Consulting’s approach to healthcare transformation is clinically-led, i.e., all change at its core must deliver improved outcomes and patient experience, thus creating better value for money expended. We recognize the challenges that change presents to the compendium of organizations that make up the U.S. healthcare system, and that while many of these challenges are similar across the healthcare delivery system, there are myriad subtleties and differences at the local healthcare economy (LHE) level that must be addressed to ensure a high likelihood of successful change for any particular organization.
An economic model of the LHE can inform decision makers by empirically assessing different options and associated uncertainties and risks, taking specific account of changing demographics, epidemiology, technology, patient expectations, clinical standards and the need to deliver improved access and outcomes at better value for money. FTI Consulting has developed a modular empirical approach to modeling transformational change within a LHE to answer questions, such as those listed to the right.
FTI Consulting’s modular approach provides an ideal method for answering these and similar questions posed by regulatory authorities and providers. Our approach explicitly considers the uncertainties inherent in projecting the impact of programs designed to change the trajectory of diseases/conditions within a LHE, implementing outcomes-based or risk-based payment schemes and restructuring the funding and delivery of care across more appropriate care settings.
Questions We Answer
- How will demographic and socioeconomic changes affect healthcare demand and resources required to meet that demand?
- Which population health management efforts will have the greatest effect in reducing healthcare inequalities?
- What effect will investing in particular healthcare interventions or therapies have on the needs of patients with specific chronic conditions?
- What is the most effective approach in moving from fee-for-service to value/riskbased contracting scheme?
- What impact will this have on the clinical and financial viability of affected providers?
- What payment schemes will incentivize providers to actively engage in solutions that will modify the present trajectories of disease/conditions to reduce hospital admissions, readmissions and A&E episodes?
Senior Managing Director – Chief Operating Officer, Center for Healthcare Economics and Policy