In today’s episode of the LogicStreaming Podcast, host Patrick Yoder, CEO and co-founder of LogicStream Health, talks with Dr. Richard Priore, a leading expert on healthcare system transformation and CEO of Excelsior Healthcare Group, a healthcare management consulting firm, about the necessity of involving physicians in the business case for healthcare – partnering with clinicians to identify waste, evaluate costs and deliver return on investment (ROI) while driving quality of care and appropriate utilization.

The conversation began with a discussion about the pressure that hospital systems are feeling from reductions in reimbursement and the significant savings that can be achieved by addressing use of high-cost medications through formulary management.

According to Dr. Priore, the number one challenge facing healthcare systems today – the thing that keeps healthcare executives awake at night – is finances. Financial challenges once again topped the list of concerns in the recently released 2017 results of the annual survey by the American College of Healthcare Executives. It’s no surprise – revenues are going down along with reimbursements while the costs of doing business are rising. The impact on communities can mean less access to care. Yet health systems still have a focus on patient safety and quality.

Yoder raised the concept of value-based care and the impact on financial challenges. With healthcare representing a $3.3 trillion expense – and expected to consume 20% of U.S. GDP by 2020 – the focus on positive clinical outcomes rather than paying for volume of services rendered will continue.

Dr. Priore emphasized that cost and quality are inextricably linked. No health system has an unlimited budget, after all. Yet physicians – the people most responsible for making healthcare decisions – often do not have the data, insights and financial training to evaluate the business case of the decisions they are making. Health systems need to improve their level of clinician engagement. Educating clinicians about the financial impact of the types of tests, procedures and other aspects of care they order helps them be more judicious. That’s not automatically a popular suggestion among clinicians. Yet, as scientists, they are influenced by accurate and actionable data.

To learn more about this important conversation, including why Dr. Priore considers it essential that clinicians play a role in achieving ROI – and what it takes to make a successful business case – listen to the podcast.

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