9 'Cs,' part 2: The 'back-end'

'The nine C’s are about the need to change care delivery and business delivery.'
By Jeff Rowe
10:57 AM

Much of healthcare reform involves changing the relationship between providers and patients. But for providers, efforts to deliver more accountable care necessarily involves changing the way they manage their practices and keep abreast of near-constant developments across healthcare.

Lumeris, an operations, technology and services company, recently released what it has dubbed the "9 Cs" framework to help providers transition to accountable care models. Not surprisingly, nearly half those "Cs" focus on the business end of healthcare delivery.

[See also: 9 'Cs' lead to accountable care]

As Deborah Zimmerman, MD, chief medical information officer at Lumeris, described it, "The nine C’s are about the need to change care delivery and business delivery." In other words, successfully reforming healthcare means moving to an accountable care delivery system, not just accountable care.

So what are those "back-end" Cs?

C6: Collaborative learning - According to Zimmerman, population-based healthcare will involve "continually evaluating populations and looking for ways to improve care." And that goes for more than just providers, as payers, too, will need to learn new ways to become more effective collaborators so that stakeholders share data across the board to ensure improvements in safety, quality and the best outcomes.

C7: Cost-effectiveness - Naturally, finding the best outcomes for the best cost is the surest way to optimal cost-effectiveness. With that in mind, Zimmerman said the search for cost effectiveness involves, among other things, working with physicians on ensuring optimal resource allocation.

C8: Capacity expansion - Hovering over the resource allocation discussion is a looming shortage of providers. "We’re faced with an impending shortage of primary care physicians," Zimmerman said, "so we need a team approach to care delivery." Those changes will involve physicians, nurse practitioners, care managers, social workers, and other professionals practicing together, as well as communicating more regularly via email and telephone.

C9: Career satisfaction - Not often found in reform discussions, the ninth and final "C" involves restructuring both compensation incentives and the overall healthcare culture to improve physician satisfaction. Ideally, that will involve reducing paperwork while enabling providers to retain control of their practices, giving them both autonomy and the ability to shape their careers as they see fit.

In summing up the 9 C’s, Zimmerman said Lumeris took the Triple Aim – better care, better health, lower costs – and added physician satisfaction.

"Because the best way to achieve accountable care," she said, "is to engage physicians and change behavior."