Because of the interrelated nature of financing, regulation, operations, and clinical care, healthcare is a complex business.
Throughout the 1970s, 80s, and 90s, healthcare organizations had a relatively simple formula for profit. Healthcare providers needed only to master the revenue cycle, day-to-day operations, and the science of medicine to succeed. Insurers in the non-governmental sector only had to accurately predict premium needs and pass along cost inflation to purchasers to compete. But by the early 2000s, acceleration in the complexity of medical treatment, plus years of cost inflation, resulted in significant push-back on premiums from purchasers—and a call for a change in healthcare financing in the US.
Setting the stage for change
From the 1970s through the 90s, those of us who now make up Attune Healthcare Partners were deeply involved in governmental healthcare policy and the administration of public and private insurance programs. We were on the forefront of creativity in new benefit configurations and more effective approaches to care management. Each Partner’s goal was to contribute to positive change in the cost-quality equation of healthcare.
When Elliott Fisher coined the term “Accountable Care Organization,” Attune’s founders were advancing transformation of the healthcare system through changes in the Patient Centered Medical Home, Medicare, and Medicaid. By the time the Affordable Care Act was passed, Attune had come together; designing systems to implement the Triple Aim—and we were engaged in doing so in Oregon, the national epicenter of ACO transformation in Medicaid.
A unique skill set
From this perspective in transformation in the US, and from experience in international healthcare systems, the core Attune team developed the skills needed to help clients deliver the Triple Aim.
- Understanding how to blend market strategy and organizational structure to deliver high-quality care within a budget
- Perfection of the financing mechanism between purchaser and provider, balancing the payment streams that promote collaboration
- Expertise in creating models of care and tools that improve care coordination and reduce costs
- Skill in guiding physician practices to select and implement new protocols to achieve cost and quality benchmarks
- Mastery of data sharing and use to manage populations cost effectively
- APM designs and provider compensation models that improve care access, experience, quality, and the cost of care
- Use of Lean principles to reduce staffing costs and increase operational efficiency, and
- Understanding how care settings influence the cost and quality of care.
We offer in-depth understanding of how facilities and practitioners can surpass competitors with top performance in value-based contracts. Our experts in care models, Lean, work and data flow analysis, and facility design bring together key skills for integration and facility planning in a value-based reimbursement economy.
Our experience in governmental and private health financing and delivery systems enables us to guide clients through strategy development, prioritizing goals, and aligning models of payment and care delivery—and personally assist to implement operations as designed.