Abstract
Like any business, healthcare organizations must evolve to stay competitive. Specifically, in the new healthcare environment, a firm’s essential focus on the customer must expand from thinking solely of the patient to considering other healthcare providers as customers. Healthcare organizations that have succeeded in creating service business model innovation in the new world of accountable care, integrated delivery, shared-savings and value-based approaches have certain characteristics in common. In these contexts, a health organization must trust its partners more than ever before. In the old paradigm, a healthcare organization “partnered” through referrals, but there were no consequences to the organization if the referred patient performed poorly. Now, and increasingly in the future, a healthcare organization must be concerned about the quality of care a patient receives from other providers in accountable care organizations or other parts of the integrated network. Innovation that leads to improved performance requires focusing on the role of cooperation and trust in changing both processes and resources required to deliver value to customers. Organizations that were formerly competitors may become partners through service business model innovation. What does it take to create trust and cooperation between former competitors who are now internal customers? The chapter will present four case studies illustrating trust, cooperation and leadership as essential components of successful service business model innovation in healthcare. Examples will be provided that clearly show how to build trust and cooperation with other healthcare providers in clinical expertise, financial management, care coordination and patient satisfaction through strong leadership and management.
Keywords
- Cleveland Clinic
- Healthcare Organization
- Accountable Care Organization
- Integrate Delivery System
- Shared Saving
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Allison, J. (2015). Collaborating with the nation’s best to improve your heart health. Accessed April 28, 2016, from https://www.baylorscottandwhite.com/ceo-notes/pages/collaborating-with-the-nations-best-to-improve-your-heart-health.aspx
American Medical Association. (2016). Shared savings. Accessed March 25, 2016, from http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/state-advocacy-campaigns/private-payer-reform/state-based-payment-reform/evaluating-payment-options/shared-savings.page
Bailit, M., & Hughes, C. (2011). Key design elements of shared savings payment arrangements. The commonwealth fund issue brief. Accessed April 28, 2016, from http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Aug/1539_Bailit_key_design_elements_sharedsavings_ib_v2.pdf
Baylor Scott & White Health. (2016). Our numbers. Accessed March 25, 2016, from https://www.baylorscottandwhite.com/pages/our-numbers.aspx
Bertko, J. (2009). Delivery system reform: Developing accountable care organizations. Brookings Institution. Accessed March 25, 2016, from http://www.academyhealth.org/files/Bertko.pdf
BJC Collaborative. (2016). About us: The BJC Collaborative. Accessed April 28, 2016, from http://www.bjc.org/About-Us/The-BJC-Collaborative
Burwell, S. M. (2015). Setting value-based payment goals—HHS efforts to improve U.S. health care. New England Journal of Medicine, 372(10), 897.
Centers for Medicare & Medicaid Services. (2011). What providers need to know: Accountable care organizations. CMS Fact Sheet. Accessed March 25, 2016, from https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2011-Fact-sheets-items/2011-03-315.html
Centers for Medicare & Medicaid Services. (2016). Better care. Smarter spending. Healthier people: Improving quality and paying for what works. CMS Fact Sheet. Accessed March 25, 2016, from https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-03-2.html
Cleveland Clinic. (2016). U.S. news rankings. Accessed April 28, 2016, from http://my.clevelandclinic.org/us_news_rankings
Cohen, S. (2014). The concentration of health care expenditures and related expenses for costly medical conditions, 2012. Statistical Brief 455. Rockville, MD: Agency for Healthcare Research and Quality. Accessed May 3, 2016, from http://meps.ahrq.gov/mepsweb/data_files/publications/st455/stat455.pdf
CoxHealth. (2012). BJC collaborative Q & A. Accessed April 28, 2016, from http://www.coxhealth.com/BJCCollaborativeQA
Enthoven, A. C. (2009). Integrated delivery systems: The cure for fragmentation. American Journal of Managed Care, 15(10 Suppl), S284–S290. Accessed March 25, 2016, from http://www.ajmc.com/journals/supplement/2009/A264_09dec_HlthPolicyCvrOne/A264_09dec_EnthovenS284to290/
Falk, I. S., Rorem, C. R., & Ring, M. D. (1933). The costs of medical care: A summary of investigations on the economic aspects of the prevention and care of illness (pp. 515–593). Chicago: University of Chicago Press. as cited in Crosson FJ. 21st-century health care—the case for integrated delivery systems. N Engl J Med. 361(14):1324–1325.
Health Care Transformation Task Force. (2016). Patients, payers, providers and purchasers committed to better value now. Accessed March 25, 2016, from http://www.hcttf.org/
Horn, D. M. (2016, April 20). Telephone interview.
Interbrand Health. (2014). Best global brands: Cleveland Clinic. Accessed April 28, 2016, from http://interbrandhealth.com/views/best-global-brands-cleveland-clinic-paul-matsen/
Jacobson, G. (2014). Baylor, Methodist hospital systems aligning with elite. The Dallas Morning News. Accessed March 25, 2016, from http://www.dallasnews.com/business/health-care/20140829-baylor-methodist-hospital-systems-aligning-with-elite.ece
Maeda, J. K. L., Lee, K., & Horberg, M. (2014). Comparative health systems research among Kaiser Permanente and other integrated delivery systems: A systematic literature review. Permanente Journal, 18(3), 66. Accessed March 25, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116268/pdf/permj18_3p0066.pdf
Magaw, T. (2014). Cleveland Clinic’s heart program forms alliance with three Baylor Scott & White Health Hospitals. Crain’s Cleveland Business. Accessed March 25, 2016, from http://www.crainscleveland.com/article/20141219/FREE/141219826/cleveland-clinics-heart-program-forms-alliance-with-three-baylor
Martin, A., Hartman, M., Benson, J., Catlin, A., & National Health Expenditure Accounts Team. (2016). National health spending in 2014: Faster growth driven by coverage expansion and prescription drug spending. Health Affairs, 35(1), 150–160.
New York State Department of Health Medicaid Design Team. (2016). A path toward value based payment: Annual update June 2016: Year 2. New York State roadmap for medicaid payment reform. Albany, NY: New York State Department of Health.
Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 et seq. (2010).
Pavarini, P., McGinty, C., & Schaff, M. (2015). The ACO handbook: A guide to accountable care organizations (2nd ed.). Washington, DC: American Health Lawyers Association.
PR Newswire. (2014). Baylor Scott & White Health launches alliance with America’s No. 1 Heart Hospital, Cleveland Clinic. Accessed April 28, 2016, from http://www.prnewswire.com/news-releases/baylor-scott--white-health-launches-alliance-with-americas-no-1-heart-hospital-cleveland-clinic-300012013.htm
Robertson, T., & Lofgren, R. (2015). Where population health misses the mark: Breaking the 80/20 rule. Academic Medicine, 90(3), 277–278.
Sutter Health. (2016). 2016 SMN dashboard: Setting a uniform bar for performance.
Wreden, D., & Krevans, S. (2016, March 1). Telephone interview.
Zuvekas, S., & Cohen, J. (2016). Fee-for-service, while much maligned, remains the dominant payment method for physician visits. Health Affairs, 35(3), 411–414.
Acknowledgements
Thank you to Dr. Horn (MGPO), Sarah Krevans (Sutter), Dr. Mack (BSW), Sandra Van Trease (BJC) and Dr. Wreden (Sutter) for participating in interviews in March and April, 2016, on behalf of their organizations.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Gleason, B., Bohn, J. (2017). Essential Characteristics of Service Business Model Innovation in Healthcare: A Case-Study Approach. In: Pfannstiel, M., Rasche, C. (eds) Service Business Model Innovation in Healthcare and Hospital Management. Springer, Cham. https://doi.org/10.1007/978-3-319-46412-1_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-46412-1_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-46411-4
Online ISBN: 978-3-319-46412-1
eBook Packages: Business and ManagementBusiness and Management (R0)