Exploring the Quadruple Aim – Reducing Costs

The U.S. healthcare industry has been focused on Improving healthcare quality since at least 1999, when the Institute of Medicine (IOM) published To Err is Human: Building a Safer Health System. The current framework for making healthcare better, adopted widely by the U.S. Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), and other institutions, is commonly known as the “Quadruple Aim.”

Reducing healthcare costs is one of the four major goals

This blog post continues our blog series based on the HealthStream eBook, The Quadruple Aim, that explores this important effort to improve and reform U.S. healthcare. Here we will briefly examine the effort to reduce the cost of providing and receiving care.

Hospitals and other healthcare organizations were in financial trouble even before COVID-19 became a global problem. Even in the best of times, the typical hospital barely survives by operating on a super thin margin—in the vicinity of 3.5%—which is expected to decline for many in coming years. Even pre-pandemic, as many as half of all U.S. hospitals were expected to experience negative margins as soon as 2025. The outlook was bleak, and COVID-19 may turn it into a disaster. 

How to improve healthcare’s bottom line

Hospital margins have plummeted during the pandemic—many are in a deep financial hole from which it may take multiple years to recover. In reaction, there will be a strong incentive to reduce costs in many directions. The pandemic may be an impetus for greatly increased government financial involvement in healthcare, as well as in encouraging many organizations to make far greater changes in how they provide care. Here are some suggestions many hospitals may implement in their efforts to earn to do more with less while still working to improve care: 

• Widespread measures to improve staff retention, given the huge cost involved in hiring and training replacement clinicians
• Cross-training to make sure staff are upskilled and available to fill gaps as they occur
• Adopt widespread online training options, which is far less expensive than tradition, classroom-based in-person training
• Work to substitute telehealth encounters for costly emergency department visits whenever possible
• Invest in analytics to make sure healthcare operations are understand and run as efficiently as possible
• Promote preventive care that can keep patients out of the hospital
• Make following evidence-based care guidelines a standard process for all care
• Refocus on value-based care that emphasizes outcomes over care volumes
• Rework the process for elective surgeries to ensure they are possible even during times of emergency
• Develop local supply-chain relationships to avoid resource issues and shortages at critical times

Even in the midst of a challenging moment in healthcare, many people are working to find ways to make caregiving more effective and successful in the future. Download the Quadruple Aim eBook to learn more about each Aim and how HealthStream has mapped multiple solutions to each of these critical issues. 

From solutions with a focus ranging from clinical development and reimbursement to quality and performance management, HealthStream is dedicated to improving patient outcomes through the development of healthcare organizations’ greatest asset: their people.