Few would dispute that health care should be provided in seamless, well integrated clinical care environments that provide patient-centered care, educate trainees, and conduct research into a particular disease or episode of care. Yet there are relatively few examples of successful or sustained clinical integration, either in the community setting or in academic health centers (AHCs). This article, published in Academic Medicine, addresses why AHCs have not made better progress in developing integrated centers of clinical care. Steve Levin, a Director at The Chartis Group, along with executives from Emory University and Emory’s Woodruff Health Sciences Center, characterize two fundamental types of integration that have evolved within the AHC setting: lateral and vertical. The vast majority of examples of clinical integration, whether lateral or vertical, fail to integrate essential administrative and financial functions, which has significant consequences for providing seamless, patient-centered care. The article identifies the emergence of several new examples of vertical clinical integration that also integrate administrative and financial functions as models for AHCs to follow. To learn more regarding how AHCs and others can address the cultural, financial, and governance issues that continue to limit the development of vertically integrated, patient-centered care, we encourage you to read "Developing Integrated Clinical Programs: It’s What Academic Health Centers Should Do Better Than Anyone. So Why Don’t They?"
 

For academic medical centers, there is surprisingly little written on standardized methodologies to align financial support across the academic and clinical missions. However, professional fee reimbursement has not kept pace with costs, and this, combined with potential decreases in research funding associated with the reductions in National Institutes of Health funding, creates additional financial challenges for academic clinical departments that do not share in technical fee reimbursement. As an integrated academic health system, the University of Pennsylvania School of Medicine and Health System recently took the opportunity to broadly restructure funds-flow opportunities, so as to help align the strategic goals across all of the clinical department activities. To learn more about The Chartis Group’s partnership with Penn on this initiative, we invite you to read our article published in Academic Medicine entitled, "Aligning Academic and Clinical Missions Through an Integrated Funds-Flow Allocation Process."
 

Most provider organizations face an increased need to manage capacity and achieve enhanced Return on Assets performance; this need will only increase as operating costs continue to grow in the face of constrained reimbursement. In addition, many institutions find their volume growth strategies constrained by an inability to assure physicians that they can admit their patients in a timely fashion. This white paper examines the pressures hospital executives face as they strive to meet the rapidly growing demand for inpatient beds. The paper also describes how optimizing patient throughput—the cycling of patients through a hospital’s physical resource base—can improve Return on Assets by increasing revenue per bed and reducing unit cost and the number of new beds needed while improving patients’ access to the hospital. To learn more about our perspective on this essential operations management strategy and the key drivers of success for achieving optimal inpatient throughput, we invite you to read "Patient Throughput: A Critical Strategy for Success".

The field of Radiology has rapidly transformed from a traditional, static diagnostic tool to a proactive, interventional treatment and diagnosis discipline based on the field of imaging. Growth in imaging services demand is staggering, particularly in the face of countervailing capital and human resource scarcity. Additionally, advances in imaging are altering the way clinical medicine is practiced, changing the traditional definitions of service lines and programs, and increasing the need for organizational alignment across physician sub-specialties and between physicians and hospitals. This paper examines these and other challenges facing today’s healthcare leaders and discusses how leadership can strategically take advantage in this evolving environment. To learn more about our perspective on the strategic implications this transformation has for the nation’s hospitals and health systems, we invite you to read "The Imaging Revolution: Challenges and Opportunities."
 

The Chartis Group was commissioned by the American Hospital Association (AHA) to conduct a study examining the standby role of America’s full service hospitals. The “standby role” refers to three unique services provided by full service hospitals today:

• 24/7 Access to Care: The provision of healthcare services 24-hours a day, seven days a week (24/7), 365 days a year
• The Safety Net Role: Caring for all patients who seek emergency care regardless of ability to pay
• Disaster Readiness and Response: Ensuring that staff and facilities are prepared to care for victims of large-scale accidents, natural disasters, epidemics and terrorist actions

This report, entitled “PREPARED TO CARE: The 24/7 Role of America’s Full-service Hospitals,” explores the standby role and its critical importance to the health, well being and safety of our communities; analyzes the nature of demand and the basic and specialized resources required to meet it; outlines the capacity and financing pressures hospitals face in maintaining the standby role; and frames critical economic and policy questions that must be addressed to ensure future hospital standby capacity can meet the growing health and public safety challenges.

These roles often are taken for granted, but represent an essential component of our nation’s health and public safety infrastructure. Despite its importance, the standby role is not explicitly funded.

Chartis Applied Research, in partnership with the Malaria Research and Development Alliance and APCO Worldwide, completed a study entitled Malaria Research & Development: An Assessment of Global Investment. This study was publicly released by the Malaria R&D Alliance, an international coalition of malaria research groups.

The study reveals that governments, the private sector, foundations, and research institutes invested $323 million in malaria research and development in 2004. This figure represents roughly 0.3 percent of total health-related R&D investments. Yet, according to the report, malaria’s impact on humanity is roughly 10 times that amount, accounting for 3 percent of global disease burden.

The 52-page landmark study analyzed funding in the following R&D categories: antimalarial drug discovery and development, vaccine development and trials, basic research, implementation research, vector control research, and development of malaria diagnostics.

Read the press release  Malaria Study Press Release
 

As US Healthcare enters the second half of the decade, the landscape looks markedly different than it did in the mid-1990's when concerns of over-supply and capitation loomed large. Today, hospitals are adding beds at a rapid pace; capitation has ebbed as a market force; demand is increasing as financial and human resources diminish; physicians represent an increasingly complex strategic challenge as their dual nature as hospital supplier and competitor becomes increasingly pronounced; and many health systems are struggling to achieve the optimal balance between scale, consolidation and local agility.

In this White Paper the questions we address are: 1) Why was it difficult to accurately foresee and effectively plan for evolving US Healthcare delivery? 2) What lessons can be learned from the past, and applied in the future to ensure incisive superior planning? To learn more, we invite you to read "Applying Economics in an Uncertain World".
 

We are pleased to release our first white paper entitled "The Art and Science of Execution." The white paper is an outgrowth of an assessment of management challenges that we conducted. Our research indicates that over ninety percent of senior healthcare executives believe that “Ideas or strategies themselves are no longer the source of distinctive advantage in the marketplace.” More and more, these executives argue that the organization’s ability to execute consistently in a rapidly changing environment represents the critical differentiating factor. To learn more about our findings, we invite you to read "The Art and Science of Execution".