02

Quality is the result of intelligent efforts. Quality means doing it the right way even when no one is vigilant.

In the healthcare profession, precision and perfection are not a dispensable luxury, but a simple primary necessity. Providing quality care has become a way of life but it comes at a price. How quality is maintained and improved in hospitals and healthcare services at an optimum cost is indeed a debated topic.

Managing cost and multiple demands: Managing costs effectively with quality is one of the important agendas for healthcare providers especially at a time when sustainability concerns along with regulatory, financial and operational uncertainties, complex challenges and pricing pressures are plaguing the industry. Though quality and pricing are interrelated, one has to understand the existing realities and perspectives of our healthcare system that is also a victim of activism, over-governance and regulation.

As a doctor and a healthcare professional in this space for the past 30 years, I can understand the problems of our industry first hand. Our health care system is in drastic need of innovative, patient-centric reforms that encourage healthy competition and increase consumer choice.

Currently, the healthcare providers face multiple demands from different stakeholders, including increased pricing pressure from the government, cost and quality concerns and affordability issues from patients, intense competition, increasing consumer demand with their rising capacity to pay more and the pressure on margins straining returns on capital.

Newer realities: By taking into account procurement, monitoring, staffing and pricing, the industry designs operations to manage costs and boost profitability. Service providers have adopted many new measures to improve revenue and reduce cost. But the new realities of value-based care aren’t that easy to get adjusted too. Stakeholders in the whole value chain including pharma companies, medical device manufacturers, employers and individuals are closely introspecting the changing circumstances of containing costs and improving transparency in providing quality healthcare.

Fee-for-service model: The current trend is indeed critical considering rising healthcare costs which doesn’t go in sync with the marginal graph of average and negative margins. So, it is important to look at and evaluate the fee-for-service model.

The model rewards physicians on the basis of the number of patients they see. Is this business motivated model fool proof? It goes without saying that tough times are ahead of where all the stakeholders have to adjust qualitatively and quantitatively in the greater interest of delivering quality healthcare services.

Financial system: Over the past few months a few hospitals have tried to find ways to make payments easier for patients through equated monthly installments (EMIs) but this has given rise to a new problem of payment defaults.

Most healthcare service providers are constrained in terms of their investments in required areas to manage costs. Even though the Insolvency and Bankruptcy Code (IBC) reforms have been in place, NPA woes continue to dog the banking sector and the IBC is not being used to the full extent. However the severity of each case may vary, care is not standardized, and the quality of clinical delivery is variable over time and across players. As a result, under the evolving market scenario, patient experience and service standards can deteriorate as providers struggle to get funding leading ultimately to an adverse impact on costs.

Practice model at Medica: Healthcare providers have reduced costs through three methods which include, front-end manpower cost optimization, material cost optimization, and overhead cost optimization. A good cost transformation strategy focuses on particular need, profile and behavioural patterns of customers.

The Medica cost model:  From inception, Medica has focused on providing quality healthcare based on patient feedback opted for accreditations, which leads to higher-quality patient care and safety. This accreditation approach, which is a self-assessment and external peer assessment process, to assess the level of performance in relation to established standards, not only benefits patients but also distinguishes hospitals in a competitive environment.

Accreditation is not just about setting a benchmark: There are other aspects like analytical, counselling and self-improvement dimensions to the whole process. Minimising medical error is a key role of the accreditation process. Meanwhile, the focus is always going to be the urge to provide enhanced patient experience which plays an integral role in providing patient satisfaction with the providers.

Quality is everyone’s responsibility at Medica: Enhancing overall operational excellence in structured ways in hospitals can provide a win-win situation for all, I believe: providers, patients and other healthcare stakeholders keeping in mind the truth that patients are the most important stakeholders in the chain, who deserve to live a healthy fulfilling life.

The author is the Chairman of Medica Group of Hospitals