Felix Valbuena Jr
The key question that I see in your initial post is the following: are you trying to maximize profits on meds to beds or is the ultimate goal to minimize readmissions? If it is the first, then you have to expand pharmacy capacity to meet the demand. If it is the latter, then you should focus on timely transitions of care to the PCP, who will manage all follow up including medication reconciliation.
Unfortunately, until you can significantly impact the current compensation model to start the shift from productivity to include outcomes-based incentives; you will not be able to see a positive effect on outcomes. There is no dis-incentive for poor outcomes in the current model, so providers will never focus on anything other than volume. The key is to start looking at alternative compensation models that will continue to provide financial incentives for productivity, but also for improved patient outcomes.
Payors are moving, some faster than others, at incentivizing outcomes over volume. The trick is shifting providers’ incentives from volume to value, at the same rate as the payors. Bonuses from payors for meeting preventive care, chronic illness control and overall improved health metrics for members; help incentivize staff while improving the quadruple aim (lower cost, improved outcomes, patient satisfaction, provider/staff satisfaction).
Decision-making and autonomy at the service line level is the best way to foster employee engagement and satisfaction, along with clear metrics/expectations/targets. Continuous support from upper management must be available as needed/requested to develop and implement the skills needed at the service line level to meet expectations.
This sounds like an attempt at shifting the volume proposition in medicine to value. Looking at the incentives of staying under the cap, both financial as well as quality of life for providers and staff; a strategic focus on maximizing efforts to excel in metrics will improve the bottom line as well as provider/employee satisfaction.