Frontiers of Health Services Management最新文献

Healthcare spending in the United States continues to rise as patient demand shows no signs of slowing. In response, health system executives have invested billions in technology modernization to boost efficiency and reduce costs through automation, such as machine learning models, generative AI models, deep learning models, and others. These efforts have improved access, enhanced outcomes, and standardized patient data collection, fueling advances in research and the development of future treatments. Now, the industry stands at a pivotal moment: how to responsibly leverage years of patient and outcomes data to train artificial intelligence (AI) to generate return on investment (ROI) through data monetization, accelerate care delivery, and lower costs while managing the risks and unintended consequences of IT adoption. This article explores how AI and other emerging technologies in healthcare demand critical evaluation of responsible data use, careful consideration of data privacy and compliance, and clear strategies for measuring the positive or negative unforeseen consequences of AI across different stakeholders.

The urgent need for healthcare transformation in the United States has long been evident. The traditional system of healthcare in a community has typically revolved around the acute care center, whether these communities are in large city neighborhoods or in remote rural areas, hundreds of miles from tertiary or quaternary services. One way in which healthcare leaders can transform systems of care is by considering local acute care centers as one aspect of a larger care ecosystem. Healthcare's most expensive work is in the acute care center. By most estimations, 25 percent of that work is waste (Bauchner and Fontanarosa 2019). According to the most recent data by the Centers for Medicare & Medicaid Services (CMS), national health expenses grew 7.5 percent in the year ending 2023, with hospital expenses experiencing double-digit increases (Centers for Medicare & Medicaid Services 2025). Building systems of care with the highest quality of service in the most coordinated and cost-efficient manner is needed more than ever. Despite limited resources, we must begin to invest capital dollars in value-based care and promote it in capital investment conversations as the leading strategy for healthcare systems.

Private capital has been a powerful force in driving healthcare innovation, fueling digital tools, team-based care models, and many other modernizations of care. Yet skepticism remains about whether financial investment can align with improved outcomes, improved access, and lowering of costs based on negative examples. In a healthcare system that spent $4.9 trillion in 2023, with most of the supporting investment funded by nongovernmental sources, the role of private capital is not just influential but essential. Consequently, working to reduce negative implementations and increase transparency is worthwhile based on the needs for innovation in healthcare-digital and physical. This article provides approaches for private investment to analyze not only financial return on investment but also health value return on investment (HV-ROI). That means measuring how well capital deployment improves care outcomes, expands access, targets community needs, and supports providers while impacting healthcare costs. Investors should be true health partners. Adopting HV-ROI practices can help them and partnering healthcare executives align financial goals with value-driving both financial viability and improved outcomes for patients and communities. Key insights include: Blended funding is essential. Public programs, philanthropy, and private investment each play a role. Only together can they support the cost of care, scale proven solutions, and sustain innovation across all communities.Private investment must evolve. While it has enabled telehealth, diagnostics, and behavioral health platforms, instances of private for-profit investment with poorly aligned incentives have also led to staffing cuts, reduced services, and worse outcomes in areas like emergency medicine and nursing homes.HV-ROI offers a solution. This framework proposes embedding health value throughout the investment lifecycle:Evaluating clinical outcomes, access, affordability, and local needsAligning investment key performance indicators with patient, provider, and payer prioritiesBuilding governance structures that reward long-term health impactTransparency and accountability matter. Publishing impact analyses, engaging third-party evaluators, and sharing lessons learned will build trust and legitimacy.

The One Big Beautiful Bill Act (OBBBA) contains $1.3 trillion cuts in funding to federal healthcare programs-including $1 trillion cuts to Medicaid and $300 billion cuts to the Supplemental Nutrition Assistance Program (SNAP)-mandating a significant response from the US healthcare system. Important responses to this sweeping legislation include an update of strategic and capital planning, optimization of revenue cycle management, labor and the supply chain, and development of new sources of nonoperating revenue to support the organization's mission. The OBBBA represents a movement toward a market-based healthcare system in which healthcare organizations must become less dependent on third-party reimbursement and more reliant on disposable spending, nonoperating revenue, and market-based demand.

Health system venture groups are far more than finance vehicles on the periphery of care delivery. They serve as high-impact engines for clinical and operational innovation, empowering frontline clinicians, administrators, and care teams to reimagine and improve how care is delivered and experienced. By providing dedicated funding, strategic focus, and governance, these groups accelerate the adoption of breakthrough technologies, expand access to specialized services, and optimize clinical workflows. Their unique access to healthcare environments allows them to validate, implement, and spread impactful innovations faster than traditional investors. The result is better outcomes for patients, reduced burnout for providers, and sustainable growth for the health system. This article explores why ad hoc innovation stalls without governance, how venture capital functions as a capability enabler, and the purposeful design of Intermountain Ventures as a model for other health systems. We also examine concrete examples of successful investments-in areas such as care delivery, access to care, and next-generation technology-and offer a practical playbook for executives looking to launch or refine their own venture programs. Finally, we reflect on the strategic imperative of putting mission-based capital to work, today and in the future, enabling responsible innovation with long-term impact.

University of California (UCI) Health acquired an integrated healthcare delivery system from Tenet Healthcare in March 2024. The acquisition, which included four hospitals and added 858 beds to the system, was a pivotal move toward pursuing the organization's commitment to the long-term health needs of the region and progressing UCI Health's strategic priorities to improve health, increase sustainability, and transform healthcare. Following the acquisition, UCI Health embarked on a journey to integrate the system. This process strengthened the system's ability to deliver high-quality, patient-centered care across the region. From the beginning, UCI Health established three guiding principles to support a successful integration and inform the path toward systemness: 1. Quality and access 2. People and culture 3. Financial performance The integration of the acquired hospital facilities, referred to as the UCI Health Community Network, has been a dynamic process. UCI Health began by addressing challenges related to the format of a divestiture, identifying opportunities for synergies within this new structure, and then advancing transformative initiatives that can bring lasting benefits. UCI Health has also established an integrated mission and vision, as well as coworker values, ensuring that all these statements are representative of the broader system. The integration efforts demonstrate UCI Health's commitment to systemness and the positive impact it has had across the organization.

In response to growing challenges in health care, such as regulatory changes, financial pressure, and physician and workforce shortages, Methodist Le Bonheur Healthcare (MLH) has embraced "systemness," a concept emphasizing coordinated, unified operations with a shared focus on high quality and efficiency, to ensure sustainability. Drawing from foundational theories in systems thinking, MLH applies a systemness mindset to improve care quality, operational efficiency, and patient experience across its six hospitals and dozens of physician practices and outpatient services. MLH's strategic initiatives have included chartering a Systems Operational Improvement Team (SOIT) to achieve $73 million in savings in its first year, and the Methodist Associate Advancement Program (MAAP) to support workforce development. To actualize a branded commitment to enterprise-wide excellence, MLH implemented a transformational change in its accountability framework to boost Leapfrog Hospital Safety Grades and Centers for Medicare and Medicaid (CMS) star ratings with the Organizational Performance Tracker (OPT), an innovative dashboard aligning more than 90 performance goals to national benchmarks. Technology integration has been central to MLH's systemness journey with a transition to unified Epic electronic health record (EHR) and Workday platforms to streamline operations and enhance care coordination. The interprofessional care model supports important collaboration across disciplines and facilities to ensure consistent patient-centered care. Key to the systemness strategy is a balance between standardization with local innovation, recognizing unique needs of diverse patient populations. Programs like the Power of One Idea and Performance Excellence Award have encouraged staff-driven improvements to realize measurable gains. For MLH, systemness is an ongoing journey to deliver the exceptional care each patient deserves.