In early 2019, ECG distributed a nationwide survey to gain a deeper understanding of service line constructs, utilization, and performance management in all types of healthcare organizations. Clinical and administrative leaders of single hospitals and multihospital regional systems responded and provided insight into the true value proposition of service lines and how they serve as the platform to optimize patient care across the care continuum.
In the infographic below, the data highlights key trends from our survey, including the following:
- Cardiovascular, neuroscience, and oncology were consistently highlighted as core service lines within each organization, with high patient volumes and an even greater return on investment. Many respondents also emphasized women’s health and musculoskeletal as areas of growing opportunity with patient-centric care offerings and a potentially positive contribution margin.
- The dyad leadership structure was in place with over 75% of respondents; however, 74% of all respondents indicate that they utilize a service line council of clinical, operational, and support leaders to support initiatives around service line strategy, quality, clinical practice, or other operational initiatives. The survey was inconclusive as to whether the dyad leadership model itself is sufficient to drive service line operational performance and align clinicians to strive for clinical excellence. ECG’s experience is that a triad of administrative, physician, and nursing leadership is essential, with higher-performing service lines also adding a financial leader.
- A vast majority of service lines focused both on strategic endeavors and operational effectiveness, balancing goals between overall volume growth, provider alignment, quality/safety, capacity management, and clinical distinction.
- A cross-continuum focus continues to be prevalent among current service lines, highlighting the need to not only focus on the acute care space but also be cognizant of growth demands in ambulatory and post-acute services.
- Due to IT and financial constraints, most service lines do not have their own budgets or profit-and-loss statements, making it increasingly difficult to show direct returns on investment or cross-system financial performance. Moving forward, most respondents expressed their desire to create “horizontal” financial statements across all hospitals or entities rather than focusing solely on “vertical” hospital financial results. This will increase the emphasis on clinical programs and provide justification for investments in future innovative equipment and clinical resources.
In response to the survey, ECG has created a planning approach for health systems to realize the underlying value proposition of a system-level service line approach. The fundamental elements of this approach address four key questions:
- What is your vision for success, and how will you utilize service lines to lead organizational change?
- How will you drive performance through your portfolio of clinical programs?
- How do you develop a more effective avenue to physician alignment and engagement?
- What are the benefits/results we can expect out of building a comprehensive service line platform in terms of quality, patient and clinician engagement, growth, and financial performance?
Our approach helps health systems discern which clinical areas may offer the greatest opportunity to realize the most impact across these four questions by establishing (or redesigning) a service line model, drafting the strategic aims for the service line, designing the optimal organizational and governance model, and executing health system strategy.