TY - JOUR
T1 - Creating and Maintaining a Successful Service Line in an Academic Medical Center at the Dawn of Value-Based Care
T2 - Lessons Learned From the Heart and Vascular Service Line at UMass Memorial Health Care
AU - Phillips, Robert A.
AU - Cyr, Jay
AU - Keaney, John F.
AU - Messina, Louis M.
AU - Meyer, Theo E.
AU - Tam, Stanley K.C.
AU - Korenda, Kathleen
AU - Darrigo, Melinda
AU - Kumar, Pooja
AU - Challapalli, Sailu
N1 - Publisher Copyright:
Copyright © 2015 by the Association of American Medical Colleges.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - The service line (SL) model has been proven to help shift health care toward value-based services, which is characterized by coordinated, multidisciplinary, high-quality, and cost-effective care. However, academic medical centers struggle with how to effectively set up SL structures that overcome the organizational and cultural challenges associated with simultaneously delivering the highest-value care for the patient and advancing the academic mission. In this article, the authors examine the evolution of UMass Memorial Health Care's heart and vascular service line (HVSL) from 2006 to 2011 and describe the impact on its success of multiple strategic decisions. These include key academic physician leadership recruitments and engagement via a matrixed governance and management model; development of multidisciplinary teams; empowerment of SL leadership through direct accountability and authority over programs and budgets; joint educational and training programs; incentives for academic achievement; and co-localization of faculty, personnel, and facilities. The authors also explore the barriers to success, including the need to overcome historical departmental-based silos, cultural and training differences among disciplines, confusion engendered by a matrixed reporting structure, and faculty's unfamiliarity with the financial and organizational skills required to operate a successful SL. Also described here is the impact that successful implementation of the SL has on creating high-quality services, increased profitability, and contribution to the financial stability and academic achievement of the academic medical center.
AB - The service line (SL) model has been proven to help shift health care toward value-based services, which is characterized by coordinated, multidisciplinary, high-quality, and cost-effective care. However, academic medical centers struggle with how to effectively set up SL structures that overcome the organizational and cultural challenges associated with simultaneously delivering the highest-value care for the patient and advancing the academic mission. In this article, the authors examine the evolution of UMass Memorial Health Care's heart and vascular service line (HVSL) from 2006 to 2011 and describe the impact on its success of multiple strategic decisions. These include key academic physician leadership recruitments and engagement via a matrixed governance and management model; development of multidisciplinary teams; empowerment of SL leadership through direct accountability and authority over programs and budgets; joint educational and training programs; incentives for academic achievement; and co-localization of faculty, personnel, and facilities. The authors also explore the barriers to success, including the need to overcome historical departmental-based silos, cultural and training differences among disciplines, confusion engendered by a matrixed reporting structure, and faculty's unfamiliarity with the financial and organizational skills required to operate a successful SL. Also described here is the impact that successful implementation of the SL has on creating high-quality services, increased profitability, and contribution to the financial stability and academic achievement of the academic medical center.
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U2 - 10.1097/ACM.0000000000000839
DO - 10.1097/ACM.0000000000000839
M3 - Article
C2 - 26222322
AN - SCOPUS:84957558729
SN - 1040-2446
VL - 90
SP - 1340
EP - 1346
JO - Academic Medicine
JF - Academic Medicine
IS - 10
ER -