A strategic & collaborative approach to healthcare delivery

The Afford­able Care Act changed how the U.S. health­care system will func­tion. But according to Tim­othy Hoff, a newly appointed asso­ciate pro­fessor of man­age­ment, health­care sys­tems, and health policy, one imper­a­tive remains: the need to think both col­lab­o­ra­tively and strate­gi­cally in restruc­turing health­care delivery.

“The health­care reform law didn’t change that reality, it only advanced it,” said Hoff, who holds joint appoint­ments in the D’Amore-McKim School of Busi­ness and the School of Public Policy and Urban Affairs. “There are many views taken into account around the health­care policy table—there’s the patient, there’s the clin­i­cian, and there’s the organization—and everyone has to begin to realize we’re working with a fixed pool of resources, and that we don’t have the system yet in place for meeting the needs of health reform. These two real­i­ties will shape what it is we have to do.”

Hoff studies health pro­fes­sionals and how busi­ness thinking and prin­ci­ples apply to health­care sys­tems. In par­tic­ular, he explores the area of pri­mary care, a system already strained by a growing elderly pop­u­la­tion and one expected to see a mas­sive surge in demand under new fed­eral and state health­care reforms. He has written sev­eral op-​​eds and schol­arly arti­cles on the trans­for­ma­tion of the Amer­ican health­care system, including a recent com­men­tary for the Amer­ican Journal of Man­aged Care.

“In pri­mary care, there are not enough physi­cians to meet the need, espe­cially after giving mil­lions more people access to insur­ance under health­care reform, and placing greater emphasis on keeping indi­vid­uals healthy,” Hoff said. “We must make some very real and pro­found changes to that part of the system.”

For instance, struc­tural changes in the delivery of pri­mary care may include empow­ering phar­ma­cists and nurses to make doc­tors’ deci­sions. “There won’t be enough doc­tors and tra­di­tional prac­tices to go to,” Hoff explained, noting the poten­tial rise of walk-​​in clinics in super­mar­kets and pharmacies.

Prior to joining the North­eastern fac­ulty, Hoff was an asso­ciate pro­fessor at the Uni­ver­sity at Albany, SUNY, where he also earned his doc­torate in public admin­is­tra­tion and policy. He said he chose North­eastern in part because of its com­mit­ment to health-​​related research and ini­tia­tives and its strong ties to the health­care com­mu­nity in Boston and Mass­a­chu­setts, which enacted sim­ilar health­care leg­is­la­tion sev­eral years before the fed­eral government.

“The Boston area is the center of the U.S. health­care uni­verse,” said Hoff. “The state is doing a lot of things we’re going to expect the rest of the country to do down the road. It’s a real leader on the national stage.”

Hoff looks for­ward to working with stu­dents in a variety of dis­ci­plines, a col­lab­o­ra­tive approach that will define how health­care func­tions in the future. “I think there’s great ben­efit that comes from bringing in a lot of dif­ferent perspectives—business, public health, clin­ical, consumer—and having a real, holistic dia­logue about how to improve health­care,” Hoff said.

“There’s no doubt we can do a lot of things better, and busi­ness ideas and inno­va­tions will cer­tainly help,” he added. “But that rela­tion­ship between the patient and the provider must always be at the center of what everyone is thinking about.”

– by Matt Collette