b'4.Reimagining Value:Downstream ImpactsLooking forward, there are clearly untappedT E C Hopportunities to impact quality and cost componentsNof the value equation. By maturing hospital medicineOprograms beyond our well-established foundations,Lhospital medicine can further impact quality, assistOhospitals in managing cost constraints, and provide new levels of professional sustainability for the specialty.HOSPITALISTS GYImproving Quality TELENOCTURNISTSTELEADMISSIONISTSWe can evolve the quality side of the equation byTELEHOSPITALISTSadopting two critical strategies: clinical focus on metrics and supporting the full patient journey. Clinical Focus on MetricsWhile treating the patient in front of them, hospitalists can focus on their role in achieving high performance on the quality metrics of the facility, whether it be mortality and sepsis metrics, MIPS requirements, HCAHPS or otherSupporting the Full Patient Journeyfor value-based initiatives.The hospitalist can support smooth patient transitions to ensure continuance of quality care. In 2018, The The quality metrics of a tertiary facility that is part of aCenters for Medicare and Medicaid Services introduced national chain may be different than for a small rurala new alternative payment equation, Bundled Payment hospital. Regardless, the hospitalist team must be ablefor Care Improvement Advanced (BPCI Advanced), which to acknowledge the customized quality needs of theeffectively extended the fiscal responsibility for inpatient facilities and translate quality into an executed process,care providers to 90-days post discharge for all episodes.successful in achieving the goals. Achievement of these quality goals is critical to assurance of CMS performanceThis is a sea change in the traditional hospital medicine expectations and avoiding financial penalties andmindset, in which responsibility ended at discharge. In withholds. that time, hospitalists would admit and care for patients and see them through their hospital-based episode The most under-valued tactic in this area of theof care. But that care ended when the patient was hospitalist arsenal is the dedicated, so-called non- discharged. However, in a programmatic approach that productive time of clinical leadership to address andforeshadows the future direction of hospital medicine, support the management of these quality metrics.hospitalists are already responsible not just for the Non-direct patient care time is critical to developing carecare they provide to patients while they are admitted, pathways, algorithms, and collaborative processes withbut also for the 90-days post-acute continuum, as per facility staff so that the metrics which are indicators ofBPCI Advanced. The bundling of the 90-days post-quality patient care can truly be improved. discharge, with attribution sourced to the hospital medicine physician, creates a new level of integration and coordination between the hospital medicine program and the next sites of care, with laser focus on readmission prevention. Together, we healTogether, we heal 4Together, we heal SCP HEALTHIA NEW HOSPITAL MEDICINE EQUATION FOR A POST-COVID FUTURE'