Fierce Healthcare reports: "While accountable care organization (ACO) Pioneers are set to launch before the year's end, a recent report indicates that many hospital executives remain unaware of the federal regulations needed to become an ACO.
According to a survey of more than 200 provider organizations, it is most often the hospital CEO who is responsible for ACO development, yet only 15 percent of hospital executives said they were "very familiar" with ACOs as currently proposed; 25 percent were "not familiar" with them, at all.
The survey, conducted by consulting firm Beacon Partners, also found that almost half of hospital execs (48 percent) don't know how an ACO will impact their organization, or whether it will improve patient care.
Despite the unfamiliarity, 92 percent of respondents already are in the planning/development phases of an ACO, with 30 percent in the operational phase.
Half of the responding organizations (53 percent) have yet to create a department or executive position dedicated to ACO development, and only 10 percent plan to hire additional staff to implement ACOs, leading the survey authors to question whether the healthcare sector will be fully prepared for reform."
It is terrifying that the deficit is creating the norm in Washington that spending will be reigned in and half the CEOs in the US are somewhat to absolutely clueless about how they can move their organization to a sustainable rate of return based on changing the norms of care. The CEO is the most important player in moving an organization to focus on the need to decrease the cost of traditional care by substituting less costly outpatient and preventive care at a lower rate of reimbursement. The CEO needs to understand that the reimbursement paradigm is so different and a transition must occur to assure that the organization is positioned to fully deliver in the future.
Sunday, September 25, 2011
Tuesday, September 6, 2011
Letter to the Editor
I read the article in Tuesday's Wall Street Journal on Patient Navigation with interest. But more interesting were the slew of negative comments about "added" or "unnecessary" expense of the navigator. I was compelled to write a letter to the editor (which will not be published most probably) so I am sharing some thoughts via the blog!
Only someone who has luckily never had a chronic disease or a surgery would suggest that the Doctor was all you need to manage your healthcare experience and your healthcare outcomes. Navigation is fast becoming the norm.And a necessity.
What is navigation? It is the support and coordination that most patients need to understand and make the most of the care available to them. Usually provided after an assessment by a social worker or nurse, it can range from something as simple as directions and a parking voucher, to accessing wigs, interceding with employers, explaining the appointment system, arranging transportation or housing to deciding on participating in a clinical trial. Most patients and families in these complex and costly treatment cycles need support and navigation is there to provide whatever support will facilitate care.
Navigators do not replace clinical teams. They are part of the team. They support and reinforce patient education. They arrange support groups. They open doors. They do not diagnose, or determine treatment options.
This is an expense that makes a difference both in lives and in overall cost of care.
Our study of navigation among different ethnic groups who historically have had disparate care, showed a significant improvement in the compliance with care regimens for late stage high risk patients. In addition, for those patients with Medicaid or no insurance, navigation made a significant difference before and after navigation in the patients ability to access care in a timely and cost effective manner. Compliance saves lives and navigation improves compliance. Its that simple.
Only someone who has luckily never had a chronic disease or a surgery would suggest that the Doctor was all you need to manage your healthcare experience and your healthcare outcomes. Navigation is fast becoming the norm.And a necessity.
What is navigation? It is the support and coordination that most patients need to understand and make the most of the care available to them. Usually provided after an assessment by a social worker or nurse, it can range from something as simple as directions and a parking voucher, to accessing wigs, interceding with employers, explaining the appointment system, arranging transportation or housing to deciding on participating in a clinical trial. Most patients and families in these complex and costly treatment cycles need support and navigation is there to provide whatever support will facilitate care.
Navigators do not replace clinical teams. They are part of the team. They support and reinforce patient education. They arrange support groups. They open doors. They do not diagnose, or determine treatment options.
This is an expense that makes a difference both in lives and in overall cost of care.
Our study of navigation among different ethnic groups who historically have had disparate care, showed a significant improvement in the compliance with care regimens for late stage high risk patients. In addition, for those patients with Medicaid or no insurance, navigation made a significant difference before and after navigation in the patients ability to access care in a timely and cost effective manner. Compliance saves lives and navigation improves compliance. Its that simple.
Obamacare: Why are the deficit hawks not for it?
From 2000 through 2009, Medicare’s outlays climbed by an average of 9.7 percent a year. By contrast, since the beginning of 2010, Medicare spending has been rising by less than 4 percent a year. On this, both Standard Poor’s Index Committee and the Congressional Budget Office (CBO) agree.
Why are we not hearing that indeed the cost curve is bending. The objective of the Affordable Care Act is to expand care to the uninsured and to make sure that those that need care are getting care that is of high quality and affordable (the value proposition!). So why when the healthcare industry, especially providers, are beginning to put in place, often to their own short term disadvantage, changes in practice that save money, does the Act still have a bull's eye on it?
When you start talking about cutting entitlements when there are ways to save billions annually right in front of us is surprising and seemingly not in the best interest of anyone. The only thing that makes sense to me is that it is a sound bite that is so simplistic (government is the boogyman) that the political appeal is too much to resist. Because from a practical sense, there is not a tea partier alive that resides in Vermont or New Jersey that wants FEMA and disaster area funds cut.
In the twelve months ending in May, overall spending by commercial health insurers climbed by 7.35 percent. By contrast, over the same span, Medicare claims rose at an annual rate of just 2.6 percent.(S&P and Congressional Budget Office)
So why do we think that the government cannot manage this huge national problem? The facts just don't add up to support privatization.
Here are a few of the programs that have proven that expenditures can be reduced and not only not reduce quality but actually improve it (From Healthcare.gov
Proven Results with Bundled Payments
Both Medicare and private health care providers have shown that bundling payments improves care for patients, and leads to better health, better care and lower costs.
Why are we not hearing that indeed the cost curve is bending. The objective of the Affordable Care Act is to expand care to the uninsured and to make sure that those that need care are getting care that is of high quality and affordable (the value proposition!). So why when the healthcare industry, especially providers, are beginning to put in place, often to their own short term disadvantage, changes in practice that save money, does the Act still have a bull's eye on it?
When you start talking about cutting entitlements when there are ways to save billions annually right in front of us is surprising and seemingly not in the best interest of anyone. The only thing that makes sense to me is that it is a sound bite that is so simplistic (government is the boogyman) that the political appeal is too much to resist. Because from a practical sense, there is not a tea partier alive that resides in Vermont or New Jersey that wants FEMA and disaster area funds cut.
In the twelve months ending in May, overall spending by commercial health insurers climbed by 7.35 percent. By contrast, over the same span, Medicare claims rose at an annual rate of just 2.6 percent.(S&P and Congressional Budget Office)
So why do we think that the government cannot manage this huge national problem? The facts just don't add up to support privatization.
Here are a few of the programs that have proven that expenditures can be reduced and not only not reduce quality but actually improve it (From Healthcare.gov
Proven Results with Bundled Payments
Both Medicare and private health care providers have shown that bundling payments improves care for patients, and leads to better health, better care and lower costs.
- During the five-year Heart Bypass Center Demonstration (started in 1986) Medicare saved $42.5 million – or 10 percent – on Coronary Artery Bypass Graft surgery at participating hospitals in Atlanta, Columbus, Ann Arbor (Michigan), and Boston, largely through improved hospital processes and a reduced need for intensive care. Medicare patients saved $7.9 million in coinsurance payments.
- Medicare’s three-year cataract surgery demonstration (started in 1993) was also successful in reducing Medicare spending by $500,000 for approximately 7,000 procedures at sites in Cleveland, Dallas/Fort Worth, and Phoenix.
- The fixed price for Coronary Artery Bypass Grafts (CABG) under Geisinger’s ProvenCare reduced costs and improved patient care showing that hospital costs dropped 5 percent, average length of stay fell by 0.5 days, and the 30-day readmission rate fell 44 percent over 18 months for Pennsylvania hospitals in Geisinger’s network.
Subscribe to:
Posts (Atom)