Consider this startling statistic: The cost of health care represents 16% of the Gross Domestic Product (GDP) in the United States. Is this too much or too little? Who knows? The news is full of varying opinions on the topic. I suspect that a person’s perspective is largely situational. A 25-year-old facing building a career while paying for large student loans has a vastly different opinion than perhaps a baby boomer with a spouse suffering from cancer.
This year our industry faces the beginning of reforms which will continue through the year 2020. Over the next decade, we can expect two major challenges that will certainly impact our success: reimbursement will decrease and regulations will increase. For example, according to a March/April 2010 survey of hospitals by the American Hospital Association, nearly nine in 10 hospitals reported an increase in care for which their hospital received no payment at all. Additionally, new incentives are being offered to hospitals that launch electronic medical records early and who meet high customer satisfaction expectations. Reform means our payment for the services we render will directly result from those of us who can consistently demonstrate the highest quality services and outcomes.
What does that mean for CVMC and each of us? In this new paradigm, we have to take steps to effectively count not only the traditional quantity of services we provide, but also the quality of those services in order to insure that our outcomes are accurately reflected.
In order to demonstrate the quality (and value) of our services, we should expect that they will be measured in the following ways:
- Hospitals with greater than expected 30 day re-admission rates will see federal reimbursement cut across the board for all discharges.
- Beginning in 2013, hospitals with the highest efficiency and HCAHPS patient satisfaction scores will be able to earn back money that will be automatically reduced — beginning in 2012.
- Hospitals with the worst risk-adjusted rate of patients with conditions acquired in their facilities will lose 1% of payments they would have otherwise received.
These new measures of accountability insure the need and permanence for performance management and continuous improvement. Each of us must be held accountable for delivering and tracking service excellence on a daily basis.
Obviously, we have an exceptional facility. We could not have earned a third Magnet Hospital award or navigated through a challenging Joint Commission survey with such high accolades from the surveyors. We do, however, face significant challenges in the new paradigm of healthcare reform. In the new environment, this approach will now impact not only our reputation and standing in our community, but also our funding.
Understanding the impact to each of us is the first step in embracing and improving accountability in our work culture. Old ways of doing business are and will no longer be either effective or acceptable. We must now abandon old methodologies the way we would discard an outdated medical procedure.
I know that each of us can be successful both as individuals and as a group. We have proven time and time again that we are a compassionate and talented organization. We are recognized for our ability to innovate and achieve good outcomes for our patients. We have a superior organization in the traditional role of healthcare provider. I predict that we will each embrace the new levels of performance and accountability required to maintain that level of importance and excellence as our paradigm shifts. I look forward to sharing these challenges with each of you.