Hold onto your seats is the message for anyone involved with health care. We are all in store for a wild ride. Talk about an industry that is changing dramatically and virtually overnight. I have always said that trying to change anything in health care is like trying to turn an aircraft carrier; it takes quite a bit of time. That doesn't seem to be the case today. There is some good news from the financial crisis that our country has been experiencing; it is that quality and efficiency in health care have finally become the critical focus of payors, especially Federal and State governments. Insurers are buying hospitals and hospitals are once again buying physician practices and, to some extent, getting into the insurance business by working directly with companies on the health and care of their employees. Integration is rampant in health care and that can be a good thing.
As I have written here before, WMHS is now operating under a new and different payment methodology that focuses on the value of the care that is being delivered with the patient being the center of care delivery. We previously were paid based on volume of admissions, tests, procedures, patient days and the list goes on. There was little in what we did that was based on quality and efficiency. Then we saw the zero sum gain in Maryland related to potentially preventable conditions, core measure success, readmissions. If we were successful in each area, then we were paid incentives; if we weren't, we lost money in rates. Lose a million dollars in rates for poor performance and it is interesting to see what happens. In addition to performance improvement and being rewarded for such performance, going forward, we are now paid very differently based on the quality and the efficiency of the care delivered. The ride will continue to be wild especially until everyone is on board with all of the changes ahead in US health care. Stay tuned.