"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Monday, October 15, 2012

No Outcome, No Income

Yesterday, I attended a meeting on the future of health care.......scary to say the least, but there are also opportunities for the short term.  Some of the predictions are ominous, such as 1 in 6 hospitals will be out of business by 2020; there will be no such thing as an independent hospital or health system such as ours; global payment with all providers (physicians, hospitals, nursing homes, clinics, centers, etc.) sharing in a single payment; hospitals will once again be buying physician practices, if not, at minimum, employing as many primary care physicians and advanced practice professionals as they can. If hospitals can dominate primary care with their physicians and nurse practitioners, they will be in a position of strength.

For the short term, hospitals must focus on patient outcomes.  There are many initiatives underway throughout the health care industry and at WMHS to prevent medical errors, prevent avoidable admissions, reduce avoidable readmissions, improve efficiency and reduce cost where possible.  As we have been doing very intensely for the last two years, hospitals must focus on safe, efficient patient- centered care.   That's where the title of today's blog comes in "No Outcome, No Income."

Through payment reform, hospitals are now directly accountable for the results or outcomes in patient care.  For example, over utilizing tests and procedures, not addressing complications, not reducing medication errors, or pursuing ways to prevent infections will result in losses for hospitals.  In addition, there has to be evidence as a basis for the care that is being provided.  Hospitals must coordinate the care of their inpatients and ensure that they have an effective plan of care after discharge.

We must also care for the patient in the most appropriate setting.  If we don't eliminate unnecessary and redundant testing, avoid readmissions, provide fragmented care and not address population health, there will be no income and in fact, we will be penalized and have money taken away.

Tomorrow's blog will include specifically what WMHS has been doing to improve outcomes to ensure that there is a continued income stream.

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