There are a couple of weeks I'm selling out of the University of Southern California (USC) C-Suite Invitational in Los Angeles, where he saw spokesman Dr. Josh Lucas, discussion about the value and future of our health care system will take care based. I watched as he vigorously shook so to speak for about an hour in a room of the hospital executives. It was exciting and professionally, but every few minutes I could see the participants squirm in their chairs.
Meet Josh in recent years, I realize that the version of the health of these "experts ignored" in movies is that predicted that a great disaster is about to happen, but none of colleagues believe the soil is a few days the termination. On the independence of the Origin Day, it was Jeff Goldblum plays David, a computer scientist and MIT studied at the 11th hour was called upon to save the day.
Josh Lucas is Jeff Goldblum Healthcare. Let me explain.
From 2012, the Centers for Medicare & Medicaid Services (CMS) has significantly changed the way they pay hospitals. Instead of paying for health services based on the volume, since the number of hospitalizations is, CMS now offered to pay based on the quality of care provided that they Medicare patients. In addition, the Affordable Care Act (ACA), CMS to reduce unauthorized payments to acute care hospitals with the highest rates of readmission and expanded the use of incentive compensation approaches.
Shortly after these changes took place, hospital panic that began followed.
In 2013, Josh Lucas - who was aged 32 general director of the hospital and went to two books on the prevention of re-entry, value-based solutions to publish - has become one of the most popular are for hospital consultants in the country. He founded the National Partnership for the Prevention of readmission in 2013 and the national 2015 grouped payment to present some best-practice models of integration. Hospitals that had to avoid with these new initiatives, which are struggling to value and the necessary help by improving care coordination penalties willing to pay a pretty penny for their advice.
While most can remember of us, most patients who have ended up in the emergency room, generated more income through the hospital. Many refer to it as "Hand in beds" mentality. Now, insurers and CMS (most of the US dollar have) put pressure on hospitals to clean up their acts. Basically take hospitals more risks than ever before.
There were five general news, which I took from the presentation (the same one that made everyone uncomfortable in the room) I'll try interesting for the layman to explain with analogies.
1. Hospitals are large insurance companies now.
At the end of Part II Godfather, Michael Corleone after his father go in a rose garden to see softly, he recognized Michael messier drug business from his father, as it had taken or not taken.
That's what happened at that time in the hospital. Hospitals are in the insurance industry, like it or not, and to be the boundaries between payers and providers, the lack of definition that hospitals is more exposed to risks. "If you are the CEO of a hospital, you are essentially the CEO of an insurance company," said Josh in the crowd.
2. nursing facility (SNF) prevention is real.
"Find me an American who wants to stay in a nursing home!"
Josh cried a couple of times during the hearing, and, ironically, he is director of the nursing home were allowed. Healthcare (medical) combined with home care (non-medical) will continue to work in harmony to create a new generation of workers, I would like to call "post-acute extender" or Pacers short home.
These are Pacers as German Shepherds in the house - they are intelligent watch dogs, trained to give the love and companionship barking most of the time, but the strong, if they feel danger. Pacers also similar to that fight is generally not the intruder, who are trained to let someone come risk.
3. Hospitals should test your smarter "safe" year, new programs for initiatives payment package.
In 2015, CMS has taken important steps to increase the use of their retail payment programs. In November 2015 CMS announced more than 450 hospitals and medical groups and FRR signed on for the program.
In April 2015 CMS launched a new rule for a replacement joint global initiative of Care (CJR), more than 800 hospitals forcing an output target to establish based on the performance in previous years. Hospitals are primarily "at risk" because their total cost of the treatment will be different again from the amount you will receive a refund. Unfortunately, too many hospitals choose to provide for "sandbag" in the first year of its low benchmark.
It will stay with me for this analogy.
Usain Bolt stunned the world when the 100-meter record in the world at the Olympic Games of Beijing 2008 was broken while barely breaking a sweat. Approximately 80% of the race looked through the crowd and beat their breasts in defiance and crossed the finish line with a shoelaces flapping in the wind. No doubt I could have run faster.
What many do not know, Nike had already agreed a big advantage Perno (up to $ 500,000 according to some sources) to pay each time a new world record. He received financial incentives for their best in every race to do. It was better to have a gradual and slow progress make the record many times as possible to break, which in turn makes it more exciting spectator sport.
In this case, the incentives and Nike pins are aligned. Hospitals, on the other hand, is almost certain that they would repent of this strategy. The first year is a year without risk, so that hospitals provide an opportunity, new programs and initiatives should be tested. Unfortunately, many are not.
4. Hospitals should the election result in the post-acute.
require Medicare legislation that patients should have the choice of suppliers. In discussing hospital officials the options for post-acute care for patients, to the extent that promotes the hospital a provider "Director" is considered. Hospitals generally fall into one of three categories: 1) no leadership, 2) gradual or 3) hard direction.
While supporters of the hospital for years fear of all forms of treatment for patients with providers of certain assets, financial penalties for hospitals that usually ran presents too big to work with post-acute providers.
If the fourth category "extreme driving" was, is recommended Josh, provided patients were oriented facilities with measures of the highest quality. In other words, Medicare rules should be relaxed (creative interpretations or new) will give more voice in hospitals where patients go for post-acute care, as hospitals are forced to take on more risk.
Imagine a scenario where you (similar to receiving hip replacement surgery in the hospital) just bought a $ 700 Apple iPhone. It is said by the seller, that you should buy a case to protect your new phone, and you are looking at a wall of 300 cases of different phone than a dozen different manufacturers. At least you would appreciate as a consumer, if you recommend the options a case (for Apple) and perhaps another case of high qualification limit; or should clarify the evidence definitely show in the carton.
People have the right to choose, but you have enough information to make an informed decision. As for health care, no one wants some good options.
5. Hospitals that fail to make do anyway.
You can lead a horse to water, but you can not make him drink.
voted Summit Development Health in Laguna Beach last month as part of an exercise in fun group activities, meeting executives Healthcare "disorder" and "innovation" as the first two buzzwords of the whole hated industry. What a surprise - many hospital executives are stubborn and like things as they are.
The problem is that most hospitals to post-acute strategies are based increasingly problematic daily. Instead directing the management level, dragging many hospitals, the decision of the doctors. Because doctors to select the patient's output destination, the patients are sent to facilities, if they could just as well go home.
Josh calls this the "post-acute Merry-go-round", because doctors say the overuse FRR liability reduced. But at age criteria for admission and discharge on the basis of this argument, it keeps no reason. the preferred post-acute partner network has to be built from the top down.
--------------------------
a system maintenance reimbursement change primarily based on the value has changed the traditional model of reimbursement for health in mind, so that vendors the way to change it for the care bill. It drives real improvements in care and at a lower cost to call for better quality and better coordination of care.
For systems that effectively manage care, these programs offer new revenue opportunities and cost lower. But in these forms for the refund to be successful, health care systems have better access to information, the subsequent introduction of computer, networking and post-acute closest aggressive testing of new programs.
No comments:
Post a Comment