Healthcare

With health care spending growth still increasing, the Medicare Payment Advisory Commission (MedPAC or the Commission) continues to pursue its mission to advise US Congress on the Medicare program and its costs, which ultimately are borne by all taxpayers.

Living in interesting times may be a blessing or a curse, but 2016 proves that it certainly isn't boring. Healthcare in the United States continues to evolve—sometimes very rapidly—and those guiding healthcare organizations have particular challenges ahead of them in the coming years.

Did your hospital’s outpatient department begin operations, expand its service lines or relocate after November 2, 2015?

Think back to your last car, truck or SUV purchase. What did you want to know before spending so much money?

More than likely, you wanted to know the price range of the type of car you were considering. You might have wanted to know what features were standard on different makes and models. You might even have identified one or two features that you couldn’t live without, and that helped you narrow your choice. You aIso might have wanted to know where to find the best financing. If you’re tech savvy, you probably found much of the information you needed online—even in a single app or website. In recent years, our collective consumer needs have changed the way we buy cars. In fact, consumer preferences have changed the way we buy most things—even healthcare.

I recently saw an excellent example of offering appropriate care in the appropriate setting when I reviewed my new HORNE healthcare plan. HORNE is offering a new program called “MD Live.” For the first time, our insurance will cover employees who consult a doctor remotely by using a phone, tablet or computer. The next time I feel a cold or the flu coming on, I can visit with a doctor and get the treatment I need without traveling to the doctor’s office. 

Bundled payments. Volume-to-value. Cost accounting. Process improvement. Patient engagement. Population health. Organizational leadership.

While attending the Healthcare Financial Management Association Region 9 Conference in New Orleans, we learned that bundled payments are near and healthcare facilities should start preparing now.   

Bundled payments consolidate reimbursement into a single payment for the care and services related to a specific procedure or episode along the continuum of care. These payments are designed to incentivize the coordination of care among various health care providers, such as physicians, hospitals and post-acute care facilities, as well as to emphasize accountability for the cost and quality of care provided to patients. The Centers for Medicare and Medicaid Services estimates that by 2016, 30 percent of Medicare payments will be value-based and will expand to nearly 50 percent by 2018.   

We’ve been publishing blogs about healthcare for more than a year, and we hoped we’ve provided some good information about where the industry is and where it might be going. Sometimes we write about trends in the industry, sometimes we write about what we’ve learned, and sometimes we write about what might be possible in the future. We hope you’ve enjoyed our blogs and have taken something from each one to help you do your job better.

If I had to pinpoint the key to healthcare reform, I would use one word – quality. If I had to identify the focus of our efforts, it would be patients. And if I had to construct a timeline for action, it would begin today. We have no time to waste in creating a sustainable model for delivering high-quality care.

Quality care involves providing appropriate care in the appropriate setting so that we can improve the health of entire communities using available resources. We must develop an economically sustainable healthcare model.