Healthcare

After our second day at the AHLA Physicians and Hospitals Law Institute, some clear themes are beginning to come into focus around the volume-to-value transformation in physician compensation. Quality-based compensation is fraught with challenges—quantifying value as compared to physician productivity is foreign to many. Also, missteps in the implementation can wreck the entire process.

In nearly any value proposition, the appropriate reward depends on the level of risk assumed. In the transformation to quality-based pay, the same is true. Paying physicians for quality likewise considers the value of the services contributed and the risk borne by the provider; nobody has the silver bullet as of yet, but hospitals and physicians both need to begin the journey now.

Historic times are taking place in the healthcare industry.  Are you going to stay on the sidelines or are you going to get in the game? 

Yesterday’s sessions at the HFMA Region 9 Conference in New Orleans reinforced two key themes:

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.   

Healthcare machinery and equipment (M&E) change hands daily across the country through larger business transactions or as individual assets or groups of assets being bought and sold. M&E values can impact the viability of the transaction or the parties’ compliance with complex laws governing the deal. Below are easy-to-remember tips on the Purpose, Process, and Pitfalls of M&E appraisals.

Surveys such as the Health Leaders Media survey, Physician Alignment: New Leadership Models for Integration, indicate that physician employment will continue to be a primary integration strategy for many hospitals and health systems. Where saturation of primary care and specialist practice acquisitions and employment has occurred, several markets have moved to a second or third tier, such as urgent care centers and related physician employment. It seems that some markets are only limited by the supply of viable targets.

Physician practices, however, are not created equal, and hospitals and health systems are becoming increasingly savvy in targeting groups for alignment that can demonstrate delivery of high-quality care. As the reimbursement model continues the shift from a volume-based to value-based system, physician participation in meeting quality and cost-saving targets will require a greater nexus to methods of physician compensation. In an increasingly competitive environment, it may be difficult to meet the need for quality care without a carefully selected and motivated physician network.

Getting your patients actively involved in their health care keeps them healthy. Simple. This very important learning comes from a recent Robert Wood Johnson Foundation's Quality Field Notes brief about patient engagement¹.

And, according to other research², in order for changes to the healthcare system to be successful in reducing expenses and improving quality, the patient must be consistently "engaged" for everything to work.

The concept of patient engagement has been in existence for more than a decade. But, what is patient engagement?

Team-based Care – Part II

Look into many markets in the U.S. and you’re likely to find non-physician providers in greater demand and better paid than in the past few years. The 2013 HORNE Medical Office Staff Salary Survey supports this by reporting a significant upswing in the demand for non-physician providers. Survey results show a startling 68% jump in the number of non-physician providers added to hospitals and practices from 2009 to 2013. But perhaps the quick rise in demand isn’t as surprising when put into the context of the Affordable Care Act, and shrinking reimbursement.