Radical Approach To Huge Hospital Bills: Set Your Own Price
Jay Hancock for Kaiser Health News
“Providers are getting squeezed by Medicare, next they could get squeezed even further by small self-insured employers. The gig is up, hospitals will have a tough time defending their often outrageous pricing that has no foundation in reality. Providers must take a hard, hard look at the true cost of care delivered.” – John
How Healthcare Innovation is Leading to a Post-EHR World
Scott Mace for Health Leaders Media
“The promise of an open data approach is an old one at this point. But this article offers some insight into what can happen once it is achieved: health systems are able to piece together new processes for care delivery without as many interoperability hurdles. Sutter Health has combined EHR data along with business process management (BPM) software to reduce 30-day readmission rates, inserted patient-reported data into the EHR to improve engagement at the point of care, and is working on other innovations that leverage various data sources amidst what they call a “platform of ecosystems.” This “post-EHR” approach described in the piece has been leading to homegrown solutions at Sutter and other progressive systems around the country.” – Naveen
Hospitals select preferred SNFs to improve post-acute outcomes
Melanie Evans for Modern Healthcare
“Health systems are getting pickier about which SNFs are to receive their discharged patients. In this article, it seems like the big systems are screening out about 2/3 of the SNFs that express an interest. The difference in LOS – 22 days overall versus 16 for the selected facilities – are significant. The article dances around the 30 day readmission rate and makes it seem like the motivation is driven by bundled payments.”- Brian
“The question is: are these hospital systems measuring the correct things that impact outcomes they are looking at and do inherent measurement limitations (e.g., adequate sample size for particular conditions at a nursing home) make this endeavor possible? It is an incredibly important area as more and more payment issues including readmission penalties and bundled payments impact a larger portion of a hospital’s bottom-line.” – Matt
MEDICAID: A Small Share of Enrollees Consistently Accounted for a Large Share of Expenditures
US GAO Report to Congress
“Not exactly a new topic but a GAO report found that a small minority (5%) of Medicaid-only patients account for nearly half (48% )of the costs and the most expensive 25% of patients taking up 75% of the program’s total costs from data from FY 2009-2011. The biggest cost driver was mental health and the percentage of Medicaid patients with a diagnosed mental illness has been steadily rising. Patients with diabetes and asthma were also high cost patients. Geography mattered a lot too. Rural states tended to have more high cost patients as a share of their patients with higher hospitalization rates.” – Matt
Health IT–Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians
Suzanne Morton, et al., in Annals of Family Medicine
“In a study published in the Annals of Family Medicine, less than 50% of PCP practices routinely used computers to identify patients seen in the ER or hospital or to send a care summary to other providers. The researchers from the NCQA also found that only one in five clinicians could perform all 10 care coordination objectives originally proposed for meaningful use Stage 3. On average they could perform six of the 10 objectives when the survey was conducted last year. While progress is being made, there is still a lot of work to do to even enable a basic level of care coordination.” – Matt
7 years after stroke, paralyzed woman awarded $35m
Travis Andersen for The Boston Globe
“The lack of interoperability is not only a flashpoint in the clash of EHR titans. This case illustrates one extreme instance of the downside of the lack of very specific data. This account of a health issue that was apparently never documented in a problem list had reverberations several years after. Whatever the underlying technical or process problem, this shows that information sharing has a ways to go in healthcare.” – Brian
Interesting article, thanks for the post!