"The strategic direction embedded in these changes is to move away from a fee-for-service system," he told the crowd. "And while many of us have thrived under the system, we all know that the incentives are in the wrong places because the incentives under that system are to do more." Prevention strategies aren't employed because "we don't get paid to do those things."
It doesn't matter whether the reform bill stays or goes, he and many others say. The country can't continue on this trajectory of spending so much money without measuring value.
It's clear that with thousands of pages of regulations to come, there are going to be some mistakes, he continued. And there will be the need to make fixes. "You don't do something of this magnitude and not make mistakes or leave stuff behind," he told the attendees.
So the idea for these hospital chiefs is to take a deep breath and get to work, because they have to start somewhere.
And that somewhere means finding out all the things their hospitals aren't doing that they need to start doing quickly.
For Scott Cantley, CEO of Ohio's 200-bed Marietta Memorial Hospital, one lesson learned is that he needs to talk with his facility's employed physicians to persuade them to standardize their care practices, according to what works best for their patients. "We want to get to the point where we don't have so much deviation from doctor to doctor," he tells me.
A session on evaluating physician compensation, and understanding the concepts behind relative value units, was helpful to John Snyder, chief operating officer of 325-bed Carle Foundation Hospital in Champaign-Urbana, IL.