Rulon Stacey, ACHE's current chairman and the CEO of Poudre Valley Health System in Fort Collins, CO, also weighed in during an interview this week. "For us as healthcare executives, what Congress does or doesn't do is irrelevant to what we do in our health system," he said.
"We know what we have to do in the next three to five years; we have to drive variation out and drive costs down while keeping quality high. We have to integrate and exchange information like we never have before.”
He added, "There seems to be a lot of dysfunction on Capitol Hill right now. And I can't wait for them to run my organization. We're preparing right now as if all that money is going to be cut. If not this year, it will be next year and if not 2013, it will be 2014."
One thing he couldn't resist mentioning is the need for Congress to look at Medicare itself to reduce costs.
"Medicare itself is hopelessly inefficient,” says Stacey. “So while we're down in the trenches figuring out every single way we could increase hospital quality and decrease costs, I would like some assurance from Congress they're going to do the same thing to Medicare. You could pick any hospital in the U.S. and see they are run far more efficiently than Medicare is run."
For example, he says to look at the Centers for Medicare & Medicaid Services' regulations. "We literally built a separate building to house all the people it takes to go through Medicare regulations,” he says. “They'll send us a notice that they overpaid us last month, and expect so many dollars back in 14 days or else we go to jail. They back it up with criminal threats. But if we identify an error they've made, it's years and years before we get paid. They hold a steel hand over us, but none over themselves."
I asked Van Gorder whether all this could impact hospital quality.
"It depends," he replied. "Most hospitals lose money taking care of Medicare and Medicaid patients," he continued, and this makes the problem worse.
Now, there are significant challenges in maintaining levels of Medicaid reimbursement in many states.