Ready or Not, Reform Under Way

Philip Betbeze, for HealthLeaders Media , December 19, 2011
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Physician alignment has been a driving business imperative for a while now for many hospitals and health systems, but despite the fact that ACOs and value-based purchasing rules enacted by CMS are aimed at connecting the gaps in coordinated care, only 57% of our respondents think that the law will more closely align them with their physicians.

Additionally, there’s not a lot of faith that the act or the changes it has loosed on the healthcare market will help increase administrative efficiency. In fact, executives predict the opposite. Only 37% believe it will increase efficiency, while 50% believe efficiency will decrease under the law. However, contrast that opinion with clinical efficiency and the attitude undergoes a 180-degree turn. Some 52% believe clinical efficiency will increase, while 37% believe it will decrease.

ICD-10, a new coding system that more precisely identifies diseases and conditions for patients, presents the most serious problem associated with the act, according to the survey. Some 67% believe ICD-10 implementation will be difficult or very difficult to implement, while only 23% feel the same way about IRS Form 990, for example, and only 44% say the same thing about value-based purchasing standards. The challenge of dealing with the overall effects of PPACA will be difficult or very difficult for 66% of the leaders who answered the survey.

Manning says integration isn’t the problem, but that hospitals and health systems need to look at ways to continue to subsidize money-losing but essential services that improve and maintain patient experience and management.

“There are some parts in fully integrated systems that are perennial money-losers if you look at them in isolation,” Manning says. “The possibility of getting out of those services completely is a little tough if you’re really about value of care, because you need robust mental health services, for example, even at the primary care sites, to have a good patient experience and manage the patient correctly. I could see outsourcing in some cases, but not eliminating.”

This article appears in the December 2011 issue of HealthLeaders magazine.

Philip Betbeze is senior leadership editor with HealthLeaders Media.
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