Half Blame Feds for Healthcare Industry Mess

Karen Minich-Pourshadi, for HealthLeaders Media , February 21, 2012

"There's no other answer than the government is to blame for where we are today," says Pumpian, whose system includes four acute care hospitals, three specialty hospitals, two affiliated medical groups, and a health plan.

"The government is always politically prudent, but that doesn't always bring about the most cost-effective or efficient results. Look at the accountable care regulations; healthcare providers had to push hard just to make it so the patients would be aware that they would be participating in one of these models. Or look at the paper reduction act, which tripled our paperwork," she adds.

Interestingly, while healthcare leaders point to the government and health plans as getting the industry to its current state, most survey respondents feel certain it won't be either who ultimately correct the industry's problems. Twenty-two percent of all respondents and 24% of finance leaders believe it will be the hospitals that save healthcare.

"Hospitals have the deepest pockets and those are the ones that have the ability to effect change," says Pumpian. "Now that a lot of hospitals are hiring physicians and the delivery networks are being significantly streamlined … institutions will have to become all things to all people."

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2 comments on "Half Blame Feds for Healthcare Industry Mess"

Alton Brantley, MD,PhD (2/24/2012 at 3:50 PM)
The reason for the discrepancy in the survey regarding government interventions is straightforward: What was sought from the government was standardization in data formats and interchange, so that medical information would not be tied into specific EHRs, and that different vendors and payers wouldn't make life more complicated for hospitals, health systems, and doctors. What the government provided was rigid coercion of adoption of incompatible systems and multiple changing expectations all occurring during the same time frame. The end result is that hospitals and doctors are spending more time changing systems, meeting deadlines, reprioritizing, and disrupting patient care. As an example of how this COULD have worked, the internet, specifically the web-supporting data standards, started simply, grew in a stepwise fashion, and have enabled an explosion of creativity and utility, without certifying browsers and setting up unreasonable and expensive conversion processes. The problem of physician adoption would have melted away from the aging of the clinical population (technicians, nurses, and doctors), and costs would have gone down, not up. Finally, had the government adopted state of the art technology, rather than the enshrined fixed field, positional coding structure of documents, computer processing could have been accomplished through evolution rather than gut-wrenching cutovers.

Phyllis Kritek, RN, PhD (2/21/2012 at 9:49 AM)
I am hoping that one of the analyses of this very excellent survey will grapple with three interacting and amazingly contradictory findings: 1. 59% of your respondents said the reason that the health care industry could not solve its own problems was "too much self-interest among the different stakeholders". The second highest response, which I think is related, focused on lack of incentive to innovate and garnered only 14%, so I consider this pretty high consensus. 2. Having established why the industry cannot save itself, the blame for the current state of affairs put the it squarely on the government (40%)! I was startled: we can't work together so we cannot fix ourselves, but it is the government's fault. 3. Then, the highest ranking answer for who will save the industry is hospitals (22%) unless you ponder the nebulous "other" at 31%. Apparently, we are going to save ourselves from the awful government intrusion while acknowledging we cannot do so due to competing self-interest agendas among ourselves. Your final analysis focuses on the need to collaborate as "the common theme". Recalling my freshman level logic classes, as I read this: a. We do not know how to work together, with our self-interest corroding our efforts at collaboration. b. We think we should be the ones to fix this. c. Therefore: it is all the government's fault. I look forward to an analysis of this interesting finding.




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