Half Blame Feds for Healthcare Industry Mess

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

"We kind of know what we're facing in 2012; that's not where the significant changes will occur. It's what's happening in 2013 and beyond that we aren't as confident about. In 2012 it's all about sharpening our focus for better operational returns."

To achieve that end and to continue to strengthen the financials overall, one area finance leaders will likely concentrate on in 2012 is growth, according to the survey. Fifty-five percent of finance leaders surveyed say their organization will be part of an accountable care organization within the next three to five years, with half expecting to be part of the Medicare Shared Savings program and only 16% planning to participate in a commercial ACO.

Adding or expanding service lines may also be on the agenda for hospital and health system finance leaders, with the survey showing the most likely areas for growth to be: geriatrics (66%), cancer centers (66%), orthopedics (64%), primary care (63%), and emergency medicine (62%). This year may also see finance leaders investing more in capital projects, such as service line expansion and technology; nearly 20% expect to significantly increase the organization's capital spending and another 36% say a slight increase over last year is planned.

Pumpian believes the majority of capital dollars will go toward technology, as hospitals and health systems strive to meet the ICD-10 and meaningful use deadlines. However, some funds could go toward long-delayed equipment and facility upgrades or physician practice acquisitions.

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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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