Value-Based Purchasing Model Waits for No One

Philip Betbeze, for HealthLeaders Media , February 7, 2014

The fact is that managing chronic care is becoming more important as the population ages, and investments in better coordination as well as seeking the most efficient use of expensive health resources will pay off through rewards or penalty avoidance.

Lose the Old Thinking
Part of the struggle is getting healthcare executives to let go of some of their old internalized attitudes about what's "good" for the hospital and getting back to focusing on what's best for the patient. That sounds simple, but it's far from it given how hospitals and physicians have historically been reimbursed. Personally, I've heard tales similar to the following:

A patient comes in with bronchial symptoms, and stays overnight on suspicion of pneumonia, but the hospital or physician doesn't get an antibiotic prescription to the patient for three to four days after discharge. Some organizations have even waited for six or seven days with hopes they could put that patient in a ventilator unit. It would mean more money, after all.

Except often, even now, it isn't. The hospital would not be reimbursed for the additional days in the ventilator unit, but the thinking among those who make such decisions at a patient care level had not changed.

Even disregarding the many other problems within such a scenario, why would you fill a bed at a loss?

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