This article appears in the November 2011 issue of HealthLeaders magazine.
Whatever the catchphrase or program being discussed to make healthcare more cost-effective, the question usually boils down to a simple proposition: Can doctors and hospitals deliver better care for less cost? While there will be doctors, nurses, administrators, and other key players at the table discussing that question, all answers will at some point go through the chief financial officer.
It is for that intersection of solutions that HealthLeaders Media convened 28 health system and hospital chief financial officers from across the nation at the HealthLeaders Media CFO Exchange earlier this fall in La Jolla, CA. The CFOs shared best practices and solutions for a variety of strategic and regulatory issues.
When CMS unveiled its value-based purchasing program earlier this year, the goal was to switch the largest purchaser of healthcare in the United States from being a passive consumer to a smart shopper. By withholding a percentage of hospital payment to build an incentive program to reward achievement and progress on a set of core measures, CMS hoped to spur better quality, but with virtually the same dollar spend as traditional volume-based DRGs.
The healthcare leaders at the CFO Exchange expressed doubt that VBP, as designed, will have the desired incentive effect.
“We did a projection out through 2013 and VBP didn’t really move the dial, quite frankly, in terms of its size of dollar amount, at least as it’s being measured now,” said Charlie Hall, CFO at Atlanta-based Piedmont Healthcare. Other regulatory and compliance concerns—such as ICD-10, 508 wage reclassification, and meaningful use—are much more pressing revenue threats, the panel agreed. James Moylan, CFO for Derby, CT–based Griffin Hospital, says, taken singularly, programs like VBP may not move the quality and cost lever, but when bundled with the others being pushed by CMS, the pressure on hospitals to move is clear.