Healthcare reform: Friend or foe?

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Kaitlyn Dmyterko, Senior Writer

With the future of the U.S. healthcare payment system still up in the air, hospitals struggle to find ways to perform care at the most effective price. While some have chosen integration as a means to stay afloat, others have turned to hospital IT to help meet meaningful use criteria and gain reimbursements for high quality care. What are the best tactics hospitals can take to streamline care at a more cost-effective price tag?

This week, a report released by MedeAnalytics showed that the future of Medicare payments may be grim. In fact, the payments under Medicare's Inpatient Prospective Payment System program could potentially drop $5 million by 2021—between $162 billion to $177 billion within the next 10 years.

The firm said these cuts will most likely be due to reductions outlined under the Patient Protection and the Affordable Care Act (PPACA), the expected increase in risk-based reimbursement and the current debt ceiling.

Yet, new patient visits and consults and imaging exams continue to rise. A recent MedAxiom survey showed that the total cognitive encounters per cardiologist increased 50 percent in the last two years. Additionally, the average number of outpatient echocardiography exams per cardiologists was 194 in 2000 and rose to 503 in 2010.

Despite the outlined cuts that are expected to take place, MedAxiom President Patrick White said that for the next 19 years, 10,000 Medicare beneficiaries are expected to be admitted per day to hospitals. “If there are 20,000 cardiologists in the U.S., it is half a Medicare enrollee per day.” How will the industry keep up with this demand?

With a focus on transforming hospital systems to be automated to reach meaningful use goals—e-prescribing initiatives, among others—a presentation at this year’s AMDIS Physician-Computer Connection Symposium questioned whether the political climate will set back meaningful use funding.

David W. Roberts, MPA, vice president of government relations, HIMSS, noted that several bills introduced in the House seek to reduce federal spending, which could in turn debunk the welcomed healthcare funding. 

While costs remain on the chopping block, hospitals must think of innovative, strategic ways to effectively manage high quality care. Whether it is partnering with hospitals nearby, flushing paper-based systems and moving on to automated health IT or focusing on quality initiatives to cut readmissions, there needs to be a change.

What will you do to stay afloat?  E-mail us and let us know your strategies.
Kaitlyn Dmyterko, senior writer
Cardiovascular Business