As Pierre Bogacz, managing director at HFA Partners, told Modern Healthcare, the situation makes hospitals “better-suited for a 10- to 15-year bank loan {for information technology} than for a bond issuance with a 30-year amortization schedule {for new building projects.”
Fierce Healthcare cites as an example the University of Minnesota’s new Ambulatory Care Center, which ”’eschews traditional offices in favor of a choice of different work settings that include ‘places where various providers and caregivers can interact,”’ says a recent Healthcare Design Magazine article.
But how much time in their already long days do these groups to have in which to “interact” more?
Fierce Healthcare reports: ”These ‘collaboration spaces,’ in the center of each clinic and intended to host interactions with patients, are in contrast to the ‘touchdown spaces’ that line the perimeter of the building and provide a place for staff to engage in more focused work outside of clinic hours, the article states.”
And the Gates Vascular Institute, in Buffalo, N.Y., has what it calls “collision zones” outside of operating rooms and laboratories that encourage doctors and researchers to sit down and compare notes, FierceHealthcare previously reported. ”Another innovative design idea comes from Owensboro Health Regional Hospital, in Kentucky, which renovated to place its heart center and operating rooms on the floor directly above the emergency department to speed up patient transfers.”
But many workers find that they don’t like open office space because of the noise and lack of privacy. Indeed, we suspect that most people, from the broom pusher on up, would prefer private offices.
In any event, the new focus on outpatient care makes a lot of sense, given how healthcare in general and reimbursement in particular are going.
- Financial challenges
- Healthcare reform implementation
- Governmental mandates
- Patient safety and quality
- Care for the uninsured/underinsured
- Patient satisfaction
- Physician-hospital relations
- Population-health management
- Technology
- Personnel shortages
It’s interesting that population-health management is still so low considering the inexorable move to risk contracts. The execs are just trying to get through the year, and many will be retired by the time that risk contracts became the major game in town.
Within financial challenges, hospital CEOs ranked Medicaid reimbursement, bad debt and decreasing inpatient volume as their top concerns.
Perhaps surprisingly, Fierce Healthcare noted, “Of all financial concerns, emergency department (ED) overuse was ranked lowest, despite reports that the implementation of the Affordable Care Act has led to an influx of ED visits.”
This might be a growth area.
The Affordable Care Act raised the financial incentives that employers can offer workers for participating in workplace wellness programs and achieving measureable results. People talk about the Nanny State but this is also about the Nanny Company seeking to cuts its insurance costs.
“Wellness-or-else is the trend,” workplace consultant Jon Robison of Salveo Partners told Reuters.
Reuters also noted that “Incentives typically take the form of cash payments or reductions in employee deductibles. Penalties include higher premiums and lower company contributions for out-of-pocket health costs.”
Still, as Reuters notes, “But there is almost no evidence that workplace wellness programs significantly reduce those costs. That’s why the financial penalties are so important to companies, critics and researchers say. They boost corporate profits by levying fines that outweigh any savings from wellness programs.”
“There seems little question that you can make wellness programs save money with high enough penalties that essentially shift more healthcare costs to workers,” said health policy expert Larry Levitt of the Kaiser Family Foundation.
“Thicket of the Mind” (archival inkjet print), by TERRY GIPS, in his show at Galatea Fine Art, Boston, Feb. 4-28.
He says, in his gallery notes:
I have been making art about tangled complexities; the process is like playing a
game of chess between order and chaos, knowing and not knowing, remembering and
forgetting. I sometimes use grids to structure the chaos, wildness and randomness
found in nature. And I take notice of the parallels between these natural entanglements
and those of the mind and the brain and hope that perhaps through these images I
can catch a glimpse of the 500 trillion synapses, and the dendrites, axons, and
nodes in my brain and nervous system.
Thirteen percent of all U.S. health systems now offer insurance in one or more market.
The report says that special circumstances explain the success of the few health systems that have succeeded — such as Intermountain Healthcare, Geisinger and the University of Pittsburgh Medical Center.
Further, medical apps don’t interest them very much. It’s not a matter of lack of health knowledge; it’s just that they don’t have the energy or interest to participate more in protecting their own health.
Thus the promotion from Silicon Valley types generally falls on deaf ears and the hopes that the medical apps would help slash healthcare costs may be dashed. On the other hand, this may be good news for hospital revenues.
“{H}ealth apps are definitely not a hot commodity,” Ms. Oran says.
The Centers for Medicare & Medicaid Services is about to recognize interventional cardiologists as a subspecialty. CMS officials say that this wil encourage fairer and more accurate comparisons of in heart matters. Modern Healthcare reported that , the new classification means these cardiologists can bill Medicare for consultations requested by a general cardiology colleague. It also means yet more paperwork.
Stephen Ramee, M.D., chairman of the American College of Cardiology’s Intervention Council, told Modern Healthcare:
“General cardiologists are ‘cognitive’ doctors, we’re ‘doing’ doctors. It’s akin to a general cardiologist being the general contractor, the electrophysiologists being the electricians and the interventional cardiologists being the plumbers.”
