He looks at four initiatives:
• The team approach.
• Patient engagement positions.
• Group appointments.
• Telehealth technologies.
But the little hospitals are under much stress from, as he notes, longevity, industry consolidations, advances in medical technology and dramatic changes in payments for services.
And the trend of “inadequate Medicaid and Medicare reimbursements will continue. Almost every time the hospitals make cost reductions to meet lower reimbursement rates, the rates get lower again.”
Thus Waterbury Hospital, St. Mary’s Hospital, in Waterbury, Bristol Hospital, Manchester Memorial Hospital and Rockville General Hospital, all nonprofits, are imperiled.
Meanwhile, political, ideological and regulatory pressures have repelled such out-of-state for-profit hospital chains as Tenet that could save some or all of these little hospitals if they’d buy them.
Something gotta give!
But human trials are probably two to three years away and it could be five years before the drug is commercially available, reported FierceHealthcare.
She notes that in a 2014 survey of U.S. physicians by Deloitte that 80 percent oppose a change in reimbursement, including economic incentives, “although many acknowledge that the current system does not offer {adequate?} value to those it serves.”
”These survey results support the theory that if physicians are to actively focus on the key objectives of value-based care (quality/outcomes and cost/price), then processes of care and systems need to be aligned with appropriate care provider teams, organizational structures to facilitate communication and coordination, and data to support analysis and process change from both a clinical and financial perspective.”
Note that even when such records are required by the Feds, these companies make it difficult to track this spending.
As they note: “Many boards and executive teams have pursued an affiliation and undertaken the exhaustive due diligence process requisite in a merger, only to find that ‘softer’ issues — cultural alignment, board members’ compatibility and preferred business styles, physician willingness to combine clinically, or a lack of shared vision for the future — cause their newfound partnership to collapse. ”
Here are some of the specific challenges they address:
”Blending governing boards.
”Joining the clinical engines.
”Developing a shared vision.”
The Supreme Court filing follows an April ruling in which a federal appeals court sided with the Federal Trade Commission’s order to ProMedica to divest itself of St. Luke’s Hospital in Maumee, Ohio. The judges said the purchase, in reducing competition, would unfairly raises prices for patients and insurers. Kaiser Health news reported that ProMedica lawyers have argued that the appeals court was flawed in assuming that ”greater market share would lead to price increases. They also have said that selling the community hospital would lead to the hospital’s demise.”
Cambridge Management Group has reported on another important hospital antitrust case, in which a federal appeals court is considering Idaho-based St. Luke’s Health System’s acquisition of a physician group.
Sigmund Freud, M.D., died of oral cancer caused by cigar smoking.
Carmela Coyle, president and CEO of the Maryland Hospital Association, writes in Hospital Impact about some hospitals in that state that have banned the hiring of tobacco users. As she notes, some other providers in the nation, such as Cleveland Clinic, Baylor Health System and WellSpan, have done the same thing.
They’re on to something, she writes: “From a public relations perspective, it’s tough to preach smoking cessation to patients and the community when hospital employees, who, in this new world of community partnerships, serve in many ways as hospital representatives, are smokers themselves. More importantly, however, is that the mindset of hospital executives and trustees is changing, as hospitals shift from fee-for-service payment models to those built on a foundation of population-health management. This new zeitgeist is one of abiding responsibility, for every single life in a hospital’s care. Its employees are no exception.”
* Building a dominant healthcare system for maximum pricing power.
* Applying the ”80/20 rule” to most opportunities, talent, revenues and cost areas. The rule basically means mean that 80 percent of your outcomes come from 20 percent of your inputs.
* Testing new areas but doubling down on winners.
* Embracing ownership of physician practices.
Of course, some of these ideas are recycled banalities — or just sense for sale at very high hourly rates.
