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Patient experience isn't only about attempting to wow and delight patients and their families.
In a recent phone conversation, a long-distance friend of mine--I'll call her "Debbie"--described her father's hospitalization. She explained that when her father was there, the hospital was overcrowded and had more admitted patients than beds. The result: Her father received his care in the hallway of one of the hospital's inpatient units.
Debbie noticed several aspects of the basic care experience missing in the hallway when compared to a patient room.
Following up from last week, let's resume our list of healthcare reform's unintended consequences for healthcare leaders.
3. Medicare reform
In response to political and economic pressures to expand Medicaid and the growing numbers of Medicare beneficiaries with the boomers, the Centers for Medicare and Medicaid Services and states are working to create meaningful incentives through cost-sharing, means testing and sliding scale payments based upon behavior-related healthcare choices (e.g., not smoking, committing to a regular exercise program).
Healthcare organizations increasingly partner with large employers, third-party payers and patients to create population health and wellness programs that significantly impact both quality outcomes and cost of care. Providing a wide array of nutritional options, exercise facilities and time to utilize them, smoking cessation programs, child care, and addiction rehabilitation programs have been found affect the cost of insurance, particularly for the elderly.
My first introduction to medical futility was as an intern in Chicago in the late 90s. I was working on a medical floor when a code blue was called overhead. I responded to find the nursing staff attending to an elderly male. As I started CPR and called out orders, I inquired as to what his medical conditions were and started looking at this shell of a man.
The nurse reported, "He is a 99-year-old male with diabetes and cardiovascular disease." I realized the man was blind, had above knee amputations to both legs and also had bilateral arm amputations. He was a full code. I am not sure if that was because there was no family to make him DNR (do not resuscitate) or he had chosen to "have everything done."
Futile medical care is the continued provision of care when there is no reasonable hope for recovery or cure of the patient. It is surprisingly quite common. There are many reasons for this.
A wave of renaming activity has been taking place among healthcare organizations throughout the past two years. Our research shows almost 75 hospitals or healthcare systems have changed their names, and the list is still growing.
So what are hospital administrators' reasons for changing their institutions' names--never a simple or inexpensive undertaking--and what are the real consequences--seen and unseen--that accompany these name changes?
Whether these new names are actually going to help their brands during changing times is up in the air and only time will tell. But hospital leadership that believes a name change is necessary to rebrand and reposition their healthcare system for the future may be seriously mistaken.
To say the roll out of the Patient Protection and Affordable Care Act of 2010 (PPACA) has been difficult is a gross understatement. It is a classic study in mismanagement, poor planning, poor judgment and administrative hubris.
Unfortunately, something akin to the PPACA was necessary and yet its unanticipated consequences have created unexpected challenges for healthcare leaders.
1. Insurance reform
In more than 29 states, one or two insurance entities make up more than 70 percent of the states' market share. For instance, New Hampshire's health insurance exchange consists of a single entity, Anthem Blue Cross and Blue Shield, which defeats the purpose of an insurance marketplace that encourages competition and lower prices.
Thus, healthcare organizations are merging through various means (e.g., sale, affiliation or collaborative agreements, etc.) to gain economies of scale sufficient to both negotiate with insurance carriers and to partner with them. In 2012, there were more than 100 mergers despite the concerns of the Federal Trade Commission and the Department of Justice.
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