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For decades, hospitals nationwide operated on a fairly straightforward business model--treat patients and charge them for those services; subtract expenses and you have a solid operating margin. If the margin is too narrow or in the red, treat more people or charge them more for your services.
While this was a long-time successful business plan, it's now headed the way of the dodo bird. Hospital care in the 21st century is not that simple. Medical bill payers, including Medicare and some of the country's largest insurance companies, push for providers to reduce costs. But there's a danger in doing that. Does reducing costs mean the quality of care also will go down?
Put another way: Can hospitals care for patients more cheaply without sacrificing their commitment to top-notch care?
The short answer is yes. But the path to cheaper, better care is complicated. And the hospital community is only now beginning to understand how to get there.
"Maybe I should premedicate, too," a CEO of a Western community hospital said to me the night before I presented the data on 27 interviews of her medical and nursing staff.
A little context is in order:
by Lynn McVey
Chuck Lauer is a former healthcare news publisher turned author and public speaker. I don't know his age, but he talks like my dad; a man from the "greatest generation." Men who pledge humanity, integrity, honesty and service. Men who make an effort to locate the owner of a lost $5 bill--like my dad.
Lauer's response to healthcare reform challenges, printed last month in Becker's Hospital Review, is huge. When he read the American College of Healthcare Executive's (ACHE) report that hospital CEO turnover grew to 20 percent in 2013, the highest rate since 1981, his reaction was like a slap in the face.
He said, "The CEO post is a pressure cooker. All that's true, but I and a number of other observers think the data reflect a lack of will and commitment. Faced with a once-in-a-lifetime opportunity to overcome silos, inefficiencies and quality problems plaguing American hospitals, more and more CEOs are making a beeline for the exit, hefty retirement packages in arm." Ouch.
by Barry Ronan
At the end of January 2014, I had the opportunity to speak at the American Hospital Association's Board Retreat in Miami, "Redefining the H." As AHA President and CEO Rich Umbdenstock explained, "that big H on those blue and white signs denoting 'Hospital' always carried the promise of help, hope and healing; the hospital of the future will continue to extend that promise but in new ways by improving quality while lowering cost."
Prior to my presentation, Rick said that the environment in which hospitals operate is extraordinarily challenging, but--by becoming proactive rather than reactive and keeping people healthy, by moving care out of the hospital and into the communities, by increasing the use of medical and information technologies, and by applying evidence-based practices to better manage all illnesses more effectively--hospitals will meet their commitment to their respective communities.
His opening was a great lead in for my presentation on our transition to value-based care delivery three and one-half years ago and the success that Western Maryland Health System achieved through the Total Patient Revenue demonstration project that is now the standard in Maryland healthcare delivery.
This past weekend we brought our son to a student acceptance day at a college he is considering attending.
As we participated in the numerous events of the day I was struck by the similarities between academia and healthcare, i.e., colleges and hospitals.
We began the day with hundreds of other students and parents listening to the opening presentation, where much focus was placed on sharing the history, mission, good works and values of the school. The pride of the president, admissions director and other organization leaders was clear. And each made note of how they instill these values in each student of this prestigious school.
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