This is another article not about our specialty but something that can effect our practice.
Although preventing infections should be at the top of a hospital’s to-do list, a rapidly approaching penalty will soon give them a financial incentive to do so.
A program which started at the beginning of the 2015 fiscal year, hospitals are ranked based on several different criteria. Those that land in the lower quartile of care could face a penalty of 1 percent reduction of reimbursement from the Centers for Medicare and Medicaid Services through the inpatient prospective payment system.
The intent is to force hospitals to improve their care systems, and while it may have initial financial burdens on hospitals that fall in the penalty group, the long-term benefits are obvious.
Like all health care systems, Memorial Hermann is making an effort to reduce its health-care associated infections and other issues that happen in the hospital. And now with the federal government paying close attention to a hospital’s data, it gives health systems an independent way to show how they fare against the competition.
“I’m all for transparency,” said Dr. M.Michael Shabot, chief medical officer forMemorial Hermann Health System. “I welcomed it then, and I welcome it now.”
In years past, health care systems and hospitals measure themselves against one another through U.S. News and World Report and media outlets lists on various criteria, but Shabot said these government-certified numbers will give the patient the best possible information for making a decision.
And for hospitals that exceed expectations, there’s incentives. Accountable care organizations, or ACOs, allow hospitals to earn money through a shared savings program. Memorial Hermann’s ACO, for example, saved $58 million, making it one of the highest performing in the country. The ACO and its doctors then received a sizable cut of that savings.
But to earn those savings, there needs to be a “culture shift” for doctors, said Dan Wolterman, CEO of Memorial Hermann Health System, because it’s changing the way doctors think of a patient. Rather than using a barrage of often unnecessary and expensive tests, doctors have to think about a patient’s care in a proactive way, he said.