Lower costs, better care seen coming from Obamacare
Eleanor Snite, Research director- Jacksonville Business Journal
The leaders of area hospitals are seeking several advantages from the Affordable Care Act, including lower overall health care costs and improved health for their patients.
We asked them: What steps are you taking or what programs are you implementing to prepare for the Affordable Care Act? What do you think will be the main impact on your facility?
Here are their replies:
“Major initiatives are under way to prepare for changes in payment methodology and to better coordinate care. These include focusing on ‘transitional care’ as patients leave the hospital by working closely with post-acute providers to avoid readmissions... We’re also focusing on significant integration with physicians to achieve better clinical integration and care management, and improving the flow of our information with electronic medical records.
“The most immediate financial impact will result from our state’s decision not to expand Medicaid as intended in the ACA. We will soon be facing federal Medicare cuts, connected to the reform law, that were intended to be offset by revenue increases from Medicaid eligibility expansion.”
Hugh Greene, President, CEO, Baptist Health
“We have worked with Coventry and Florida Blue on exchange products that are available to the community. There are navigators, and our HOPE Program counselors are available to assist with the application process. In addition, we are taking advantage of some of the innovative initiatives available to us in the ACA. We are moving forward with bundled payment projects in total joint replacement, spine surgery and congestive heart failure. These initiatives are intended to improve patient outcomes and reduce the costs of care.”
Kyle Sanders, President, St. Vincent’s Medical Center Southside
“We are implementing processes to improve our patients’ experience, outcomes and care efficiency. This includes working with our acute hospital partners and physicians to ensure seamless transitions for our patients between care settings and to share best practices to reduce avoidable hospital readmissions. One example is the implementation of a telehealth program in our home health division that allows for daily monitoring of patients to identify risks and provide earlier intervention.
“Brooks applied for and was selected to participate in a pilot program for patients who have suffered a hip fracture or joint replacement. We have named the program CompleteCare. Brooks will be provided with one lump sum payment to cover all of the patient’s health care needs for the 60 days following their acute hospital stay. This model really forces providers to think about how care is delivered and how to achieve the best outcome for a patient by ensuring they are treated in the right care setting for the right amount of time.
“We are also taking a much more holistic view of our patients’ needs, which includes not only clinical care but wellness programs. Once traditional therapies end, individuals can choose from a stroke wellness program, adaptive sports program or our Brooks Clubhouse for community reintegration.”
Douglas Baer, President, CEO, Brooks Rehabilitation Hospital
“Here’s a summary of what we are doing:
• We are participating as navigators for the insurance marketplace.
• Developing roles to assist those with chronic disease in managing their health outside of the hospital.
• Participating in the Bundled Payment for Care Improvement Initiative for total joint replacement, spine surgery and congestive heart failure.
• Creating models that support the development of best-practice care protocols coordinated across an integrated team of clinicians.
• Partnering wherever it makes sense, including partnerships with historical competitors.
“We will work more across multidisciplinary care teams and other nonhospital providers and reduce the consumption of resources with improved outcomes for our patients.
“This will reduce the need for our traditional primary source of revenue — an inpatient admission at one of our hospitals. That’s certainly one of our biggest challenges, since it reduces our revenues as we improve for the future.
“We are seeing readmission rates
decrease significantly among many chronic disease categories.”
Moody Chisholm, CEO, president, St. Vincent’s HealthCare