Push for sys­tem changes to find sav­ings is theme at HFMA

Speak­ers at ANI put fo­cus on sys­tem changes

Modern Healthcare - - Front Page -

Sev­eral of the big-name speak­ers at the Health­care Fi­nan­cial Man­age­ment As­so­ci­a­tion’s An­nual Na­tional In­sti­tute last week prod­ded the hos­pi­tal fi­nance ex­ec­u­tives in at­ten­dance to re­make their or­ga­ni­za­tions to deal with a world in which all pay­ers are push­ing to save on health­care costs.

Cut­ting costs in a hos­pi­tal sys­tem does not have to mean ra­tioning care if ex­ec­u­tives em­brace changes in sys­tem de­sign, Mau­reen Bisog­nano said in her key­note ad­dress kick­ing off the ANI, held in Or­lando, Fla. Bisog­nano, pres­i­dent and CEO of the In­sti­tute for Health­care Im­prove­ment, told at­ten­dees that by im­prov­ing safety, en­gag­ing pa­tients and pro­vid­ing true lead­er­ship to their hos­pi­tal sys­tems, ex­ec­u­tives can cut costs by 1% to 3% an­nu­ally with­out hurt­ing pa­tient care.

Bisog­nano de­scribed how 478-bed Cincin­nati Chil­dren’s Hos­pi­tal Med­i­cal Cen­ter at­tacked health­care-ac­quired in­fec­tions and showed not only the money that pay­ers saved when in­fec­tions were avoided but how the hos­pi­tal pros­pered as well: Over a quar­ter, a hos­pi­tal bed could be filled by six pa­tients who ac­quired an in­fec­tion or 18 pa­tients who did not, she said.

“You know the money is there,” Bisog­nano said. “You know that we have to drive down costs. With the con­tin­ued fi­nan­cial pres­sure hos­pi­tals face, you have to do that in ways that don’t hurt out­comes.”

At­ten­dance for the ANI was up, with HFMA es­ti­mat­ing that at­ten­dance was just over 4,700 peo­ple, ac­cord­ing to a spokesman, which would be a 4% to 5% in­crease from last year when the con­fer­ence was re­lo­cated to Las Ve­gas af­ter flood­ing in the orig­i­nal Nashville lo­ca­tion.

An­other keynoter, Peter Orszag, for­mer di­rec­tor of the Of­fice of Man­age­ment and Bud­get, warned that an over­haul of U.S. health­care pay­ment to re­ward value can­not suc­ceed with­out Medi­care, yet pol­i­cy­mak­ers face grid­lock amid a highly politi­cized en­vi­ron­ment. Com­mer­cial in­sur­ers are too frag­mented to change health­care pay­ments, but Medi­care has the clout, he said.

A po­lit­i­cally po­lar­ized Congress sup­ports the need for the Cen­ter for Medi­care and Med­i­caid In­no­va­tion and the In­de­pen­dent Pay­ment Ad­vi­sory Board, both of which op­er­ate in­de­pen­dently from Congress, said Orszag, now a vice chair­man with Cit­i­group. Providers must push to elim­i­nate un­nec­es­sary care, make health in­for­ma­tion tech­nol­ogy in­vest­ments and re­duce un­needed vari­a­tion in de­liv­ery and em­brace new pay­ment mod­els, he said.

Richard Clarke, pres­i­dent and CEO of the HFMA, told his mem­bers that pay­ers and pol­i­cy­mak­ers are not go­ing to tol­er­ate the grow­ing gap be­tween the qual­ity their or­ga­ni­za­tions are pro­duc­ing and how much pay­ers are shelling out for it. Clarke said the HFMA’s Value Pro­ject gives health­care or­ga­ni­za­tions the tools nec­es­sary to adapt to a value-based pay­ment sys­tem (June 20, p. 12).

With all the talk of the econ­omy, strapped state bud­gets and the chang­ing de­mands of the busi­ness, hos­pi­tals’ ac­cess to credit for con­struc­tion and tech­nol­ogy de­pends mostly on in­vestors’ opin­ions of the in­dus­try and bor­row­ers’ fi­nan­cial per­for­mance, said Martin Ar­rick, man­ag­ing di­rec­tor of not-for-profit health­care rat­ings for Stan­dard & Poor’s. At a well-at­tended session, he said: “Your ac­cess to cap­i­tal, I re­ally think, is up to you.”

Physi­cian em­ploy­ment and other physi­cian align­ment strate­gies formed a thread run­ning through sev­eral ses­sions. The struc­ture of physi­cian align­ment ar­range­ments is im­por­tant, but the real key is to hire or part­ner with the right physi­cians in the first place, ac­cord­ing to one set of pan­elists. “You have to pick the right docs,” said pre­sen­ter Keith Moore, chief fi­nan­cial of­fi­cer of Hos­pi­tal Sis­ters Health Sys­tem in Spring­field, Ill. “It’s all about your se­lec­tion process.”

Moore also said one huge dif­fer­ence be­tween the cur­rent wave of physi­cian em­ploy­ment and the one in the 1990s is who is ini­ti­at­ing the dis­cus­sions. “In 1995, they didn’t knock on our door. We kicked their door down and of­fered them the moon,” Moore said, adding later that, now, “The doc­tors are at our door ev­ery­day.”

The videos and all of Mod­ern Health­care’s ad­di­tional cov­er­age of the ANI are avail­able at mod­ern­health­care.com/sec­tion/liveat-hfma/. — by Paul Barr, David Burda, Me­lanie

Evans and Vince Gal­loro

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