July 2014

Which ratings matter most to hospitals? The number of groups evaluating and awarding top grades to health care organizations is growing. Consumers can pick from the government’s web site Medicare Hospital Compare or a handful of assessments from private and nonprofit organizations, such as U.S. News and World Report, Consumer Reports, Truven Health Analytics, and the Joint Commission, among others. Hospital ratings vary widely as each rater uses a different methodology that can provide vastly different results. As the Affordable Care Act’s (ACA) provisions are implemented, quality metrics will become a bigger agenda item in a hospital’s board room. Medicare’s quality incentive program has sent a large signal to other insurers and the health care industry at large with its risk-based contracts to achieve quality and cost targets via incentives, or in some cases, financial penalties. Additionally, both payors and purchasers have stepped up their demand for high-value health care with the start of mandated insurance changes this year. Those agencies and organizations that rate hospital performance are paying particular attention to the sea change and currently are determining how to incorporate quality measurements into their methodologies. Evolving Credit Ratings In the near future, quality measures could impact a hospital’s cost of capital as health care reform focuses on transitioning from a fee-for-service to a fee-for-value model, with hospitals expected to take on risk and deliver measurable quality of care. From a capital markets perspective, the ability to access capital at low rates and competitive terms often depends on the…

  The Triple Aim As health care organizations pursue the Triple Aim vision, they need to explore every facet of their care delivery systems. Reliance on technology, the vehicle for reform, requires organizations to take a fresh look at how they view technology assets. This paper briefly explores a new paradigm for technology acquisition and lifecycle management that aligns with improving patient care, reducing health delivery costs, and improving population health. An old strategy in a new environment Historically, most health care organizations viewed technology like an emerging nuisance–with reluctant providers preferring pen and paper. Technology equipment was not regarded with the same esteem as equipment used to deliver direct patient care, nor could a direct line be drawn to the bottom line. Therefore, in many health care organizations, an efficient and cost-effective strategy was never developed to acquire and manage the lifecycle of technology, resulting in costly maintenance and repairs over time. What has changed? HITECH and the PPACA have created an environment where technology is critical in improving patient care, enhancing the patient experience, and reducing health delivery costs. Electronic Health Records (EHR) utilization incentives and penalties are directly tied to an organization’s financial performance. New regulations and new technology require new strategies. While holding on to outdated technology may have been an option in the past, employing this strategy today will hinder performance, competitiveness and the bottom line. What makes this so different? 2014 is a pivotal year in health care: + Decreases in reimbursements + Technology…

For those readers not familiar with Dr. Alex Vaccaro, he is the Everrett J. and Marion Gordon Professor of Orthopaedic Surgery and Professor of Neurosurgery at Thomas Jefferson University in Philadelphia, Pennsylvania. He was the recipient of the Leon Wiltse award given for excellence in leadership and clinical research for spine care by the North American Spine Society (NASS) and is the past President of the American Spinal Injury Association and current President of the Association for Collaborative Spine Research. Dr. Vaccaro has over 530 peer reviewed and 195 non-peer reviewed publications. He has published over 300 book chapters and is the editor of over 44 textbooks and co-editor of OKU-Spine I and editor of OKU-8. Dr. Vaccaro is Vice Chairman of the department of Orthopaedic Surgery, Co-Director of the Regional Spinal Cord Injury Center of the Delaware Valley and Co-Director of Spine Surgery and the Spine Fellowship program at Thomas Jefferson University Hospital where he instructs current fellows and residents in the diagnosis and treatment of various spinal problems and disorders. In light of the increase in spinal trauma during the summer months and the rural nature of many areas in Texas, Dr. Alex Vaccaro offered his insights into the types of injuries that occur, the best practices for improved patient outcomes, and trends in spinal care. The main sources of these injuries are sports, automobile, and water injuries. How patients are stabilized and treated can have a significant impact on cost and the provider’s revenue cycle. RR: A…