Gawande: Financial Leadership Needed to Improve Quality, Reduce Costs

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Data and leadership by healthcare finance experts will have the biggest effects on improving quality and cost control in the U.S. healthcare system, according to a leading healthcare researcher and quality improvement expert. Atul Gawande, MD, a surgeon at Brigham and Women’s Hospital in Boston and researcher on cost and barriers to quality improvement, told attendees at ANI: the HFMA National Institute this past June that improving the care of and reducing costs for the most expensive patients show the way to improving the overall system. “It’s still all about the sickest; what we do and whether our systems can care for the sickest in our society,” Gawande said about the 5 percent of patients who account for 50 percent of healthcare spending. “That’s how we fix health care.” To improve clinical and financial outcomes for the sickest parts of the population, providers and payers have to change how the healthcare system interacts with those patients. Initiatives, such as one focused on 100 of the highest healthcare users in Camden, N.J., found that teams of providers were needed instead of just one clinician. That initiative found problems were not identified by the many separate providers seeing a patient, such as the asthmatic patient who required repeated hospitalizations because no one ever taught him how to use his inhaler correctly. The same patient also benefited from nontraditional healthcare interventions, such as buying him a vacuum to help clean the air in his home. “For these highest-cost patients we need entirely new…

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President’s Message – July 2014

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As our new year begins, I reflect on the experiences and friendships I have developed over the years. I feel they have prepared me for this role and I am forever grateful. I am honored and humbled to serve as President of our amazing chapter. I thank the Past Presidents, Officers, Board Members, Committee Chairs and membership for entrusting me with the privilege of leading you this year. I thank outgoing President, Tammie Galindez, for her tireless dedication and innovative ideas over the last two years. She has set the bar high, demonstrating what it takes to lead with passion and commitment. With a strong board, officer team and committee volunteer base, I am confident we will continue to be an indispensible resource for this chapter. During this year’s Leadership Training Conference in National Harbor, MD, Kari Cornicelli, 2014-2015 National Chair, announced her theme, “Leading the Change.” Cornicelli said, “finance is at the heart of the ongoing transformation in healthcare. As finance leaders, we are uniquely qualified and have the skills to lead our industry into the future.” As I look forward, I ask all of you for your ideas and thoughts to help us fulfill our commitment to our chapter. We are over 400 members strong and have the resources to stay at the forefront of the issues facing healthcare finance today. There is an opportunity for each of you to get involved, join a committee and help lead the change. The chapter leadership has reviewed the results from…

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CHRISTUS Santa Rosa Hospital – Medical Center {Featured South Texas Hospital – July 2014}

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Located in the South Texas Medical Center, CHRISTUS Santa Rosa Hospital – Medical Center (CSRH – MC) is an acute care destination for patients and physicians throughout South-Central Texas. The campus brings together compassionate care, state-of-the-art equipment, knowledgeable Associates and physicians, and educational support to provide quality services, such as cardiology and open heart surgery, general and robotic surgery, orthopedics, wound care and hyperbaric services, kidney transplantation, and urology, in a safe, family-centered environment for all patients. In addition to providing emergency care services, CSRH – MC also administers CHRISTUS Santa Rosa Emergency Center – Alon, a freestanding emergency department located in Shavano Park. Recently, CSRH – MC underwent a makeover and renovation. As part of this project, the surgical facilities were increased, and the patient care within the Intensive Care Unit was enhanced. With the recent Nurses Improving Care for Healthsystem Elders (NICHE) designation, Associates in all units at CSRH – MC are being trained to provide high-quality elder care in order to improve the health of hospitalized seniors. Additionally, CSRH – MC received $500,000 from the Hazel and Fred Kingman Endowment to renovate and enrich The Orthopedics and Neurosciences Center. With its opening July 2014, The Orthopedics and Neurosciences Center now offers comprehensive orthopedic services including total joint replacement, back and spine surgery, and fracture treatment. Also opening this month is the Hazel and Fred Kingman Education and Conference Center, a fully-equipped multimedia education and conference center dedicated to providing pre-operative patient education, patient activities, and team conferences….

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How Will Quality Metrics Impact a Hospital’s Credit Rating?

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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…

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A New Paradigm for Technology

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  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…

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Specialty Insights – An Interview with Spine Trauma Expert, Alex Vaccaro, MD, PhD.

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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…

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Annual Institute 2014

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The first post on the HFMA South Texas Chapter Blog! A slideshow of a few of the pictures I took at the Annual Institute. To see more, go to our Facebook page! BE SURE TO LIKE US! http://www.facebook.com/stxhfma This blog will be used to post all the articles in the newsletter, to give them more exposure. Be sure to check back for updates from the chapter and more!

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