Letters to the Editor

The Future is Integration
I read Molly Rowe's article "The Hospital of the Future" (July 2008) and completely agree that the hospital will primarily need to be designed to reduce waste and inefficiency and meet the needs of patients and families. The best examples today of future facilities lie in the integrated obstetrical facilities or heart hospital models. The related inpatient and outpatient services are consolidated into one area. This raises the level of service and expertise at the same time that it improves efficiencies—of the hospital and physicians. These centers of the future will revolve around heart and vascular, obstetrics, cancer, orthopedics, general surgery and general medicine.

Facilities shape how we do things in healthcare as well as the organizational structure. It is always interesting as I travel across the country and see new hospitals being built as a "replacement" for an existing hospital—sometimes down to the location of utility rooms. The critical issue underlying all of the components and strategies that must be addressed is the fact that the efficiencies obtained must exceed the cost to invest in the new facilities and the need to change how we deliver healthcare and how we view the healthcare system.

Carolyn Weaver
Executive Consultant
J O Goodman & Associates, Inc., Las Vegas, NV

The Holy Grail is Already Uncovered
Philip Betbeze's article "Out of the Shadows" in September 2008 was well done. The topic of price estimation is an important and timely one.

I must take issue, however, with the following excerpt from the article: "The holy grail of real-time eligibility and pricing estimation often seems far away. But that doesn't mean there aren't currently stopgap solutions for both payers and providers—and even better tools in development."

Actually there are better-than-stopgap solutions available for providers right now. Technology has been developed—and is becoming more widely used—to integrate within a provider's HIS and create accurate patient payment estimates by automatically linking chargemasters, payer contracts and real-time patient insurance eligibility, and copay and deductible information. These tools are especially valuable in a hospital setting where a host of payers creates complicated price discrepancies.

Hospitals are facing a real change in the revenue cycle flow and should have the ability to quote a price for any patient, insured or not. In my weekly business interactions with hospitals and other providers across the country, the subject of patient estimates is consistently among their top priorities. For most hospitals, the best and most lucrative strategy for adapting to these changes begins with technology.

Jorge Wong
Corporate Vice President-Financial Services
Passport Health Communications, Inc., Franklin, TN