There are nearly one million hospital beds in the United States. But I've been wondering, what are we going to do with all the empty ones if the healthcare industry successfully achieves the goals of reform?
Should hospitals start thinking about closing them down? That's anathema to the premise under which the industry has functioned for decades, which holds that the number of services, buildings and patients must grow to stay in play and maintain respect in the community.
Before you ask what I've been smoking, (nothing!) hear me out:
1. One in five or six patients is now readmitted within 30 days, but penalties and incentive programs can dramatically prevent those readmissions. A one-third reduction is not an unreasonable achievement, Elliott Fisher, MD, director of the Dartmouth Institute's Center for Population Health, told me last week.
Fisher lamented how hospitals that have successfully reduced readmissions have turned around and launched questionable service lines that don't improve care, such as spine surgeries. Hospitals are expanding volumes for procedures that, given correct and balanced information about their effectiveness and their alternatives, he says, patients would choose not to have.
"With hospitals that are dependent on fees for maintaining hospital margins, reducing unnecessary readmissions and avoidable admissions causes revenue losses, which will lead them to admit other patients to the hospital" for these elective procedures, he said.