Physicians Managing Costs
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In 2011, Wellmont's 505-licensed-bed Holston Valley Medical Center in Kingsport, was rated the top hospital in the nation for interventional carotid care, and among the top for its market for heart attack treatment and other cardiac care. According to CMS data, the hospital reported a 30-day mortality rate of 16.2% for 549 patients between 2007 and 2010, consistent with the national average.
"In composite, we are where we want to be," Attebery says, referring to patient quality measures. However, "there is more variability among physicians than we'd like." He refers to recordkeeping about everything from medication to patient education. "We need to tweak their documentation to get it better embedded in the workflow," he adds. "We're not hitting those processes as we could." As a result, the hospital system is reworking some of its electronic medical record programs to improve physician accountability, he says.
As Wellmont evaluates, negotiates, and enters in contracts with physicians, "ultimately we ask if we will be lowering cost and improving quality," Attebery says. "I'd caution and admonish my cardiology colleagues that they don't allow the deal to become the endpoint.
"The move to value-based care is to try to optimize overall performance," Attebery says. "If you don't realize the value you can deliver to the market, it will be a bridge to nowhere. The bridge has to have a destination."
This article appears in the January 2012 issue of HealthLeaders magazine.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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