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Hospitals Find Their Role Diminished

Philip Betbeze, for HealthLeaders Media, October 18, 2013

Which brings us to the second main concern of CEOs: The payment system has an even longer way to go toward truly paying for patient outcomes, even if hospitals and health systems are scrambling to put the pieces of the new business model together, often at great expense.

Pay-for-performance schemes have been around for years, especially from commercial payers, but they have been crude, largely experimental, and not robust or expansive enough to truly influence behavior change among providers. CMS has also made strides, but the fact remains that only a small percentage of healthcare reimbursement is at risk currently, and the number will remain small in at least the medium-term future.

Hospitals and health systems have long been criticized as bastions of the status quo, when the status quo is playing a big part in bankrupting the country.

Now, as many recent conversations and events have proven to me, hospitals and health systems being innovative by accumulating expertise and pieces of the healthcare system that they never much cared about in the past, on the promise or threat, depending on your point of view, that payments will move toward value and away from fee-for-service.

Now, it seems, it's the rest of the world that needs to catch up.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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3 comments on "Hospitals Find Their Role Diminished"


David Hold (10/23/2013 at 3:07 PM)
I agree that may be a solution another solution is for hospital administrators to learn basic principal of finance and instead of focusing what can I bill for it focus on the bottom line and realize that you just being able to bill for it does not guarantee profitability. Savings and eliminating waste can have the same effect on bottom line

bob sigmond (10/18/2013 at 3:41 PM)
Your "traditional hospital" is almost all gone. Today, hospital income from in-patient care in almost all the hospitals with which I am familiar makes up less than half of the total. The majority comes from ambulatory and related services. Check it out. Also, today, hospitals have the opportunity to entirely eliminate being paid from fees-for-service by contracting out the entire billing and collection function to a Blue Cross Plan or insurer which will agree to pay a single monthly check for all services, based on a collaborative strategic plan and budget. The contract, of course, would provide for monitoring monthly income and expenditures to make necessary immediate adjustments when the budgeted projections of the bottom line turn out to be inadequate. Also, if the bottom line turns out to be positive, funds would be available for capital expenditures. This arrangement enables the hospital to concentrate on improving quality and access, as expenditures decline, with increasing emphasis on population and community care. For the contracting hospital, there is no longer any uncompensated care, and no unpleasant involvement with patients about collections, and no longer any worries about the bottom line. For more information about this approach, call me at 215-561-5730, or e-mail. Right on, Bob

David Hold (10/18/2013 at 2:26 PM)
I can say finally the industry or at least some in the industry are waking up to reality. Over the past few years i have been preaching that the one thing the industry lacks is vision and they should be taking lessons from their banking colleagues who learned over a hundred years ago that if a customer wants to make a dollar deposit will not travel fifty miles to accomplish it however if he needs to borrow a large sum of money he will travel and that is called branching.