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Getting Reform Right

Margaret Dick Tocknell, for HealthLeaders Media, December 13, 2012
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Investing in compliance

Meaningful use attestation, the implementation of ICD-10, value-based purchasing, and Medicare rank among the top regulatory programs for both immediate and long-term financial investment.

Mark Brenzel, CEO of Lake Cumberland Regional Hospital in Somerset, Ky., notes that his hospital, which is part of the for-profit LifePoint Hospital system, spends "a staggering" amount of money complying with Medicare regulations, including case management, billing, and physician contracting. He expects that to continue over the years.

He sees more of a time component to items such as meaningful use. He explains that while meaningful use has been "the biggest hit recently" in terms of capital investment, he expects that "eventually we'll get though the start-up costs of meaningful use and it will be maintenance costs that will be the big hit in the future."

Shifting to outpatient

Labor is a significant part of every healthcare budget. As organizations seek to improve their bottom lines in light of PPACA, many (40%) plan no PPACA-related staff reductions, and only 2% and 8% will reduce physicians and nurses, respectively. Still, 22% of respondents are expecting cuts in administrative leadership, 11% will cut HR staff, 4% will trim IT staff, and 39% anticipate cutting other nonclinical staff.

Meanwhile, only 17% of respondents expect no staffing increases at all due to PPACA. To the contrary, about one-third of healthcare leaders expect to increase staffing in certain clinical areas as a result of the health reform law: mid-levels (36% project growth), nurses (32%), and physicians (31%).

The survey also shows that many providers will shift the focus of their services over the next three years, adding or increasing in some areas, while eliminating or decreasing in other areas.

Three-quarters (74%) of leaders project expansion of ambulatory services; 71%, wellness; 69%, primary care; and 65%, community/home health.

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