Financial penalties for hospitals under the Affordable Care Act are making themselves felt locally and nationwide. Hospitals whose rate is judged too high for hospital-acquired conditions or presumably preventable conditions — such as infections patients acquire in the hospital — get reduced Medicare payments this fiscal year, which started Oct. 1. Heart of Florida Regional Medical Center, Haines City, is the only one in Polk County this fiscal year to be penalized for having too high a rate of hospital-acquired conditions, according to data from the federal government. It's one of about 724 nationwide. Penalties will reach an estimated $373 million for those hospitals, whose Medicare payments will be lowered by 1 percent, according to Kaiser Health News.
A key measure of hospital emergency room use in Los Angeles County shows continued growth during the first six months of Obamacare, but also points to shifting patterns of where patients are choosing to receive urgent medical treatment. With the healthcare expansion last year, many are watching how the Affordable Care Act affects emergency room use. President Obama has promised his signature health law will gradually reduce expensive ER visits as access to other kinds of care is expanded. Critics contend newly insured patients — especially those enrolled in Medi-Cal, the state's low-income health program that picks up most patient costs — aren't likely to seek care elsewhere, and will overwhelm emergency rooms.
The finely tuned trio of health care workers on board a rig here provide medical services on the front lines in North Dakota's oilfields. The rig is not a towering structure high above the prairie. Instead, it's a 45-foot-long Sanford Health mobileMED unit on wheels, which serves oil-producing companies and other companies supporting the energy industry. Since the unit opened in July, nurse practitioner Paula Moch, Deb Spurgeon, nurse coordinator, and tech Zach Bruner have seen on average between seven and 10 patients a day, with 98 percent male, ages 19 to 60.
There's never a shortage of major healthcare policy events in any given calendar year—and 2015 will be no exception. Here's a short list of some that are pending and noteworthy—with a few predictions. First up isn't a prediction as much as a major milestone that's reflective of escalating healthcare costs. According to CMS (here) our National Healthcare Expenditure (NHE) is projected to hit $3.207 trillion this year. The U.S. Population is currently hovering at around 320 million, so 2015 looks to be the first year healthcare spending will reach $10,000 per person. We may be "bending the cost growth curve," but the per capita amount continues to grow.
Starting Thursday, Medicaid payments to many doctors are expected to drop by an average of 43 percent. The cuts are among the most important stories heading into 2015. Essentially, they involve the sun setting of a two-year pay raise for doctors included in the Affordable Care Act. That was because the federal law sought to properly fund its expansion of Medicaid, a health care program primarily for low-income people. After spending about $5.6 billion to directly fund that two-year pay raise, the Medicaid payment rate cuts are expected to take effect in 2015, according to a report by Urban Institute, a research group.
Collecting accurate data and mining it for meaning remains a significant hurdle; however, metrics are an important part of the transparency toolbox that aims to improve clinical quality, patient experience, and value.
The paradigm shift occurring in healthcare is elevating transparency from buzzword status to a strategic component of many hospitals' and health systems' efforts to achieve the Triple Aim.
Companies that provide consumers with ways to evaluate the quality and safety of hospitals are also driving the call for more transparency. Pushing out data to internal and external audiences so that it will lead to more accountability for quality and patient outcomes takes considerable clinical, technological, and workforce resources.
Providers who are tackling the challenge of transparency often cite the various scorecards and rating systems as a starting point for change. Collecting accurate data and mining it for meaning remains a significant hurdle; however, metrics are an important part of the transparency toolbox that aims to improve clinical quality, patient experience, and value.