2013 has been billed as the year of EHR dissatisfaction, with up to 23 percent of physician practices reporting they were trading in their current EHR system for a new brand altogether, and, according to a new Black Book Rankings report, there were only a handful of vendors that came out on top.The survey finds that providers switching to new EHR systems were turning to Practice Fusion, Care360 Quest, Vitera, Cerner, Greenway, ChartLogic, GE Healthcare and athenahealth—all vendors who have risen to the top of the replacement market satisfaction polls, officials note.
In October, 2012, Medicare débuted a new hospital-payment system, known as Value-Based Purchasing, which ties a portion of hospital reimbursement to scores on a host of quality measures; thirty per cent of the hospital's score is based on patient satisfaction. New York City's public hospitals recently decided to follow suit, taking the incentive scheme one step further: physicians' salaries will be directly linked to patients' outcomes, including their satisfaction. Other outpatient practices across the country have also started to base physician pay partly on satisfaction scores, a trend that is expected to grow.
Given the inadequacies in care for discharged patients — a well-documented and common problem — is it any wonder that so many bounce back to hospitals after they're sent home? Medicare, the government's health care program for seniors, has trained its sights on the issue and is focused on trying to reduce the number of seniors readmitted to hospitals shortly after being sent home. Nearly one in five older adults discharged from a hospital returns within 30 days, at an annual cost of $17.4 billion, according to a recent study in The New England Journal of Medicine.
Medicare is accelerating plans to peg a portion of doctors' pay to the quality of their care. The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or penalties based on their performance by 2015, with all doctors who take Medicare patients phased into the program by 2017. The program is a major component of Medicare's effort to shift medicine away from its current payment system, in which doctors are most often paid for each service regardless of their performance. The current system, researchers say, financially encourages doctors to do more procedures and is one of the reasons health costs have escalated.
Back in 2011, officials at Seton Health Alliance were anxious to change the way its doctors delivered health care. The Austin-based hospital system didn't want to get paid just for the sheer volume of surgeries and patient visits their doctors delivered. Executives wanted to try something new: They wanted Medicare to pay them for taking better care of patients. Seton Health also wanted to move as quickly as possible. So in December 2011, it became a Pioneer Accountable Care Organization, one of 32 health systems across the country that would — as the name implies — pioneer value-based care, and get paid for hitting certain quality metrics.
Medical trade groups are resisting a potential change to regulations on medical imaging and radiation therapy equipment that they worry would lead to lax standards. In recent weeks, organizations have sent letters to the Centers for Medicare and Medicaid Services (CMS) urging the agency not to lower standards for the maintenance of devices that perform MRIs and other procedures. The potential rule change, which has not been formally proposed or presented to the public, would allow hospitals to deviate from specific maintenance requirements approved by the Food and Drug Administration (FDA), which regulates medical devices for medical imaging equipment.