With an influx of 32 million newly insured patients thanks to health reform just a few years away, it’s an understatement to say the U.S. hospital industry is in for big changes.
More patients means greater opportunity for revenues, but the extra volume also has the potential to stretch hospitals thin and overtax already-burdened clinical staffs. Plus, with state and federal budgets under pressure, it’s likely reimbursements will fall, further squeezing hospitals’ profit margins.
So what can hospitals do to get ready for 2014, when most of health reform’s major provisions are set to kick in? Mark Moran, CEO of Cleveland’s safety-net MetroHealth System, shared a few steps that his health system has begun taking to deal with health reform fallout. Moran spoke during a conference call hosted by HealthLeaders Media titled “More Patients, Less Money, Higher Quality.”
- Develop a strong network of walk-in health centers: Though they require a large up-front investment in overhead, ambulatory centers spread throughout a community can be an effective way of reaching far-flung patients and building market share. For MetroHealth, ambulatory centers also are a way to expand its patient base to higher-income suburbs, which is no small consideration for a health system that sees about 17 percent of its volume go toward uncompensated care.
- Tighten the supply chain: In areas like orthopedics and cardiology especially, hospitals can gain savings from coordinating among doctors and choosing a small number of preferred suppliers. “While it’s a small piece of the puzzle, it’s really helped us get cost out of the system quickly,” Moran said.
- Ensure clinicians work at their highest skill levels: Internal studies showed that some MetroHealth physicians were working at the top of their skill levels only about 30 percent of the time. For advanced practice nurses, that number was even lower. One of the keys to getting people working at their highest skill levels is to raise the skills of those around them. To that end, MetroHealth began retraining some workers to help them acquire new skills. Though daunted, workers often responded positively when they saw that the health system was committed to enhancing their job skills, Moran said.
- Envision a world after fee-for-service: Paying physicians under the fee-for-service model has brought skyrocketing health costs and skewed incentives. Those are two reasons why the model’s days likely are numbered. Filling the future void could be the much-touted patient-centered medical home (PCMH) model of care, which emphasizes care coordination, teamwork and information technology. Hospitals would be wise to examine transitioning their organizations to the PCMH model now to avoid scrambling to catch up should there be an industry-wide shift in coming years.
