Accountable Care Organizations (ACOs) figure prominently in the new Patient Protection and Affordable Care Act (PPACA). The concept behind ACOs is that by tying both physician and hospital compensation to outcomes via a bundled fee (say for pneumonia) we can expect to see an improvement in quality and value.
In principal, accountable care makes a lot of sense. Practicality speaking, however, doctors and hospitals must address a huge challenge before they can expect benefit financially. Before doctors can be held accountable for the care they deliver, they must first be held accountable for the quality of their communication with patients.
Take hospital readmissions, which are a big healthcare cost driver today. According to a recent study in the New England Journal of Medicine, 20 percent of all Medicare patients discharged from hospitals were readmitted within 30 days, and 34 percent percent within 90 days. The Joint Commission and others rightly believe that inadequate communication between physicians — as well as between physicians and patients – is a major contributing factor. Read more »
*This blog post was originally published at Mind The Gap*
Heart attack mortality fell by nearly a half a percent last year at 4,500 hospitals that treat Medicare patients. And, facilities with the lowest and highest death rates saw similar declines, according to a new hospital report card by the U.S. Centers for Medicare and Medicaid Services (CMS).
Heart attack mortality fell from a national average of 16.6 percent last year to 16.2 percent, with a range among all facilities from 14.5 percent to 17.9 percent. CMS released the data as part of its hospital report card effort to spur better quality and outcomes through public reporting of recommended treatments. The agency added heart attack and heart failure mortality to the report card three years ago.
At issue now is what’s driving the figures: public reporting of hospital data driving improvement, or faster door-to-balloon-treatment times. Areas that do need to improve include lowering readmissions and getting people to the hospital faster when they have a heart attack. (USA Today)
*This blog post was originally published at ACP Hospitalist*
In a last-minute shocker, the Senate voted Thursday against postponing a scheduled 21-percent cut in Medicare reimbursement to physicians and other healthcare providers. Sixty senators were needed to end filibuster debate and stop the cuts under Senate rules. Fifty six voted in favor, while 40 opposed. There was no Republican support. (And, of course, no support from Senator Lieberman, who is a Republican in disguise.)
Another consequence of the vote is that tens of thousands of Americans who have exhausted their jobless benefits would not be eligible for more. In addition, new taxes on wealthy investment managers would not be imposed, along with an increase in liability taxes on oil companies, leading Democrats to contend that Republicans were protecting Wall Street and the oil industry, according to the New York Times.
“We’re not going to give up,” said Senator Harry Reid, the Nevada Democrat and majority leader. “We know the American people only have us to depend on.” Read more »
*This blog post was originally published at EverythingHealth*
The American Medical Association will launch a multi-million-dollar ad campaign tomorrow to heighten pressure on Congress for a doc-fix bill. The American College of Physicians (ACP) reacted by calling for doctors to contact their member of Congress directly to let their voices be heard. Robert Centor, FACP, called for doctors to protest as well. (American Medical Association, American College of Physicians, DB’s Rants)
Meanwhile, a Florida medical society predicts a crisis in that senior-laden state. The society cited but did not name eight primary care doctors who’ve stopped accepting Medicare patients this year, and 12 cardiologists who left private practice for employment elsewhere because of already reduced payments. Unbelievably, business columnist Steven Pearlstein sorted through the issues around the doc fix, and concluded that it’s the docs that need fixing for paying themselves generous salaries. (Naples News, The Washington Post) Read more »
*This blog post was originally published at ACP Internist*
You may have noticed, uncharacteristically for me, that I haven’t posted a blog in week. I thought it would be better to allow the readers to post their own reflections, and you did — with comments ranging for unabashed pride to skepticism to disdain for the law and the American College of Physician’s (ACP’s) role in bringing in about.
I respect the principled arguments made by those who believe that the legislation gives the government too much control or those who fear that it will add to the deficit and public debt, even though the Congressional Budget Office (CBO) says otherwise. But there is one claim made by some of the critics that sticks in my craw, which is that the legislation will result in “massive cuts” to Medicare. Here are the facts. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*