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Asset & Property Management
Reality Check: Healthcare Systems Hear From Experts on Reform and Operations
Posted March 11, 2013
NexCore Group attended the
Health Dimensions Group National Summit: Shifting From Reform Strategy to Operational Reality
in San Diego on March 4-6. The sponsor, Health Dimensions Group, is a consultant specializing in offering services to the post-acute care industry, and most of the attendees were operators, planners, consultants who were involved in this sector of care. The speakers discussed many topics, but here are a few paraphrased thoughts that we found interesting:
When ACA kicks in, the newly insured will be seeking primary care visits, which won’t be available. They will head to emergency departments, which will be swamped, and the costs of care will skyrocket.
Many patients will shop exchanges for health insurance. The sites will be organized like Travelocity where the lowest cost plans appear first and the newly insured will pick the lowest cost plan.
Narrow networks will form quickly and offer fewer choices of providers and options for care. Providers not in these networks will be left by the wayside.
Capitation is back with a vengeance and, within 5 years, 50% of provider reimbursement will be in a form other than fee-for-service.
Networks will be reimbursed based on the number of patients that they “control”, measured by active charts and visits to physicians within the network.
Physician care will change to include more use of a team with a care coordinator, social worker, pharmacist, and mid-level in order to provide a comprehensive bundle of services that lower the cost of claims.
Networks will include a variety of post-acute care options and this sector will be re-named to shift the centricity away from acute care.
We are just beginning with healthcare IT—today’s systems are good with patient charts, but not so good at care management.
The current hospital focus on avoiding readmission penalties is the tip of the iceberg. The next CMS shoe to drop will be to expand the 30-days to 90-days, and include ED visits, observation stays, and surgery.
This is all pretty scary stuff to our provider clients and there will be facility ramifications.
Yesterday’s medical office building may be functionally obsolete.
Trying to provide coordinated care like an HMO in a facility where the physicians are all independent entrepreneurs is not going to achieve the efficiency, cost reduction, and patient satisfaction that is needed. We are working with providers on new facilities that are anticipating where healthcare reform is going and we’re excited about the future.
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