Health Care Thoughts: Notes from the Conference World
by Tom aka Rusty Rustbelt
Health Care Thoughts: Notes from the Conference World So in the past 10 days I have spoken to and with health care executives from 40 + states about their current view of the health care world. A few observations: Accountable Care Organizations (ACOs), a keystone of Obamacare, are being viewed with great skepticism and are generally being avoided, especially by physician groups. Hospitals and physicians are talking more, within Stark limits, about cooperative ventures without going all the way to an ACO format. Private insurers feel empowered by the feds to ratchet down rates. Older physicians are watching retirement funding very closely (shock fact: 1/3 of Michigan physicians are 60 years or older). The complexity of managing any sort of health care facility is going from severe to insane. Regulatory overload and revenue cycle problems are prominently mentioned. It is a happy time for lawyers specializing in health care transactions and regulations. The words “under siege” are used frequently. (Damn: just got an letter that my eye doctor is retiring.) Stay tuned, it is getting interesting. |
What I wish you and Michael Halasy could do is comment of the revenue cycles more…if there is a decrease in overall money in the industry, or just small increases in costs instead of the 7% we have seen in insurance premiums (which is what most people see as costs), how will it play out under different scenarios.
Much of what you present in your thoughts is from agency owners and such it seems…but the hospital association in Boston tends to emphasize labor costs as a key. There is no shortage of nurses, for instance, in this area, but it appears there is a growing shortage of nursing care due in part to increasing patient to nurse ratios…and availability of doctors as well.
Studies in this area are available. Our prestige hospitals have been shown to have somewhat less quality of routine care than outlying hospitals in the burbs for instance, with big differences in costs of procedures as well. Yet smaller hospitals do not drive the agenda.
Anecdotal evidence of ratios changing from ER ratios 1:2 going to even 1:5 currently, nursing home ratios up to 1:50, mandation as a regular way to cover shifts, complex accounting, per diem hiring as a standard, etc.
Rdan: Am I the only one who cannot see the text?
I would be glad to write up something on either revenue cycle or cost or both, keeping in mind there is not always a good match between the two (in terms of cause-and-effect).
Also keep in mind that there are many types of providers and each type has different issues.
I can not see the text either.