Quality Isn’t Enough; Today’s Patients Demand Healthcare Value

Sometimes it’s hard to explain what I do for a living – not many people are aware of the work of a healthcare trade association. But a lot of what I do centers around good old-fashioned advocacy in Trenton or in Washington, D.C., educating people about the work of hospitals and the important issues that matter to them and their patients. I find it easy to advocate for our members, who provide excellent patient care in all settings to the people of New Jersey. I often get to wear the white hat, because of the work of my membership.

But NJHA is much more than advocacy. We take our leadership role very seriously in working with our members to make healthcare better. We have a dedicated office – the Institute for Quality and Patient Safety – and staff working everyday to improve the care we deliver. And in today’s environment, patients don’t just demand good care – they also demand good value. They want quality healthcare that also is efficient and affordable.

Fortunately, New Jersey hospitals have a head start. Long before the federal healthcare reform law required new models in value and efficiency, our members have been teaming up with us in several innovative strategies to rein in rising healthcare costs while ensuring continued quality and access to healthcare consumers.

A few examples:

  • NJHA Collaborative to Reduce Readmissions. More than 5 million individuals in the United States suffer from chronic heart failure, making it one of the most common reasons for hospitalizations and readmissions. To address this costly issue, NJHA has embarked on a yearlong collaborative partnership to reduce hospital readmissions due to heart failure. More than 50 organizations are taking part including hospitals, nursing homes, home health and hospice. Hospital readmissions are a very complex issue, with many factors beyond the control of healthcare providers. Some readmissions are simply unavoidable. But we all know there is always more to be done to make our healthcare system more efficient. This collaborative aims to zero in on factors that can help us prevent certain readmissions – for the sake of our patients and the overall quality and efficiency of our healthcare system.

  • On the Cusp: Stop Bloodstream Infections. New Jersey hospitals participating in our effort to reduce central line-associated bloodstream infections have achieve a whopping 81 percent decline in the number of infections over the last two years. That score outpaces the national rate of 58 percent in hospital intensive care units across the United States. NJHA’s initiative is part of a national effort called “On the CUSP: Stop BSI. We’re partnering with the Johns Hopkins Quality and Safety Research Group, the U.S. Agency for Healthcare Research and Quality, the American Hospital Association’s Health Research & Educational Trust and the Michigan Hospital Association’s Keystone Center for this highly successful initiative. Nationwide, the CDC reports that the decline in BSIs saved up to 27,000 lives and $1.8 billion in healthcare costs.

  • Physician-Hospital Gainsharing. NJHA and 12 of its member hospitals and their participating physicians have received approval from the federal government to test an innovative new incentive method called “gain-sharing,” which aims to reduce healthcare costs while improving quality of care. Existing federal policies make it difficult for hospitals and physicians to work together to cut costs. Currently, Medicare reimburses hospitals a fixed rate for treating a Medicare patient, based on the patient’s diagnosis. But physicians are paid differently, receiving individual payments for each procedure or each day spent in the hospital. So while hospitals are encouraged to manage patient care to achieve the right balance – just enough care, but not too much care -- the financial incentives created by the current Medicare payment system can be very different for physicians. It’s one of the strange obstacles in our complicated healthcare system that frustrates efforts to reduce costs and make healthcare more efficient. Our gain-sharing project aims to bring hospitals and physicians together. The program allows physicians to reap small financial rewards for their efforts to change their practices with a closer eye toward better, more efficient patient care. It essentially makes them partners with hospitals in an effort to reduce the cost of healthcare. The strategies are endless, but one specific example could be a new timetable for physician rounds. By simply moving patient rounds to the morning and ensuring that physicians discharge patients early in the day, hospital expenses are reduced and patients are allowed to continue recovering in the comfort of their homes. This is one of many common sense approaches that could lead to significant cost savings.
Written by Betsy Ryan at 19:23

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