Wanted: Reliable Partners

Keeping the doors open around the clock, through disasters of all kinds while providing care to all who need it whenever they need it, makes operating a hospital one of the most challenging endeavors imaginable.

Today, keeping this longstanding commitment to caring is increasingly difficult because of an aging population, changing consumer expectations and a marked increase in chronic illnesses. But most frustrating is a lethal mix of outdated laws, burdensome and ill-conceived regulations and a Congress that repeatedly raids already inadequate federal funding for hospital care to pay for other programs. Nearly 60 percent of hospital revenues come from government sources, so hospitals need government to be a better business partner.

With public attention focused on coverage expansions under Medicaid and health insurance exchanges, the organizational and cultural changes that have occurred in hospitals over the past decade have been overlooked. Even before passage of the Affordable Care Act, hospitals began to reinvent how they deliver care in order to address three pressing national goals: improved patient quality and satisfaction, improved community health, and reduced per capita cost.

Doing their part, hospitals are moving from a payment system that reimbursed for procedures performed to one that recognizes the quality of the care they provide. Additionally, they are taking on increased accountability for outcomes for the patients they serve. They are also redesigning delivery systems to better serve patients by coordinating services in a seamless manner across multiple settings to reduce fragmented care and increase efficiency.

This massive undertaking has required immense human and capital investment, but hospitals are making excellent progress:

• Patient care quality, as measured by the downward trend in preventable infections, is improving, thanks to collaborative, evidence-based processes and huge investments in information technology.
• Hospitals across the country prevented 560,000 hospital-acquired conditions and saved 15,000 lives and $4.1 billion, according to HHS.
• Overall growth in health care spending has moderated for a prolonged period, fueled in part by lower growth in hospital prices.
• Hospitals are moving from health care to health, forming partnerships to improve the overall health of the communities they serve and eliminate disparities.

To continue and accelerate this progress, government must be a more reliable business partner, providing hospitals with better predictability in the payments they receive for the services they provide.

To implement the changes needed to serve their communities in the future, hospitals must make plans today:

• They must know whether federal pressure for coordinating care in different settings and with other providers will be matched with removal of outdated regulatory and antitrust barriers to such integration.
• They must look to regulators to fix well intended but seriously flawed efforts like the recovery audit contractor system that overreach in their efforts by substituting the judgment of clerks for that of physicians on clinical decisions and by diverting resources from patient care, costing hospitals millions of dollars in staff time.
• And they must ask Congress to break the habit of repeatedly cutting future Medicare funding for hospital services to pay for other programs.

When someone we love urgently needs health care, we count on our hospital to be there. Hospitals count on Congress and regulatory agencies to be there, too. Let’s work together to build a predictable future for America’s hospitals and the health of the communities they serve.

Rich Umbdenstock is President & CEO of the American Hospital Association.