The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.
About thirty years ago, I was an accountant for Arthur Young. One of my auditing clients was a young emergency physician group in Oakland. I remember working long hours and coming home late at night exhausted, watching Johnny Carson on The Tonight Show, and thinking about that physician group and its amazing culture. They were devoted to helping others, and they went about their business in such a positive way.
When I decided to jump ship to truly join the healthcare sector, I went to work for that young physician group. At the time, many of my colleagues were going to high profile jobs in the financial services industry and investment banking. But I think I made the best choice.
Our bi-weekly news updates are designed to keep you up to date with current developments relating to the Acute Care Continuum. Feel free to share your perspective on these stories or link to articles that you have found relevant to today’s healthcare environment.
This week, we examine reports and studies highlighting potential barriers to patient care, including throughput issues, understaffing, and cost-cutting policies.
The northern San Diego region is growing rapidly, and last year, Palomar Health unveiled a state-of-the-art hospital to meet the needs of the future. Palomar Medical Center (PMC) is one of the country’s largest hospital construction projects and the first new North County San Diego hospital in 30 years.
The hospital system I work for has an ED and two Urgent Care Centers (UCCs) in the same city. Between the two UCCs, we serve all payer populations so that everyone in the community can access urgent care services when needed. In this way, we try to be highly available for everyone who needs immediate care. At the same time, we have also made the decision to have limited testing facilities in the urgent cares and to focus them on particular patient populations. While our UCC set up is not the standard, the results have been beneficial for both patients and the hospital.
Hospitals across the country are starting to feel the effects of healthcare reform. Beginning in fiscal year 2013 (September 1, 2012), part of hospital reimbursement has been based on a value-based purchasing (VBP) plan that has been created by the Centers for Medicare and Medicaid Services (CMS). This is the first step in a process that will transform the current fee-for-service system into to a fee-for-performance system. This transformation will be taking place gradually, so those who prepare now will improve their strategic position for the future.
CMS established VBP with two goals in mind: to decrease healthcare costs and to improve outcomes for healthcare services. In order to create incentives for hospitals to achieve these goals, they have developed quality criteria which include both clinical process measures and patient experience measures. To start off, CMS will withhold one percent of all hospital payments, and will remit that one percent to hospitals only if they meet the new criteria. The amount withheld will increase annually, finally reaching two percent in 2017.
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I am grateful for the privilege of reading about your experience. Thank
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