In a recent Reform Realtime video, providers on the ground shared their thoughts on the biggest challenges facing acute care:
"Patients may have insurance now … but yet when they call a clinic or try to call a family physician for their care, there's a wait of several months to get in. And so many of those patients are seeking care in the emergency department because they have nowhere else to go."
"Is government regulation going to interfere with my interactions with my patients?"
"We're required to do more with less. We have fewer resources, less staffing. And everyone is concerned about the finances and where we're going today."
"In one sense, we need to see a lot of patients, admit a lot of patients. Hospitals are getting paid for having more patients in their beds. And on the other, we're trying to keep patients out of the hospital."
So our Reform Realtime correspondents had a variety of concerns, but what did you think?
Two weeks ago, we asked you about the biggest pressures facing your hospitals — and you answered!
To our Reform Realtime team, these results were somewhat expected. But as you see in the chart, there were also a few surprises:
On one hand, we expected to see Patient Flow & Throughput emerge as a leading concern. The experience of early adopting states like Oregon and Massachusetts suggests that increasing access to healthcare insurance tends to put increased pressure on emergency rooms — at least in healthcare shortage areas like rural areas. This has implications for patient flow throughout the hospital.
We also expected to see plenty of hospitals concerned about Patient Satisfaction given increasing incentive payments and the rollout of ED CAHPS coming as early as next fall.
On the other hand, we were somewhat surprised by the number of respondents who listed Volume: Growth and Space Constraints among their top concerns. Given that the thrust of healthcare reform is to manage population health in ways that prevent costly hospital admissions, we actually expect to see hospital footprints shrinking as services shift to outpatient settings. Granted, this shift isn't going to happen overnight. But it need not take decades either, as a three-year-old program in rural Maryland has demonstrated.
Which brings us to the biggest surprise of the day: After years of intense media attention focused on the Affordable Care Act and its impact, only 9 percent of respondents chose Healthcare Reform and Changes as among their paramount concerns.
Now arguably, healthcare reform is implicit in all of the pressures listed in the survey. So perhaps it's not fair to include it as a separate item as well. But the responses do suggest that for many on the front lines, the ACA itself is taking a backseat to more pressing concerns.
So that's our two cents from Reform Realtime. But what do you see in the results? Comment below to share your thoughts and join the conversation.