Imbibe in healthcare reform

Kaitlyn Dmyterko, senior writer

As 2011 comes to a close, no amount of champagne can make one forget about the year’s most talked about topic—healthcare reform. While the Patient Protection and Affordable Care Act has received considerable flak, many hospital administrators would agree that surgeons are not the only ones who must hold the knife this year. Now, more than ever, hospitals administrators will need to slash healthcare costs while still providing the utmost care to patients.

As we revisit the topic of healthcare reform, we ponder what the upcoming year will look like, what will change and what reforms will take place. But to cut costs, we must first acknowledge where the problem starts.

This week, a Healthcare Cost and Utilization Project statistical brief delineated the costs associated with inpatient hospital stays. While there were a whopping 39.4 million inpatient stays in U.S. hospitals in 2009 alone, what was more shocking was the $361.5 billion price tag linked to these stays.

For the elderly, coronary atherosclerosis, congestive heart failure and acute MI accounted for the largest aggregate costs. Additionally, costs associated with device complications almost doubled between 1997 and 2009.

A New England Journal of Medicine study this week found that readmission rates varied significantly by hospital referral region, and researchers urged policy makers to focus on reducing incentives for using hospital services rather than the current focus of disease management programs and improving transitions of care.

In fact, the researchers found that congestive heart failure (CHF) readmissions varied 11 to 32 percent across referral regions. Hospitals in the highest quartile for readmissions were more likely to be medium- or large-size hospitals, located in the Northeast and be for-profit, private nonprofit, urban or academic hospitals.

The researchers said that while improving transitions of care from the hospitals to ambulatory setting can reduce costs and readmission rates, policy makers can decrease readmission rates even lower if they focus on reducing the incentives given to clinicians when hospital services are used.

Perhaps, in 2012, the idea of accountable care organizations (ACOs) will take hold and help with cost-containment. But currently, as Jack Lewin, MD, CEO of the American College of Cardiology, would say, ACOs are still the “Bigfoot” of healthcare.

The key to reducing healthcare costs will be to improve care processes, figure out how to incorporate lower cost treatments, reduce adverse events and improve patient management.

One way to do so may be to get involved in registries such as PINNACLE, or those that focus on disease management. A study in Health Affairs this week concluded that disease registries can substantially reduce costs. Registries allow clinicians to share the best clinical practices, which would result in better health outcomes, the authors wrote.

Do you have a resolution to cut costs next year? Email me and let us know.

Kaitlyn Dmyterko
Cardiovascular Business, senior writer
Kdmyterko@cardiovascularbusiness.com