Starting on Oct. 1, the beginning of federal fiscal year 2013, hospitals will begin the Value-Based Purchasing program, in which Medicare payments will be based on quality treatments, preventable readmissions and other patient outcomes instead of volume alone.
“How can we change our mindset from how many patients we have in the beds to how many patients we are keeping healthy and out of the hospital?” said Michael Rembis, president and CEO of Los Angeles-based Hollywood Presbyterian Medical Center, in the report. “We haven’t figured out how to do that yet.”
As more provisions of the Patient Protection and Affordable Care Act also take shape, such as accountable care organizations, hospitals are looking to partner with physicians to avoid the high inpatient costs. Francisco Silva, JD, general counsel of the California Medical Association, said in the report that physicians will still need to have some level of autonomy within the ACO framework.
“If they are dominated by the hospitals, they will fail,” Mr. Silva said. “They will not reduce costs or improve efficiency. It has to be a true partnership.”
California hospitals already have fewer beds per capita and shorter stays than the national average, meaning if state hospitals cannot find more ways to cut finances or bring in extra revenue, services or entire facilities may have to be shut down. “Everyone is scrambling on the hospital side to prepare for fewer patients,” said Jim Lott, executive vice president of the Hospital Association of Southern California, in the report. “It does change the paradigm.”
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