What the Health? How Hospital Leaders Can Prepare their Systems for Reform

Recently, the United States Supreme Court sent a monumental message to healthcare providers and patients across the country when it upheld the Patient Protection and Affordable Care Act, with the sole exception that Congress cannot penalize states that decline to expand Medicaid.

Implementation of the PPACA provisions provides great challenges for hospitals, which are also struggling with significant cost, operational and clinical hurdles as they attempt to implement the far-reaching reforms of PPACA and other mandates while maintaining financial viability in an era of evolving payment models with lower reimbursements.

In a time of reform, recession and reimbursement, rethinking how we deliver patient experiences has become one of the biggest priorities amongst hospital executives.

Patients vote on their experience every day in hospitals across America. They judge how well clinicians and physicians communicate with them, how often their needs were attended and how comfortable their care environment is. As if the quest to score in the top quartile of the Hospital Consumer Assessment of Healthcare Providers and Systems survey isn't important enough to maximize reimbursement, health systems are plagued by reimbursement for readmissions, yet struggle to keep the beds filled as a revenue stream.
HCAHPS provide standardized survey metrics to gauge the patient's perception about their experience, but we all know just because a nurse answers the call light doesn't mean the patient is going to come back or become a promoter of the system.

So much evolution in the patient throughput and alignment with changing models leaves gaps in the patient experience that often go unnoticed until it shows up on a satisfaction survey or an error occurs. Align your hospital strategically to help manage the anticipated influx of patients who will now be eligible for insurance coverage and are likely to drive increased traffic to the emergency department.

1. Align your hospital and network physicians with patients' post-care delivery. Once discharged or released patients leave your hospital or network facility, ensure there is a comprehensive follow-up plan to question if patients are receiving the appropriate level of follow-up care within your facility. Return that revenue back into your system and network of providers through physician referrals, or the next visit will most likely be in the emergency department.

2. Always ask questions. Patients are more satisfied with their stay if they receive a phone call post-discharge. Beyond the stay in a hospital, a post-discharge call can extend the patient experience by providing a way for patients to ask questions, ensure medication compliance and identify adverse conditions, and to ensure follow-up appointments are made. Healthcare is complex enough for the care providers who see patients all day long; it's harder for patients to find their way along a care path. As CMS continues to enforce higher patient satisfaction scores and lower readmissions, it is becoming more evident that improved satisfaction and readmission scores are not the only strategy to engaging patients and creating loyalty.

3. Higher level of care coordination keeps patients out of the hospital and emergency department. Fast forward to 2013 and beyond, the quest will continue to improve preventative health coverage, expand how health systems bundle care and improve cost and efficiency. Data will be more important than ever in understanding patient demographics, patterns and medical history. Physicians can't be forgotten in this journey. With growing physician shortages, systems will be forced to employ more nurse practitioners and physician assistants. At the same time, the PPACA is slated to increase payments for primary care physicians, in an attempt to protect access for newly insured Americans.

Healthcare delivery and management is complex; there are physician shortages, understaffed nurses and patients with steep expectations that are right in the midst of a political movement and monumental shift in delivery guidelines. The Supreme Court has spoken, but the clear winner has yet to be determined. 

Steve Whitehurst is chief customer and strategy officer at BerylHealth, a technology based patient experience company. Mr. Whitehurst's focus at BerylHealth is to manage the overall patient experience and client facing teams, while also monitoring and aligning BerylHealth's overall business strategy with that of healthcare organizations' concerns within the market. Mr. Whitehurst welcomes your communication at steve.whitehurst@berylhealth.com, or he can be found on Twitter @Steve_Beryl .

More Articles on Patient Experience:

Creating a Culture of First Impressions and a Continuum of Patient Care
Examining the Crossroads of Culture, Engagement and Patient Satisfaction
Putting Employees First: How to Improve Patient Experience, Profitability

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