Healthcare – Is Quality of Care at Stake?

In a survey held by KPMG LLP the U.S. audit, tax and advisory firm in 2012 among 200 healthcare professionals, many respondents had raised doubts about the sustainability of US healthcare in its current form. An American Health Association (AHA) estimate states that about “10% of Medicare revenue will be at risk in 2017.” Now, a new analysis by the RAND Corporation states that “conversion to EHR has failed to improve efficiency, patient care and arrest the rising healthcare costs,” reports the New York Times quoting this month’s edition of Health Affairs, an academic journal.



 While AHA identifies new initiatives like Value-based purchasing, Penalties for high rates of readmissions etc. as possible causes that make it difficult for hospitals to “move up in the relative standings once they are among the poorest performers,” RAND Corporation study finds existing commercial systems a stumbling block. Experts like Nancy Foster, vice president of quality and patient safety at the AHA think that penalty based on new efficiency standards imposed on hospitals by CMS add to the woes of hospitals. Some of the Physicians view this policy as unfair. Dr. J. Michael Henderson, who focuses on quality and patient safety for the Cleveland Clinic, hospital’s readmission rate is not a clear measure of the quality of care it provides, noting that hospitals with higher mortality rates may also have fewer returning patients. “Dead patients can’t be readmitted,” Dr. Henderson said.


A Differing Opinion

“ACOs are estimated to save the Medicare program up to $940 million in the first four years,” writes Kathleen Sebelius, Secretary of the Department of Health and Human Services (HHS) in a recent Healthaffairs blog. According to her, Medicare readmissions rates have remained steady at 19 percent over the five years period. “In 2012 the nationwide hospital readmission rate declined to about 17.8 percent with Medicare costs going up by only 0.4 percent. At the same time there was a decrease in per-head spending in Medicaid (1.9 percent) during 2011-2012,” adds Kathleen.


Remedial Steps

As opined by the Secretary, HHS, Medicare can show the way towards delivering better care at reduced costs.  But how this can be ensured? “The best option to cut costs is to prevent illness which will build the practices of primary-care physicians and specialists who meet the system’s goals,” says Dr. Mitchell T. Rabkin and John S. Cook, two eminent healthcare professionals (Wall Street Journal, opinion column – 14th October, 2012). “Expansion of Medicare pilot programs would assign accountability for cost, quality of care and patient satisfaction,” they argue. According to a Kaisereducation report stress should be given to “greater government oversight and regulation of health insurer premiums and practices, increasing competition and price transparency in the sale of insurance policies through Health Insurance Exchanges.”

Hospitals are now ensuring that they follow up with the patients after they are discharged within 48 hours. They are even following up with their patients asking them if they are facing any health related issues. They also make sure that patients understand what medicines they are suppose to take when they are at home and they have even gone out of their way in finding where can they find a particular healthy meal for the patients post discharge.

Moreover, Delivery of Healthcare Technology solutions on tablets and mobile phones are already on its way, bringing further improvements in patient care.  Care can be given at reduced costs if standardized systems which give easy access and full control to patients over their own health data are made available, says the New York Times quoting from the Health Affairs report. “Providers have a role to play here. They should stress more on reengineering of care by making use of the healthcare IT,” suggests the article quoting the report. In such a scenario, healthcare organizations effectively turn the process of care into a team based and well coordinated medical practice that promotes better outcomes.

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