In Next Evolution of Healthcare, Will Quality Remain a Focus?
The Department of Health & Human Services reports that since 2011, hospital-acquired conditions, ranging from central line–associated infections to falls, have decreased by 17%; this drop has saved an estimated 50,000 lives and $12 billion. In addition, Medicare all-cause 30-day readmission rates fell to approximately 17.5% in 2013, translating to approximately 150,000 fewer hospital readmissions among Medicare beneficiaries between January 2012 and December 2013.
So, will quality of care continue to be a focus for healthcare organizations under the Trump presidency? Many healthcare experts say that the new administration will have no choice. Improving care quality will continue to be the foremost goal for healthcare organizations because patients have been educated to demand it.
“In regards to the election results, we believe that the ideas behind value-based care, including reducing the per capita cost of healthcare, improving the quality of care and improving patient satisfaction, are here to stay with or without the Affordable Care Act,” commented Warren Hosseinion, MD, CEO of Apollo Medical Holdings Inc., an integrated population health management company.
“The movement towards value-based care is accelerating in the United States,” added Gary Augusta, executive chairman of Apollo.
Heather Lavoie, chief strategy officer for Geneia LLC, a healthcare analytics and technology company, suggested in a recent post on Geneia’s website that the ACA simply codified a transformation that was already underway.
“Despite political sentiments about the insurance mandate and Medicaid expansion, medical societies, hospital associations, health plans and other industry experts consider the evolution to value-based care—which long-preceded the ACA—an absolute necessity to transition from a low-value, fee-for-service model of care,” Lavoie wrote.
“The law codified the tenets of value-based care, which began as voluntary private-public partnerships to address the stark reality that the United States pays more per capita for healthcare than any other industrialized nation, and ranks dead last in terms of quality. In doing so, the ACA accelerated our country’s evolution from fee-for-service medicine to value-based care,” she said.
Competitive improvements
As laid out in the president-elect’s campaign promises, the Trump administration will seek to improve healthcare affordability by promoting healthy competition among insurance providers. One might expect this competition will continue as consumers are encouraged to shop around for organizations that provide the greatest quality of care.
And many organizations advocating for a continued focus on care quality agree that improvements can only make a difference when people can afford to pursue the care they need.
“As President-elect Trump looks to improve America’s healthcare system we are ready to work with his administration to advance healthcare that is accessible, affordable, equitable, integrated and innovative,” stated Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association. “This new administration also has an opportunity to unite the country around a shared vision that puts protecting and promoting quality healthcare for all Americans above partisan politics.”
Whatever reform takes place in 2017, healthcare organizations that emphasize innovation and improvement in quality are likely to find new opportunities in the future.
About the Author
Megan Headley is a freelance writer for PSQH. She can be reached at megan@clearstorypublications.com.