MHA's Executive Briefing

AHA-supported bill would promote health care price transparency

Reps. Michael Burgess, M.D. (R-TX) and Gene Green (D-TX) recently introduced American Hospital Association-supported legislation to promote health care price transparency. The Health Care Price Transparency Promotion Act of 2013 (H.R. 1326) would require states to have or establish laws requiring hospitals to disclose information on charges for certain inpatient and outpatient services; and require health insurers to provide to enrollees upon request a statement of estimated out-of-pocket costs for particular health care items and services. In addition, the legislation directs the Agency for Healthcare Research and Quality to study the types of health care cost information that consumers find useful, and how that information might be distributed in a timely and simple, coherent way.

"This legislation builds on [the] existing structure, and also requires insurers to participate in the disclosure process by providing information on estimated out-of-pocket costs for health care services, which is often the most valuable information for insured patients," AHA President and CEO Rich Umbdenstock said, noting that AHA strongly supports the bill. "… While sharing exact information is challenging because hospital care is individually tailored to each patient’s needs, hospitals remain committed to providing meaningful and useful information for consumers."

Post-Discharge Follow-Up Isn't Just for Hospitalizations: The Value of Contacting ED Patients

As hospitals are under pressure to reduce potentially avoidable readmissions, many hospitals are learning the importance of consistent follow-up with patients after discharge. However, less attention is paid to the value of following up with patients after emergency department visits.

Monitoring post-discharge ED patients can have significant benefits, including the reduction of potentially avoidable hospitalizations, increased patient satisfaction and reduced risk. In fact, a recent study in Annals of Emergency Medicine found ED patients who were contacted after discharge had an average satisfaction score 8.3 percentage points higher than patients who were not contacted.

Read more from Becker's Hospital Review here.

Leaders brace for October readmission penalties

The Centers for Medicare & Medicaid Services will recoup about $280 million in payments from more than 2,200 hospitals beginning in October - a number that has the attention of hospital executives . Read more here.

HFMA Releases Phase 2 Value Project Report

The Healthcare Financial Management Association (HFMA) on June 22 released the first report from Phase 2 of the Value Project, Defining and Delivering Value. The report identifies five key strategies that hospitals and health systems should undertake to deliver greater value, with an emphasis on quality improvement and cost containment. 

Read more about the five strategies here.

HFMA offers guidelines on value metrics

The Healthcare Financial Management Association, which represents the industry's treasury, finance and accounting professionals, said outcome measures are preferable to process measures as the industry develops value metrics. Read more from Melanie Evans in Modern Healthcare magazine here.

On Board with Quality

As trustees become more involved in quality, it's up to leadership to help them focus on key issues such as financial penalties and new leadership standards. Read more from HealthLeaders Media here.

Will Price Competition Lead To Quality Competition?

In our third-party-payer health insurance system the price for care is typically set by entities external to the doctor-patient relationship. As a result, providers rarely compete for patients based on money prices.

Potentially they can compete on the time price of care, on amenities and on quality. In a previous post we noted that there is a tendency toward uniform (market clearing) waiting times and amenities, or at least a uniform trade-off. Yet providers rarely compete on quality; and substantial quality differences not only exist, they persist over time.

If lack of price competition is normally associated with lack of quality competition, could the reverse be true? Do providers who compete for patients on price also compete on quality? There is a lot of evidence that they do.

Health Policy Brief: Improving Quality

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the ongoing need to improve the quality and safety of health care provided in the United States. Despite some progress toward goals set a decade ago following two landmark Institute of Medicine studies, the nation faces considerable challenges in making health care safe; effective; efficient; patient-centered; delivered on a timely basis; and devoid of ethnic, racial, and other disparities.

This policy brief explains how health care quality is commonly defined; examines the issues around measuring it; highlights some recent findings on quality improvement efforts, and discusses the key challenges still to be overcome. The policy brief is a companion to Health Affairs’ April issue, “Still Crossing The Quality Chasm.”

AHA urges HHS to focus Medicaid quality measures on high-priority areas

The American Hospital Association on March 1 urged the Agency for Healthcare Research and Quality to focus and prioritize its proposed set of 51 health quality measures for Medicaid-eligible adults, and include only measures endorsed by the National Quality Forum. The Patient Protection and Affordable Care Act required the Health and Human Services Secretary to identify a core set of voluntary measures that states can use.

“The proposed measure set marks a positive step toward measuring quality for the Medicaid adult population; however, we are concerned that the proposed list lacks the focus and prioritization that could truly drive patient care forward,” AHA wrote. “We suggest that there are several national frameworks that AHRQ may look to when identifying priorities, namely the National Quality Strategy and the work of the NQF’s National Priorities Partners. In addition, we urge AHRQ to examine the successes of previous public reporting programs, such as the Medicare hospital quality reporting initiatives, and use lessons learned from prior experience to build a concise, focused initial core measure set.”

Hospitals can work better

Given their complexity, it’s a minor miracle that hospitals function as well as they do, and a tribute to the dedication of administrative and professional staff. And yet recent trends are proving that their best just isn’t good enough. A number of hospitals across the United States are trying new approaches to managing their complexity—and with their progress a new paradigm for hospital management may be taking shape.

Read the full post from the Harvard Business Review blogs.