Hospitals chart ways to boost care, funding under ACA
Hospitals are getting creative when it comes to meeting tough new mandates in the Affordable Care Act to improve care and increase patient satisfaction — and they're getting paid more as a result.
Under an ACA program, the federal government gives money to hospitals that deliver better care, rather than just paying them for procedures covered by Medicare and Medicaid. Called the Hospital Value-Based Purchasing program, it aims to increase quality care and shrink the number of patients who die from mistakes.
As part of the program, the Center for Medicare and Medicaid Services (CMS) pays hospitals for infection prevention, successful surgeries, low readmission rates and patient satisfaction scores. The CMS bases funding on both achievement and yearly improvement.
Hospitals across the country are taking steps to improve and claim the extra funds.
•Mayo Clinic branches in Rochester, Minn., Jacksonville and at the Scottsdale/Phoenix campus use iPads for cardiac surgery patients to help them track progress and to give them to-do lists for the day, says Douglas Wood, a cardiologist and director of Mayo's Center for Innovation.
•New York City's Beth Israel Medical Center and the Charleston Area Medical Center in West Virginia are among the hospitals that use the Ornish Spectrum, a 72-hour program for heart disease patients that helps them make lifestyle changes in nutrition, fitness and stress management. It was founded by physician and author Dean Ornish.
•Virginia hospitals in the Sentara Healthcare network allow patients to see their medical records on an app called MyChart. The app lets patients e-mail their doctors with questions, says Tim Jennings, Sentara's vice president of pharmacy services.
Medical technology companies are coming up with innovations that can help hospitals improve care. For instance, GetWellNetwork in Bethesda, Md., has developed a program that uses in-room televisions to instant-message patients between shows. The messages educate patients about care and help track recovery progress, says CEO and founder Michael O'Neil. Patients can instant-message doctors and nurses and give feedback during their hospitalization. The information is also available through smart phones and tablets after patients return home.
Quality care doesn't have to be high-tech. Staffers at Saint Elizabeth Hospital in Lincoln, Neb., removed regular soda from vending machines and moved diet soda and sugary drinks to the bottom rows to promote healthier choices, which can lower readmission, says Libby Raetz, vice president of nursing,
Hospitals aren't changing only because there's a financial reward but because the government tells them how to make improvements, says Nancy Foster, vice president of quality and patient safety at the American Hospital Association.
"They are responding to that signal that says, 'Here is an important opportunity to do something that will make a difference,' " Foster says.
Every year, 210,000 to 440,000 people die from avoidable hospital mistakes, according to a 2013 study published in the Journal of Patient Safety.
Such mistakes cost the health care system nearly $7.3 billion in two years, according to a 2013 study by quality awareness company HealthGrades.
"We may not be able to eliminate all of the errors, but we may be able to prevent the error from reaching the patient and causing harm," Foster says.
Doctors, too, are reacting well to changes, Ornish says: "It's a chance for doctors and other professionals to reclaim why we went into medicine — to be healers."
A previous version of this story incorrectly said one of the Mayo Clinic branches was in Rochester, N.Y., instead of Rochester, Minn.
Contributing: Jayne O'Donnell