Download presentation
Presentation is loading. Please wait.
1
What Is Keeping Our Hospital Leaders Up At Night?
2
21st Century Healthcare!
3
The Overall Story Hospital executives describe an industry that is changing rapidly Rising cost of delivering and managing healthcare Need for delivering services that reflect the changing needs of a demanding and educated patient population Need to align business, clinical, and technology strategies to maintain profitability Patient Protection & Affordable Care Act (PPACA)
4
Inadequate Reimbursement Levels:
Increased number of uninsured patients Lower reimbursements not covering health care costs. State revenue shortfalls. Niche Providers Higher patient deductibles/co-pays
5
Unwieldy Regulatory Requirements:
Hospitals are spending more to implement regulations– a situation that is expected to get worse HIPAA Joint Commission CMS HITECH ACT Others- NRC, CAP, CARF, ACR, ACoS,etc.
6
Growing Liability Issues:
Lack of Tort Reform Rising cost of malpractice insurance Increasing number of Medicare/Medicaid audits. RAC Median Medical Malpractice Award is $800,000 (Source: AMA). 57 cents/dollar awarded goes to attorneys fees.
7
Why Health Care Reform. . .
8
Health Care Challenges
78 million baby boomers begin to retire in 2010. Medicare covers 40+ million Medicaid covers 47+ million Nearly 75 million under 65 had no coverage at some time during last 2 years (Source: Robert Wood Foundation)
9
Patient Protection & Affordable Care Act (PPACA)
New landscape in Healthcare Federal law that standardizes the delivery of health care services & payment reform Foundation is to Increase Value Effective October 1, 2012, Medicare linked financial payments to hospital Quality Outcomes and Patient Perception of Care under a Value Based Purchasing model
10
Patient Protection & Affordable Care Act- 2010
Decrease in Inpatient Volumes and Increase in Outpatient Volumes Decrease in DRG/CPT-4 payments for patient care services Increase in patient co-pay and deductable portions of reimbursement Increasing pressure to decrease hospital expenses to stay in business. Closing of hospitals throughout the nation Increased demand for staff flexibility and multi-skilled taskforce. Delays in provision of healthcare services
11
PPACA (Obama Care) Covers Everyone Has “Death Panels” Free Services
TRUE FALSE Eliminates Pre-condition exemptions No Lifetime or annual limits. Requires hospitals to list standard charges for items and services. Financial penalty for not having coverage. Covers Everyone Has “Death Panels” Free Services Free Medications
12
Value Based Purchasing
Doing More For Less (With a Good Attitude!) Value Based Purchasing - HCAPS - Clinical Outcomes DRG Payments Managed Care Concept
13
What’s Next? Decrease in Inpatient Volumes and Increase in Outpatient Volumes Decrease in DRG/CPT-4 payments for patient care services Increase in patient co-pay and deductable portions of reimbursement Increasing pressure to decrease hospital expenses to stay in business. Closing of hospitals throughout the nation Increased demand for staff flexibility and multi-skilled taskforce. Delays in provision of healthcare services
14
Today’s Recipe For Disaster!
Decrease in Net Revenue Increase in Expenses - Non-Salary - Salary Loss of Operating Margin
15
Healthcare of Future Decreased Salary and Non-Salary Expenses
System-wide consolidated Delivery Approach Appropriate Use of Portals of Care Lean, Multi-skilled, Customer Oriented Staff Reduced Capital Expenditures
16
When combined, the Chinese symbols for “trouble” and “gathering crisis” mean “opportunity.”
17
Opportunities Improve Patient Care Processes
Improve Integration & Continuity of Care Improve Patient Satisfaction- HCAHPS Enhance Recruitment & Retention of Staff
18
Demonstrate Work Values
Be Informed Ask Questions Identify Options Obtain Training Demonstrate Work Values
19
Characteristics of Success
Proactive Verses Reactive Dependable Flexible Accountable Team Player Good Communication Skills Interpersonal Relationship Skills Multi-skilled Critical Thinking Skills
20
FUTURE LEADERSHIP Requirements
Individuals who can motivate team to achieve identified goals/objectives Knowledge of fiscal indicators as well as clinical/job requirements. Increased knowledge of coding & reimbursement for areas of responsibilities. Broad knowledge of regulatory requirements
Similar presentations
