QuantiaMD, the largest social learning network for physicians, developed by Quantia, Inc., conducted a recent poll of its members to understand physician perspectives regarding the implementation of the Affordable Care Act. Despite millions of enrollees, individuals and doctors remain confused about the law – a troubling fact as many patients look to their physicians as a primary resource on health care policy.
The poll garnered responses from 1,265 physicians from around the country and opened up a dialog about the ACA. Results of the study included:
84 percent of physicians said they did not feel like they had enough information on the ACA to serve as a reliable resource to their patients.
81 percent of physicians don’t feel they have enough information on the ACA to understand its impact on their practice and comply with its requirements.
When asked where they get the most reliable information about the ACA, the majority (35 percent) of physicians responded saying there aren’t any reliable sources of information.
79 percent said they would use an HHS-produced FAQ with their patients if such a resource were available.
“This poll proves how physicians have been left out of the health care reform process,” said Mike Paskavitz, Editor-in-Chief, Quantia, Inc. “As the patient’s most trusted point of access to the healthcare system, physicians can be a tremendous communication channel for the ACA, and this poll demonstrates that there hasn’t been much, if any, communication directed at them. This poll was a huge eye opener for Quantia and validates the importance of the Affordable Care Act curriculum we have been developing for our members.”
In the new healthcare ecosystem that is increasingly migrating to cyberspace, who can healthcare consumers rely on? Who in the healthcare service supply chain will prevail? Who will be the next Amazon or Yelp? Chances are it will be the organization that can deliver and mediate a centralized consumer experience – connecting healthcare consumers not only with care and treatment options, but also with pharmacists, labs, therapists, clinics, wellness coaches and other resources along the care chain.
More today than ever before as the care conundrum continues, fewer and fewer crave office visits, hospital stays or trying to reach physicians by phone. When we’re well, we see no reason to visit a physician. When we’re sick we increasingly wait until we’re sicker. And when we’re somewhere in between, we avoid calling because we know we’ll be put on hold. If there were a better way to consume healthcare, most of us would likely take it.
Interestingly, within this conundrum lies an opportunity for the myriad of healthcare players – from payers and providers at one end of the supply chain to wellness tacticians, retailers and mobile tool providers at the other end – to create a sustainable dialogue with healthcare consumers.
According to a recent survey conducted by Purdue Healthcare Advisors, a nonprofit healthcare consulting organization, hospital executives are reluctant to implement ACOs — 46 percent — and they have no plans to implement an Accountable Care Organization (ACO)-like model in the near future.
Conducted in October 2013 among 206 hospital executives at a director level and above, the survey also reveals that executives are struggling with finding solutions for lower reimbursements and increased costs, while still maintaining an acceptable level of quality care.
“This survey has identified a significant need for advocacy and education to support hospitals and help them survive the wave of changes brought on by the Affordable Care Act,” said Mary Anne Sloan, director of Purdue Healthcare Advisors. “Hospital executives are charged with enhancing patient care and managing margins with a shrinking workforce and diminishing patient volumes.”
Hospital executives find ACOs to be unstable and financially risky
Executives are waiting for ACO models that are more stable and mature to avoid having to reinvest funds to implement changes or updates, according to the survey. The executives who do not have plans to implement an ACO model in the future (46 percent) cited the following reasons:
According to a new report from AMN Healthcare, a healthcare staffing firm, 78 percent of hospital executives believe there is a shortage of physicians nationwide, 66 percent believe there is a shortage of nurses, and 50 percent believe there is a shortage of advanced practitioners. The survey also indicates that the vacancy rate for physicians at hospitals approaches 18 percent, while the vacancy rate for nurses is 17 percent, considerably higher than when AMN Healthcare conducted a similar survey in 2009.
“Change in healthcare is a continuous evolution, but the one constant is people,” said AMN president Susan Salka. “No matter what models of care are in place, it takes physicians, nurses and other clinicians to provide quality patient care, and the fact is we simply do not have enough of them.”
AMN Healthcare’s 2013 Clinical Workforce Survey asked hospital executives nationwide to comment on clinical staffing trends affecting their facilities. More than 70 percent rated the staffing of physicians, nurses, nurse practitioners and physician assistants as a high priority in 2013, compared to only 24 percent of hospital executives who rated staffing these professionals as a high priority in AMN Healthcare’s 2009 workforce survey.
Over the past year, economic pressure and regulatory changes have increased scrutiny around areas of inefficiency within the healthcare industry. With new policies like the Affordable Care Act creating the need to improve patient outcomes and prevention, 2014 will be the year for much needed efficiency upgrades across the board at hospitals. And with mounting pressure to cut costs amidst anticipated physician and other major shortages, new and innovative ways to leverage technology will be called upon to usher in changes for the healthcare industry.
The business of care will continue to be a major area of focus for hospitals in 2014. Preventable, adverse events because of medical errors cost the healthcare industry more than $29 billion in 2013 and have led to between 50,000 to 100,000 deaths each year. Healthcare professionals and hospitals cannot afford to continue accepting medical errors as balance sheet losses, which are not only jeopardizing profitability, but patient care. To save money and improve patient care at the same time, hospitals will look to learn from technology being used successfully by other industries in 2014 to enhance real-time analysis and, thereby, prevention and outcomes.
Guest post by Greg Link, co-author with Stephen M. R. Covey of the national bestseller Smart Trust: The Defining Skill that Transforms Managers into Leaders.
As the name implies, patient satisfaction scores are nothing more than a measure of a patient’s healthcare experience. Like customers in any other industry, healthcare patients expect good, old-fashioned, caring customer service and to have their expectations met. Unfortunately, due largely to the extreme complexity of the healthcare experience, patients have historically lowered their expectations and defined extraordinary service as merely having their health issue ultimately resolved. That’s like ignoring all of the service aspects of a hotel stay as long as you slept through the night.
Now, in response to the Affordable Care Act, which links hospitals’ government reimbursement payments to how well they score in the Hospital Consumer Assessment (HCAHPS) on patient care, hospitals across the country are scrambling to improve their scores.
Stephen M.R. Covey
“The reality is, hospitals can’t talk themselves out of a problem they behaved themselves into,” Stephen M. R. Covey said, author of The Speed of Trust and Smart Trust.
Covey suggests that the patient experience is not a campaign or a department; it is a function of a high-trust culture generated by good, old-fashioned, common-sense behaviors demonstrated by all stakeholders. These behaviors are common to trusted people and organizations throughout history – behaviors like listening first, clarifying expectations, talking straight, creating transparency, extending trust, and demonstrating respect. One compelling example of a remarkable extension of trust is the Cleveland Clinic, where they are so transparent they give patients online access to their own charts and medical records, including doctors’ notes.
Guest post by Ken Perez, senior vice president and director of healthcare policy, MedeAnalytics, Inc.
Chase scenes—usually involving cars, motorcycles or speedboats—are an adrenaline-producing staple of the Bourne movies, which are some of my favorites. In these scenes, one party, the villain, pursues another party, the hero. The chased tries to evade the chaser by choosing a circuitous, complex route, and often, some sort of distraction or unexpected intervention—such as a train or crowd—prevents the chaser from catching the chased.
Implementing the Affordable Care Act (ACA) can be likened to a long, long chase scene in which significant segments of the public are being asked to chase after the law, i.e., comply with it. But the ACA’s route has certainly been circuitous and complex, and there have been numerous distractions that may ultimately leave some of the populace in the dust of ignorance and nonparticipation.
One can’t blame the public. The ACA is complex, multidimensional in scope, and it features a lengthy, multi-year rollout. A product of two enormous pieces of legislation—the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act—the ACA totalled, before consolidation, over 2,400 pages and contained more than 450 sections.
Guest post by Dr. Jeff Livingston, board certified obstetrician and gynecologist, MacArthur OBGYN.
Recently on The Daily Show, a very interesting topic was covered — the lack of interoperability of electronic health records. This was a huge surprise to me as one would not expect the Comedy Central to cover a topic frequently discussed only by health information technology policy wonks.
During the satirical editorial, John Stewart lambasted the fact that the electronic health records from the VA system are unable to communicate with the electronic health records of the Department of Defense. He pointed out the illogic of having two large departments in the United States government having two different systems that cannot exchange information with each other.