As you may know, the US Supreme Court recently heard oral arguments on the constitutionality of the federal health care reform act. A decision could be made before the Court starts its summer recess at the end of June. Based on the Court’s ruling, Congress could make changes to the health-care reform legislation currently in place. The presidential election this fall might result in changes to national health policy as well. What are the potential implications for UPHS?
Regardless of what the Supreme Court, Congress, or the president may ultimately do, we’ve taken a number of steps that have prepared us for almost any eventuality. You might call these “no regret” decisions.
These steps include managing costs wisely, introducing new quality and safety initiatives, working hard to drive down preventable hospital readmissions, making significant IT investments to improve patient care (and our financial performance), and starting several pilot programs featuring new payment models.
These measures are already generating impressive results. For example, we’ve been focusing on reducing mortality and severe infections for the last five years. As a result, observed-to-expected mortality has been reduced by over 40 percent, saving over 1,200 lives from FY09 to FY12 year-to-date. And bloodstream infections have been slashed by 95 percent over the same period.
Our IT investments and strategies have earned us “meaningful use” status from the federal government. Employing electronic health records helps us improve quality of care, safety, and efficiency -- while reducing health disparities. It also helps us better coordinate care and ensure privacy and security of personal health information. We are now at work on a comprehensive IT management strategy that will link patient records throughout the health system and beyond, ranging from the physician’s office to the inpatient unit, lab, and home care, among other settings.
We’ve also intensified our interdisciplinary team-based approach to care delivery. This includes adopting the unit-based clinical leadership model, expanding our patient-centered approach in our outpatient clinics, and improving the coordination of care as patients move from our hospital beds to outpatient settings and home care.
Better coordination and integration of care has also become a priority at Penn. This is especially important as the federal government begins to examine a “bundled payment” approach. This reimbursement model combines previously separate payments for each service that patients receive during a period of care into a single sum. For example, whereas in the past a surgical procedure generated claims from the surgeon, anesthesiologist, hospital, and others, under the new framework the entire team is reimbursed with a single, combined payment. The goal is to provide financial incentives to deliver health care more efficiently while maintaining or improving quality.
We recognize that the health care environment is changing dramatically. For example, we are preparing for a new era of reduced payments -- a projection we’ve factored into our multi-year budget. And our strategic plan is focusing on ways to excel in such growing fields as personalized medicine (customized care for patients taking into account genetic factors) and biobanking (collecting and storing human biological material and related information for research purposes).
Through the steps I’ve outlined here -- and others as well -- UPHS is well prepared to address the consequences of whatever the Supreme Court eventually decides (and future actions Congress and the president might take in response). Of course no one can predict the future. But planning for likely eventualities and remaining steadfast in our commitment to excellent patient care and responsible fiscal management puts us in a position to continue at the forefront of health care in our region.