Rob Bessler writes…
I am fired up. At the recent phoenix group meeting I attended we heard from a physician working for an organization funded by the American Academy of Family Practice Physicians that is spending 16MM dollars to fund this think tank and action oriented group focused on ensuring their voice is heard and that family physicians role in our future healthcare system are at the center. I applaud them for this effort.
What I left with from a few hours of education and discourse was how important hospitalists are to viability of whatever government based payment system occurs in the future. Of course I knew this from an academic perspective but now it is flowing through my veins. Did you know that medicare who ensures more than 40MM Americans spends 68% of the funding on 10MM of the recipients who average 11 doctors and 50 prescriptions per year! How about how little those 11 doctors communicate with each other? The average pcp in the community has to communicate with 50 to 250 specialists depending on the size of the community. This can’t work without an EMR system and hospitalists communicating clearly about the most crucial stage of hospitalization where the majority of the costs lie. How about the fact that 18% of GDP is healthcare spending or that federal government based healthcare spending is the largest item in the budget, larger than even defense spending.
I have reached out to SHM through the public policy committee, volunteered to be more involved in the phoenix group as well as other groups like healthcare innovation 2009 to ensure hospitalists voice is heard and that we and our collective ideas to improve the patients hospitalization with high quality at a lower cost and the transition back to the outpatient provider happens not as a passenger but as drivers I envision that we aligned with our hospital partners to finally have a payment system that rewards better outcomes. In the same way that the current the hip replacement specialists with the best and worst outcomes get the same fee today and that needs to change the same should be true for the hospital medicine field. In some markets where Sound thrives, there are colleagues we work along side that have no motivation to move patients through the hospitalization as it is considered a revenue loss to them while the hospital and potentially the patient suffer the effects. From the people whom I have spoken with it is not a question of if we will have a bundled payment with hospitals but when. Are you and your group prepared and on the train to drive value to ensure your hospital sees you as their partner to split up a payment? I will blog from time to time with updates as I learn and discuss more on this very important subject to all of us. I am interested what you all know as well.