Stressors Affecting all Stakeholders
By Robert James Cimsai; MHA, AVA, ASA, CMP™
The changes in reimbursement for Medicare services through the introduction of prospective payment systems and physician reimbursement cuts for professional services, as well as the increased focus on patient quality and transparency initiatives and health 2.0 collaboration have forced healthcare providers to look for more efficient ways to provide services, as well as additional sources of revenue and margin-producing business. Additionally, with the rise of corporate healthcare provider networks and health systems, together with rising healthcare costs, competition among providers has become prevalent in the healthcare industry.
Assessment
Strict control of reimbursement costs from payers and consistent decreases in physician professional component fee reimbursement yields; reduction in traditional hospital inpatient use; and higher costs of capital have all contributed to the trend of physician investment in outpatient (and inpatient) specialty provider enterprises [ASCs, specialty hospitals and clinics, etc] , which often compete with general acute care community hospital providers.
Conclusion
And so, your thoughts and comments on this Medical Executive-Post are appreciated. How has this competition affected all healthcare stakeholders? How has it affected you? More importantly; how have you responded to next-gen health 2.0 competitors? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.
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Filed under: Career Development, Healh Law & Policy, Health Economics, Health Insurance, Healthcare Finance, Practice Management, Subscribe CD-ROM Journal | Tagged: health 2.0, health 2.0 collaboration, healthcare competition, HMO, IPA, Managed Care, MC, medicare, next generation healthcare, participatory medicine, PPO, PPS, prospective payment system, Robert Cimasi, www.healthcarefinancials.com
For more or moral hazard, competitive tension and health insurance costs, vist this link:
http://www.kevinmd.com/blog/2009/06/moral-hazard-and-whether-patients-should-consider-cost-in-their-health-care-decisions.html
Elizabeth
In a free-market system, competition is generally a good thing. It can lead to improved quality, better efficiencies, and eventually lower costs. It has been documented that physician-owned hospitals can increase patient satisfaction while reducing complications and mortality.
Unfortunately as it is currently structured, the healthcare system in the US is not based upon free market concepts. After millions of dollars are invested in facilities to provide needed services in a competitive manner, the viability of these facilities can be negotiated away by politicians and other interest groups. This problem is illustrated in the current healthcare debate in Washington
http://www.modernhealthcare.com/article/20090727/REG/907249983
As part of the “cost saving measures” being proposed, limitations and restrictions are being considered which may eventually lead to the demise of these facilities. Investments in facilities, technology, and services can be made instantly obsolete by changes in Medicare reimbursement. This makes it difficult for those investing in healthcare to maintain a long-term point of view for patients and for communities. Another example, in my experience, was the growth of home health services a few years ago. Medicare cutbacks in reimbursement caused these needed services to be decreased, and patient care suffered.
Brian J. Knabe; MD
Dr. Knabe,
And, the competition keeps coming … Recall one Rick Scott, formerly of the HCA debacle, who now runs a chain of convenient care clinics.
http://www.nytimes.com/2009/04/02/us/politics/02scott.html
Howard