At the Becker's Hospital Review 5th Annual CEO Strategy Roundtable on November 14, panelists discussed how healthcare reform affects ambulatory surgery centers and physician group practices. Wesley A. Curry, MD, CEO of Vituity, noted that he believed there will only be a slight uptick in patient collections as a result of the Affordable Care Act. "The ACA will not manufacture more patients, but it will shift the representation of our payer mix," he said. Dr. Curry also reiterated that many hospitals will look to emergency department physicians and hospitalists to stand as leaders in the push for integrated care. "ER physicians are the first point of patient contact. Combine this with hospitalists, and this accounts for 85 percent of hospital admissions," he said. "I think most forward thinking hospital administrators will see ER physicians and hospitalists as a unit."
A BlueCross BlueShield executive has gone on record as saying that urgent care centers may not be the solution to overcrowded EDs or lack of primary care physicians as many in the industry have thought. "The centers have not yet been successful at controlling health costs, and they have pulled volume away from primary care doctors," said Raghu Ram, MD, vice president and chief medical officer at BlueCross BlueShield of Western New York. Although BCBS of Western New York has seen a massive increase in urgent care visits, they also reported increasing ED visits as well — despite the expectation that ED visits would go down.
As the second year of the Centers for Medicare and Medicaid Services (CMS) quality incentive program begins, more hospitals are receiving penalties than receiving bonuses. "Medicare has raised payment rates to 1,231 hospitals based on two-dozen quality measurements, including surveys of patient satisfaction and — for the first time — death rates," reports Jordan Rau of Kaiser Health News. "Another 1,451 hospitals are being paid less for each Medicare patient they treat." The bonuses and penalties are intended to foster financial incentives for hospitals and providers to improve care, but it has yet to be seen how effective this system is.