A recent article in Bloomberg News reported a potential emerging trend whereby "physicians schedule emergency room appointments for patients who don't have insurance and instruct them to describe symptoms of an acute coronary syndrome when they arrive." Emergency providers, required by law to treat everyone who presents to the ER, then perform the necessary procedure at little or no cost to the patient. However, this utilization of the ER can drive up wait times and only underscores "a more systemic problem throughout the United States."
As hospitals are faced with financial penalties for readmission rates, pressure is mounting for hospitalist physicians to follow their patients through the course of their experience — often into the post-acute setting. However, these new responsibilities are being met with some resistance from the hospitalist community. "The concept of post-discharge clinics is basically turning a hospitalist into a temporary primary care physician, bringing the hospitalist movement around full circle," says David J. Yu, MD, MBA. Additionally, a recent survey of over 200 hospitalists by the Journal of Hospital Medicine found that over 60 percent of hospitalists did not want to see patients in a clinic after discharge.
Since the Centers for Medicare & Medicaid Services (CMS) tied patient satisfaction to reimbursement, hospitals and providers have been looking for ways to improve these scores while also improving the overall patient experience. However, while much of this focus has been on the clinical side, more and more administrators are realizing the importance of improving communication tactics between their providers and patients. This concept was touched upon by Melissa Maranda, MBA, PHR, in her article on scribes in Perspectives last week.