Hospitals save $100 million in Medicare costs under state experiment

[Maryland Patriot]

I dont go into the ER for me, I go with others.
I have walked out of the regular area of the hospital the last two times I was there. Rude, uncaring and ignorant nurses.

I have no idea what rudeness is supposed to have to do with global budgets. Particularly when your solution is to go to a different hospital that's also on a global budget.

then there is no sense in discussing these things with you. You lack the capacity to understand I a do not have time to educate you.

 

[Greenbeard]

then there is no sense in discussing these things with you. You lack the capacity to understand I a do not have time to educate you.

You need to go back and think out your argument. All of Maryland's hospitals are on budgets, so it's not possible to draw distinctions between them based on being vs. not being under this system.

Retcon your story to say you drove out-of-state and it'll make more sense.

 

[Sun Devil 92]

I am still trying to understand the "savings".

Just what did they save ? Or did they just spend less ? There is a difference.

 

[Greenbeard]

I am still trying to understand the "savings".

Just what did they save ? Or did they just spend less ? There is a difference.

Are you reading the thread? How you save money by freeing up providers to move beyond episodic, acute, itemized revenue generators has been addressed multiple times.

As has examples of what select hospital systems in the state are specifically doing to generate efficiencies and better outcomes on the clinical side. If you're not reading the responses to your questions, why keep asking them over and over?

That is, by achieving efficiencies, finding savings, and better managing the health of the populations they serve. How they go about doing that will vary by hospital; I'm sure there will be plenty of hospital profiles written over the next five years.

Here's one so far: University of Maryland Upper Chesapeake Health: Increased Value Under a Fixed Hospital Budget

University of Maryland Upper Chesapeake Health (UM UCH) participates in Maryland’s Global Budget Revenue (GBR) program that fixes hospital revenue, regardless of volume. This has created much stronger financial pressure for hospitals to use resources more efficiently, since additional hospital services no longer translate into higher revenue. To limit acute hospital costs while maintaining or improving quality, UM UCH has implemented a variety of emergency department (ED), care coordination, and information technology interventions to improve care. These include developing a care pathway for low-risk chest pain, supporting post-discharge call backs, participating in a health information exchange, creating care plans for high-cost patients, and developing a post-emergency department (ED) and post-hospitalization clinic. These reforms have also required some reforms in how ED physicians are paid. To date, programs have been successful: care plans alone have reduced opioid prescriptions by 50% and hospital-based encounters in high-cost patients decreased by 40-50%

There are 3 main ways to reduce acute care costs: 1) preventing acute health problems and the associated care from happening in the first place; 2) create and expand less costly (and hopefully more convenient) alternatives to ED care so people with acute problems use less expensive hospital-based care; and 3) improve the function of the acute care system itself.

The link goes into more detail on the high-risk care plan program, new comprehensive care clinic, standardized care pathways, patient call-back program, and new IT tools they've implemented so far as part of their care redesign efforts.

Here's an article from last year looking at what Maryland has started doing and how it's changed the game: Global budgets pushing Maryland hospitals to target population health.

 

[Sun Devil 92]

I am still trying to understand the "savings".

Just what did they save ? Or did they just spend less ? There is a difference.

Are you reading the thread? How you save money by freeing up providers to move beyond episodic, acute, itemized revenue generators has been addressed multiple times.

As has examples of what select hospital systems in the state are specifically doing to generate efficiencies and better outcomes on the clinical side. If you're not reading the responses to your questions, why keep asking them over and over?

That is, by achieving efficiencies, finding savings, and better managing the health of the populations they serve. How they go about doing that will vary by hospital; I'm sure there will be plenty of hospital profiles written over the next five years.

Here's one so far: University of Maryland Upper Chesapeake Health: Increased Value Under a Fixed Hospital Budget

University of Maryland Upper Chesapeake Health (UM UCH) participates in Maryland’s Global Budget Revenue (GBR) program that fixes hospital revenue, regardless of volume. This has created much stronger financial pressure for hospitals to use resources more efficiently, since additional hospital services no longer translate into higher revenue. To limit acute hospital costs while maintaining or improving quality, UM UCH has implemented a variety of emergency department (ED), care coordination, and information technology interventions to improve care. These include developing a care pathway for low-risk chest pain, supporting post-discharge call backs, participating in a health information exchange, creating care plans for high-cost patients, and developing a post-emergency department (ED) and post-hospitalization clinic. These reforms have also required some reforms in how ED physicians are paid. To date, programs have been successful: care plans alone have reduced opioid prescriptions by 50% and hospital-based encounters in high-cost patients decreased by 40-50%

There are 3 main ways to reduce acute care costs: 1) preventing acute health problems and the associated care from happening in the first place; 2) create and expand less costly (and hopefully more convenient) alternatives to ED care so people with acute problems use less expensive hospital-based care; and 3) improve the function of the acute care system itself.

The link goes into more detail on the high-risk care plan program, new comprehensive care clinic, standardized care pathways, patient call-back program, and new IT tools they've implemented so far as part of their care redesign efforts.

Here's an article from last year looking at what Maryland has started doing and how it's changed the game: Global budgets pushing Maryland hospitals to target population health.

One of these days, your are going to realize that your responses come out of a backdrop of:

1. A particular point of view.
2. Language or assumptions we don't share.
3. Perspectives that are not common.

 

[Greenbeard]

One of these days, your are going to realize that your responses come out of a backdrop of:

1. A particular point of view.
2. Language or assumptions we don't share.
3. Perspectives that are not common.

So what is it you want when you ask these questions? To not talk about health care? When lay articles/explanations are given, you find them inadequate. When more detailed information is given, you ignore it or claim it's incomprehensible.

If you're as interested in this subject as you claim to be, you're going to have learn something about health care and health policy in the United States at some point. And the only way to do that is to read new things. Otherwise you'll always be stuck in this phase of repeating the same questions on loop over and over.

 

[Sun Devil 92]

One of these days, your are going to realize that your responses come out of a backdrop of:

1. A particular point of view.
2. Language or assumptions we don't share.
3. Perspectives that are not common.

So what is it you want when you ask these questions? To not talk about health care? When lay articles/explanations are given, you find them inadequate. When more detailed information is given, you ignore it or claim it's incomprehensible.

If you're as interested in this subject as you claim to be, you're going to have learn something about health care and health policy in the United States at some point. And the only way to do that is to read new things. Otherwise you'll always be stuck in this phase of repeating the same questions on loop over and over.

When I can finally identify with something you are saying or index to the same perspective....I'll be unstuck.

 

[Arianrhod]

One of these days, your are going to realize that your responses come out of a backdrop of:

1. A particular point of view.
2. Language or assumptions we don't share.
3. Perspectives that are not common.

So what is it you want when you ask these questions? To not talk about health care? When lay articles/explanations are given, you find them inadequate. When more detailed information is given, you ignore it or claim it's incomprehensible.

If you're as interested in this subject as you claim to be, you're going to have learn something about health care and health policy in the United States at some point. And the only way to do that is to read new things. Otherwise you'll always be stuck in this phase of repeating the same questions on loop over and over.

When I can finally identify with something you are saying or index to the same perspective....I'll be unstuck.

Perhaps you can find an example of a state other than Maryland that took the same actions and resulted in failure. Or a state that did something completely divorced from the PPACA and has shown cost-cutting without sacrificing patient care. Or...

 

[Sun Devil 92]

One of these days, your are going to realize that your responses come out of a backdrop of:

1. A particular point of view.
2. Language or assumptions we don't share.
3. Perspectives that are not common.

So what is it you want when you ask these questions? To not talk about health care? When lay articles/explanations are given, you find them inadequate. When more detailed information is given, you ignore it or claim it's incomprehensible.

If you're as interested in this subject as you claim to be, you're going to have learn something about health care and health policy in the United States at some point. And the only way to do that is to read new things. Otherwise you'll always be stuck in this phase of repeating the same questions on loop over and over.

Inadequate ?

Many of your explanations are given using references or metrics I know nothing of......why would I just sign up at that point ?