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Hospitals could save a lot of money if we allowed them to turn away people at the ER.
They can also save a lot of money if they get to people before they show up in the ER, as Maryland is showing. Once hospitals can generate margin by keeping people healthy instead of increasing service volume, they've got a whole new business model to operate under. One in which health care isn't just about waiting for acute events to hit and making money off them, but rather about focusing on the health of the community outside the hospital's walls.
If this means all hospitals, I find that amazing.
Of course the statement could be taken one of many ways.
Did they set all prices ? And who set them ? Was it a government agency ?
Whose paying that revenue ?
So what is this fixed revenue supposed to cover ?
How do they generate that margin ?
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.
They already know their TOTAL Revenue before the year starts ?
This means they have incentives to keep people from coming to the hospital....or denying them access to the hospital ?
Worst US recovery ever, most debt in all human history -- but we saved $100MM by throwing old people to the curb
They already know their TOTAL Revenue before the year starts ?
That's what a global budget is. This is the entire point of the thread.
This means they have incentives to keep people from coming to the hospital....or denying them access to the hospital ?
This is why they're investing in low-cost interventions outside the hospital to keep people healthy and prevent more expensive inpatient episodes where possible (not to mention improving care inside the hospital for those that do need inpatient level care).
Worst US recovery ever, most debt in all human history -- but we saved $100MM by throwing old people to the curb
You couldn't be more wrong.
They already know their TOTAL Revenue before the year starts ?
That's what a global budget is. This is the entire point of the thread.
This means they have incentives to keep people from coming to the hospital....or denying them access to the hospital ?
This is why they're investing in low-cost interventions outside the hospital to keep people healthy and prevent more expensive inpatient episodes where possible (not to mention improving care inside the hospital for those that do need inpatient level care).
I wonder if part of the problem here is that many people are not familiar with what goes into the process of preventing return hospitalizations? Maybe an example would help:
A patient is released from the hospital following heart surgery. Back in the day, he'd need to remain in the hospital for a week or more post-surgery. Aside from the added costs of multiple nights in the bed, extra meds, extra personnel to care for him, etc., the process of getting him back on his feet and fit to go home often involved physical therapy, transport to home (the longer you're immobilized, the harder it is to just bounce out of bed and drive home), etc.
Today patients are assessed and, unless there are complications, allowed to go home far sooner. Here's what happens at home for the first few weeks after surgery:
Someone from the cardiac team calls the patient daily to check up on him. If he's part of a clinical trial, he was given a blood pressure monitor that's connected to the hospital's computers so that when he takes his blood pressure every morning, the reading goes straight to the hospital.
A visiting nurse stops by once or twice a week (oftener if the patient lives alone) to take the patient's vitals and ask him questions. How is his appetite? How is his energy level? Is he in any pain? If he had invasive surgery, is he managing wound care (incisional infections are a major cause of rehospitalization)? Is there anything that concerns or worries him?
Yes, these interventions cost money, but not nearly as much as the costs of transport to the ER by ambulance and possible readmission.
From the patient's perspective, he's back home and able to resume his normal activities much sooner.
Win-win.
Worst US recovery ever, most debt in all human history -- but we saved $100MM by throwing old people to the curb
You couldn't be more wrong.
They already know their TOTAL Revenue before the year starts ?
That's what a global budget is. This is the entire point of the thread.
This means they have incentives to keep people from coming to the hospital....or denying them access to the hospital ?
This is why they're investing in low-cost interventions outside the hospital to keep people healthy and prevent more expensive inpatient episodes where possible (not to mention improving care inside the hospital for those that do need inpatient level care).
I wonder if part of the problem here is that many people are not familiar with what goes into the process of preventing return hospitalizations? Maybe an example would help:
A patient is released from the hospital following heart surgery. Back in the day, he'd need to remain in the hospital for a week or more post-surgery. Aside from the added costs of multiple nights in the bed, extra meds, extra personnel to care for him, etc., the process of getting him back on his feet and fit to go home often involved physical therapy, transport to home (the longer you're immobilized, the harder it is to just bounce out of bed and drive home), etc.
Today patients are assessed and, unless there are complications, allowed to go home far sooner. Here's what happens at home for the first few weeks after surgery:
Someone from the cardiac team calls the patient daily to check up on him. If he's part of a clinical trial, he was given a blood pressure monitor that's connected to the hospital's computers so that when he takes his blood pressure every morning, the reading goes straight to the hospital.
A visiting nurse stops by once or twice a week (oftener if the patient lives alone) to take the patient's vitals and ask him questions. How is his appetite? How is his energy level? Is he in any pain? If he had invasive surgery, is he managing wound care (incisional infections are a major cause of rehospitalization)? Is there anything that concerns or worries him?
Yes, these interventions cost money, but not nearly as much as the costs of transport to the ER by ambulance and possible readmission.
From the patient's perspective, he's back home and able to resume his normal activities much sooner.
Win-win.
Riiiiight, preventing return hospitalization -- for white and black seniors, if you're an Illegal with no ID, it's OK, no worries
Worst US recovery ever, most debt in all human history -- but we saved $100MM by throwing old people to the curb
You couldn't be more wrong.
They already know their TOTAL Revenue before the year starts ?
That's what a global budget is. This is the entire point of the thread.
This means they have incentives to keep people from coming to the hospital....or denying them access to the hospital ?
This is why they're investing in low-cost interventions outside the hospital to keep people healthy and prevent more expensive inpatient episodes where possible (not to mention improving care inside the hospital for those that do need inpatient level care).
I wonder if part of the problem here is that many people are not familiar with what goes into the process of preventing return hospitalizations? Maybe an example would help:
A patient is released from the hospital following heart surgery. Back in the day, he'd need to remain in the hospital for a week or more post-surgery. Aside from the added costs of multiple nights in the bed, extra meds, extra personnel to care for him, etc., the process of getting him back on his feet and fit to go home often involved physical therapy, transport to home (the longer you're immobilized, the harder it is to just bounce out of bed and drive home), etc.
Today patients are assessed and, unless there are complications, allowed to go home far sooner. Here's what happens at home for the first few weeks after surgery:
Someone from the cardiac team calls the patient daily to check up on him. If he's part of a clinical trial, he was given a blood pressure monitor that's connected to the hospital's computers so that when he takes his blood pressure every morning, the reading goes straight to the hospital.
A visiting nurse stops by once or twice a week (oftener if the patient lives alone) to take the patient's vitals and ask him questions. How is his appetite? How is his energy level? Is he in any pain? If he had invasive surgery, is he managing wound care (incisional infections are a major cause of rehospitalization)? Is there anything that concerns or worries him?
Yes, these interventions cost money, but not nearly as much as the costs of transport to the ER by ambulance and possible readmission.
From the patient's perspective, he's back home and able to resume his normal activities much sooner.
Win-win.
Riiiiight, preventing return hospitalization -- for white and black seniors, if you're an Illegal with no ID, it's OK, no worries
and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.Interesting early results from one of the little state experiments enabled by the ACA.
Maryland's state government has been setting hospital prices for decades but last year they kicked it up a notch, using authority in the ACA to essentially put their state's hospitals on budgets.
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.
Now the state's hospital association is out with a preliminary look at the results in the first year and they're promising: Hospitals save $100 million in Medicare costs
Maryland hospitals collectively generated more than $100 million in Medicare savings in the first year of an experimental payment system being watched closely by the federal government as a possible national model for reducing health care costs.
The state's medical institutions agreed last year to a five-year agreement with the U.S. Centers for Medicare and Medicaid Services. It drastically changed the way they did business and aimed to curb costs, in part by reducing expensive hospital stays and handling more patient care at the doctor's office.
"Hospitals at the blink of an eye really changed their systems into something that hasn't been broadly tested before — and we are pleased with the first year results," said Carmela Coyle, CEO of the Maryland Hospital Association.
Hospital officials — and health care advocates — also contend that the new cost-cutting effort has not come at the expense of patient care.
An unusual approach but one to keep an eye on.
and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.Interesting early results from one of the little state experiments enabled by the ACA.
Maryland's state government has been setting hospital prices for decades but last year they kicked it up a notch, using authority in the ACA to essentially put their state's hospitals on budgets.
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.
Now the state's hospital association is out with a preliminary look at the results in the first year and they're promising: Hospitals save $100 million in Medicare costs
Maryland hospitals collectively generated more than $100 million in Medicare savings in the first year of an experimental payment system being watched closely by the federal government as a possible national model for reducing health care costs.
The state's medical institutions agreed last year to a five-year agreement with the U.S. Centers for Medicare and Medicaid Services. It drastically changed the way they did business and aimed to curb costs, in part by reducing expensive hospital stays and handling more patient care at the doctor's office.
"Hospitals at the blink of an eye really changed their systems into something that hasn't been broadly tested before — and we are pleased with the first year results," said Carmela Coyle, CEO of the Maryland Hospital Association.
Hospital officials — and health care advocates — also contend that the new cost-cutting effort has not come at the expense of patient care.
An unusual approach but one to keep an eye on.
AAMC is looking like they are ready to just shut down. On the average night they might have one nurse in the ER.
trust me, they are faking it. At one time it was the best hospital you could go to, but over the last year they have gone so far down that I can only equate them to a crack corner clinic.and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.Interesting early results from one of the little state experiments enabled by the ACA.
Maryland's state government has been setting hospital prices for decades but last year they kicked it up a notch, using authority in the ACA to essentially put their state's hospitals on budgets.
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.
Now the state's hospital association is out with a preliminary look at the results in the first year and they're promising: Hospitals save $100 million in Medicare costs
Maryland hospitals collectively generated more than $100 million in Medicare savings in the first year of an experimental payment system being watched closely by the federal government as a possible national model for reducing health care costs.
The state's medical institutions agreed last year to a five-year agreement with the U.S. Centers for Medicare and Medicaid Services. It drastically changed the way they did business and aimed to curb costs, in part by reducing expensive hospital stays and handling more patient care at the doctor's office.
"Hospitals at the blink of an eye really changed their systems into something that hasn't been broadly tested before — and we are pleased with the first year results," said Carmela Coyle, CEO of the Maryland Hospital Association.
Hospital officials — and health care advocates — also contend that the new cost-cutting effort has not come at the expense of patient care.
An unusual approach but one to keep an eye on.
AAMC is looking like they are ready to just shut down. On the average night they might have one nurse in the ER.
They sure seem to be faking it online, then:
Anne Arundel Medical Center - Living Healthier Together
trust me, they are faking it. At one time it was the best hospital you could go to, but over the last year they have gone so far down that I can only equate them to a crack corner clinic.and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.Interesting early results from one of the little state experiments enabled by the ACA.
Maryland's state government has been setting hospital prices for decades but last year they kicked it up a notch, using authority in the ACA to essentially put their state's hospitals on budgets.
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.
Now the state's hospital association is out with a preliminary look at the results in the first year and they're promising: Hospitals save $100 million in Medicare costs
Maryland hospitals collectively generated more than $100 million in Medicare savings in the first year of an experimental payment system being watched closely by the federal government as a possible national model for reducing health care costs.
The state's medical institutions agreed last year to a five-year agreement with the U.S. Centers for Medicare and Medicaid Services. It drastically changed the way they did business and aimed to curb costs, in part by reducing expensive hospital stays and handling more patient care at the doctor's office.
"Hospitals at the blink of an eye really changed their systems into something that hasn't been broadly tested before — and we are pleased with the first year results," said Carmela Coyle, CEO of the Maryland Hospital Association.
Hospital officials — and health care advocates — also contend that the new cost-cutting effort has not come at the expense of patient care.
An unusual approach but one to keep an eye on.
AAMC is looking like they are ready to just shut down. On the average night they might have one nurse in the ER.
They sure seem to be faking it online, then:
Anne Arundel Medical Center - Living Healthier Together
well lets see, who are you going to believe, you who most likely has never even seen the hospital, or me who has actually been in it. and the last two times I walked out do to inferior care and drive myself to Howard county hospital which is part of the John Hopkins network.trust me, they are faking it. At one time it was the best hospital you could go to, but over the last year they have gone so far down that I can only equate them to a crack corner clinic.and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.Interesting early results from one of the little state experiments enabled by the ACA.
Maryland's state government has been setting hospital prices for decades but last year they kicked it up a notch, using authority in the ACA to essentially put their state's hospitals on budgets.
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.
Now the state's hospital association is out with a preliminary look at the results in the first year and they're promising: Hospitals save $100 million in Medicare costs
Maryland hospitals collectively generated more than $100 million in Medicare savings in the first year of an experimental payment system being watched closely by the federal government as a possible national model for reducing health care costs.
The state's medical institutions agreed last year to a five-year agreement with the U.S. Centers for Medicare and Medicaid Services. It drastically changed the way they did business and aimed to curb costs, in part by reducing expensive hospital stays and handling more patient care at the doctor's office.
"Hospitals at the blink of an eye really changed their systems into something that hasn't been broadly tested before — and we are pleased with the first year results," said Carmela Coyle, CEO of the Maryland Hospital Association.
Hospital officials — and health care advocates — also contend that the new cost-cutting effort has not come at the expense of patient care.
An unusual approach but one to keep an eye on.
AAMC is looking like they are ready to just shut down. On the average night they might have one nurse in the ER.
They sure seem to be faking it online, then:
Anne Arundel Medical Center - Living Healthier Together
Anything other than your opinion to support that?
..and by put them on a budget you mean they had to turn away the Untermenschen and hand them aspirins?
maybe they're giving them breathalyzers and telling them to go die or something
People still surprised that obamacare is such a total clusterfuck, look who invented it
well lets see, who are you going to believe, you who most likely has never even seen the hospital, or me who has actually been in it. and the last two times I walked out do to inferior care and drive myself to Howard county hospital which is part of the John Hopkins network.trust me, they are faking it. At one time it was the best hospital you could go to, but over the last year they have gone so far down that I can only equate them to a crack corner clinic.and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.Interesting early results from one of the little state experiments enabled by the ACA.
Maryland's state government has been setting hospital prices for decades but last year they kicked it up a notch, using authority in the ACA to essentially put their state's hospitals on budgets.
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.
Now the state's hospital association is out with a preliminary look at the results in the first year and they're promising: Hospitals save $100 million in Medicare costs
An unusual approach but one to keep an eye on.
AAMC is looking like they are ready to just shut down. On the average night they might have one nurse in the ER.
They sure seem to be faking it online, then:
Anne Arundel Medical Center - Living Healthier Together
Anything other than your opinion to support that?
But, go ahead and think what you will.
actually I cant be bothered because unlike you, I have first hand experience of how downhill they have gone.well lets see, who are you going to believe, you who most likely has never even seen the hospital, or me who has actually been in it. and the last two times I walked out do to inferior care and drive myself to Howard county hospital which is part of the John Hopkins network.trust me, they are faking it. At one time it was the best hospital you could go to, but over the last year they have gone so far down that I can only equate them to a crack corner clinic.and the level of care has gone down incredibly in Maryland Hospitals over the last year. Its not working.
AAMC is looking like they are ready to just shut down. On the average night they might have one nurse in the ER.
They sure seem to be faking it online, then:
Anne Arundel Medical Center - Living Healthier Together
Anything other than your opinion to support that?
But, go ahead and think what you will.
You could prove me wrong with a third-party report. That you can't be bothered gives me a not-unexpected answer.
and the last two times I walked out do to inferior care and drive myself to Howard county hospital which is part of the John Hopkins network.
I dont go into the ER for me, I go with others.and the last two times I walked out do to inferior care and drive myself to Howard county hospital which is part of the John Hopkins network.
...which is also on a budget. Unless you're going to the VA, you're not going to find a hospital in the state that's in a different boat.
Also, how often are you visiting emergency rooms? If you're using it as a usual source of care (in nonemergent enough states that you're willing to drive 35 minutes for better service) perhaps you're part of the problem. Might be time to start picking a more appropriate setting for your acuity level.
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.
