Three Resolutions Any Hospital Can Follow for Better Performance in 2015

Jan. 12, 2015 / By Kristine Daynes

There is plenty of speculation about the fate of hospitals and healthcare IT. The uncertainty could make it difficult for hospital executives to set strategies for the coming year. Yet, there are a few near-certainties as we go into 2015. Here are three resolutions hospital executives should make to keep pace with 2015 trends.

1. Train your physicians for ICD-10. Although the AMA claims physicians can’t be ready, ICD-10 is on the calendar for October 2015. Health systems and large physician groups can avoid productivity losses by making sure their doctors are trained and their IT systems tested. There are excellent resources you can make use of.  For example, CMS has provided “Road to 10,” a comprehensive resource for small physician practices.

2. Closely monitor your quality gains. Over the past several years, most hospitals have improved readmission and complication rates, at least in some areas. However, quality isn’t “won and done.” It is a continuous process. Improvements backslide if there is a lapse in attention. For example, Syracuse hospitals achieved impressive reductions in preventable readmissions and hospital-acquired complications over a four-year period—only to have rates rebound in years five and six. The program appears to be correcting itself, in large part to a commitment to continue tracking and reporting. Lesson learned: Rather than take attention away from “completed” programs, look for long-term sustainability. If possible, scale programs strategically to include other conditions or patient populations. In this way you can start to cut waste from your delivery system in preparation for broad value-based care programs.

3. Plan for changing patient mix as outpatient care becomes a larger part of services. The shift from inpatient to ambulatory care doesn’t just change utilization. It changes hospital case mix index and has implications for staffing, revenue cycle, and quality management. In addition to tracking the effect on inpatient utilization, you should also measure outpatient/ambulatory patient mix. Start by establishing baseline utilization by diagnosis and treatment setting (e.g., using APCs). If you are really serious about measuring the effect, you need a DRG-style classification system to risk adjust cost and quality based on patient severity of illness (e.g., 3M EAPGs).

Easier said than done, I know. But, these activities can make a big difference in hospital efficiency. Fortunately, several of my fellow 3M bloggers have plenty of advice on following these resolutions. Here are some of my top picks.

ICD-10 training for physicians:

• Ready, Set, Now: Your Guide to ICD-10 Success – If nothing else, download this free e-guide from 3M.
• HIMagine That! ICD-10: What’s in it for Physicians? and ICD-10 Physician Education – Some Quick Wins for Everyone – Two popular posts from Sue Belley and Donna Smith.
• To Physicians: Some Non-Hype about ICD-10 – Don’t be misled by the 2011 byline. This post is as relevant today as when Rhonda Butler first wrote it.
• Cost of Converting Small Physician Offices to ICD-10 Much Lower than Previously Reported – Not a blog post, but a Journal of AHIMA article co-authored by three 3M bloggers.

Monitoring quality improvement:

• Accuracy Matters – Speaking from experience, Cheryl Manchenton describes how quality improvement hinges on consistency.
• What Every Hospital Ought to Know About Measuring Patient Quality, Cost, and Experience – Insights from one of Allina Health’s quality analysts.
• Five Simple Principles for Tackling Hospital-Acquired Complications – A summary of the quality improvement process followed by the Syracuse hospitals.

Measuring ambulatory care:

• OPPS Proposed Rule for 2015 (July blog post) and OPPS Final Rule Coding Changes (December Coding Forum webinar available to 3M customers) – Dave Fee summarizes CMS changes to the Outpatient Prospective Payment System.
• Who Will Win at Population Health Management? – Dr. DeBuono’s comments on the shift from volume to value are just as relevant for the shift from inpatient to ambulatory.

Best wishes for success in 2015!

Kristine Daynes is marketing manager for payer and regulatory markets at 3M Health Information Systems.