Dominoes continue to fall: The Cleveland Clinic

[Mac1958]

.

Inevitable, more on the way:

Citing Obamacare, Cleveland Clinic to Cut $300M, Warns of Layoffs - US News and World Report

But let's not forget the standard response:

Don't like Obamacare?
Losing your job?
Losing hours?
Losing your doc?
Not getting that job you would have gotten?
Victim of cutbacks?

Tough shit, we don't care about your problems, here it comes.

.

 

[Greenbeard]

"To prepare for health care reform, Cleveland Clinic is transforming the way care is delivered to patients," the Clinic's representatives said in a statement. "Over the past several years, we have had an ongoing focus on driving efficiencies, lowering costs, reducing duplication in services and enhancing quality to make health care affordable to patients."

If a bloated sector becomes more efficient and finds it can deliver higher quality care with fewer resources, then it probably would look a bit like this. Record-low cost growth and improving quality (check, check), but also some people having to shift into other sectors of the economy.

I realize lower costs and better quality aren't of much interest around here, but those were sort of the point of the ACA.

 

[dblack]

.

Inevitable, more on the way:

Citing Obamacare, Cleveland Clinic to Cut $300M, Warns of Layoffs - US News and World Report

But let's not forget the standard response:

Don't like Obamacare?
Losing your job?
Losing hours?
Losing your doc?
Not getting that job you would have gotten?
Victim of cutbacks?

Tough shit, we don't care about your problems, here it comes.

.

C'mon! Don't be a spoiled sport. Everything will be all better when the government is running things.

 

[Mac1958]

.

Inevitable, more on the way:

Citing Obamacare, Cleveland Clinic to Cut $300M, Warns of Layoffs - US News and World Report

But let's not forget the standard response:

Don't like Obamacare?
Losing your job?
Losing hours?
Losing your doc?
Not getting that job you would have gotten?
Victim of cutbacks?

Tough shit, we don't care about your problems, here it comes.

.

C'mon! Don't be a spoiled sport. Everything will be all better when the government is running things.

Indeed, we can always depend on Our Great & Glorious Leaders In Central Planning to pick the winners and losers, to effectively create and implement massive programs that effect virtually all parts of both our economy and our personal lives, and to ignore & avoid all unintended consequences resulting from all bureaucracies therein.

Because they "care". And they are here to make life "fair".

Feels good, huh?

.

 

[R.C. Christian]

Awesome.

 

[BillyV]

"To prepare for health care reform, Cleveland Clinic is transforming the way care is delivered to patients," the Clinic's representatives said in a statement. "Over the past several years, we have had an ongoing focus on driving efficiencies, lowering costs, reducing duplication in services and enhancing quality to make health care affordable to patients."

If a bloated sector becomes more efficient and finds it can deliver higher quality care with fewer resources, then it probably would look a bit like this. Record-low cost growth and improving quality (check, check), but also some people having to shift into other sectors of the economy.

I realize lower costs and better quality aren't of much interest around here, but those were sort of the point of the ACA.

How about another quote from the same article?

"Health care reform has really changed things, and the burden of cost is going to be falling on patients,"spokeswoman Eileen Shiel told The Plain Dealer..."We know we're going to get paid differently and reimbursed less to do more," Shiel explained. "It will affect the work force, but we're not sure how yet. There will be a reduction."

"Lower costs" have yet to be shown, but please explain how doing "more with less" will result in "better quality". How do you define "better quality"?

 

[rdean]

Hilarious. Republicans want to use a clinic that gets most of it's money from "Medicaid" as an example. Medicaid is a government program. They keep screaming for cuts. Well, here's a cut staring them in the face and the tards "cry". Fucking tards. Stop your whining.

Financing & Reimbursement | Medicaid.gov

 

[Greenbeard]

"Lower costs" have yet to be shown, but please explain how doing "more with less" will result in "better quality". How do you define "better quality"?

I suppose I should be more precise and say better "value," which means better or equivalent quality for less money. Quality in this case meaning performance on validated quality measures in widespread use in the health sector. As to whether this is being shown, we're seeing it all over the place lately:

Obamacare-like groups may produce 'spillover' savings

(Reuters Health) - A program focused on primary care and coordination of services between groups of doctors and hospitals reduced costs for patients who were not even covered by the plan, according to a new study.

In the new study, researchers found that Medicare spent less money on services for older patients after their health providers became part of the ACO, and that there was no change in the quality of care after the switch.

Obamacare Shows Hospital Savings as Patients Make Gains

Less than five months before the Affordable Care Act fully kicks in, hospitals are improving care and saving millions of dollars with one of the least touted but potentially most effective provisions of the law. . .

Under the program, hospitals and physician practices take responsibility for tracking and maintaining the health of elderly and disabled patients. If costs rise beyond an agreed upon level, hospitals may become responsible for reimbursing the government. If they cut the cost of care while maintaining quality, hospitals share in the savings. The government expects the savings may be as much as $1.9 billion from 2012 to 2015. Early indications suggest they are starting to add up.

Obamacare pilot project lowers Medicare costs

An ambitious program under the health law to change how care is paid for lost nearly a third of its participants after the first year, but not before all were able to boost the quality of care provided to patients in an experiment that some experts say holds promise to bring down health care costs in the long run.

The Centers for Medicare & Medicaid Services announced Tuesday that all 32 health care organizations had hit performance benchmarks for improving care in the Pioneer Accountable Care Organization program, and 13 had done so while substantially lowering Medicare costs. In part, that was by reducing hospitalization and rehospitalizations, CMS reported.

And of course we're seeing progress with similar private sector initiatives as well: Study: Mass. Global Payment Approach Lowers Costs, Improves Care

The Alternative Quality Contract, a global payment model put in place by Blue Cross Blue Shield of Massachusetts in 2009, has both curbed costs and improved the quality of care, according to a Harvard Medical School study published today in the journal Health Affairs. . . The AQC is very similar to the Affordable Care Act’s Pioneer Accountable Care Organization contracts – a part of the Medicare shared-savings program. . .

After studying data from Blue Cross Blue Shield’s claims and comparing them to claims from doctors not participating in the AQC, the researchers found that – during the second year – providers participating in the global payment system spent an average of 3.3 percent less than the other groups. Those providers who came from traditional fee-for-service contract models achieved the greatest savings – as much as 9.9 percent in year two.

The study also found the participating provider groups achieved quality improvements in chronic care management, pediatric care and adult preventive care, especially in year two.

The point of the new payment models is that if you don't maintain or improve quality in conjunction with any savings you achieve, you don't actually benefit from them financially. The good news is that it's possible to do both, and that's the future of the American health care system.

As the Cleveland Clinic's CEO has admitted, the ACA is pushing them to do what they do better:

The new federal provisions—which include cutbacks to Medicare payments and the creation of new health-insurance marketplaces for consumers—will test institutions like Cleveland Clinic, as will new forms of payment that swap the fee-for-service model for one intended to reward hospital systems for efficient, high-quality care. . .

WSJ: How does the health overhaul affect you?

Dr. Cosgrove: We knew that we had to reduce costs and we had to drive a more efficient health-care delivery system. [The law] just gave additional impetus to get that done.

 

[BillyV]

"Lower costs" have yet to be shown, but please explain how doing "more with less" will result in "better quality". How do you define "better quality"?

I suppose I should be more precise and say better "value," which means better or equivalent quality for less money. Quality in this case meaning performance on validated quality measures in widespread use in the health sector. As to whether this is being shown, we're seeing it all over the place lately:

Obamacare-like groups may produce 'spillover' savings

(Reuters Health) - A program focused on primary care and coordination of services between groups of doctors and hospitals reduced costs for patients who were not even covered by the plan, according to a new study.

Obamacare Shows Hospital Savings as Patients Make Gains


Obamacare pilot project lowers Medicare costs


And of course we're seeing progress with similar private sector initiatives as well: Study: Mass. Global Payment Approach Lowers Costs, Improves Care

The Alternative Quality Contract, a global payment model put in place by Blue Cross Blue Shield of Massachusetts in 2009, has both curbed costs and improved the quality of care, according to a Harvard Medical School study published today in the journal Health Affairs. . . The AQC is very similar to the Affordable Care Act’s Pioneer Accountable Care Organization contracts – a part of the Medicare shared-savings program. . .

After studying data from Blue Cross Blue Shield’s claims and comparing them to claims from doctors not participating in the AQC, the researchers found that – during the second year – providers participating in the global payment system spent an average of 3.3 percent less than the other groups. Those providers who came from traditional fee-for-service contract models achieved the greatest savings – as much as 9.9 percent in year two.

The study also found the participating provider groups achieved quality improvements in chronic care management, pediatric care and adult preventive care, especially in year two.

The point of the new payment models is that if you don't maintain or improve quality in conjunction with any savings you achieve, you don't actually benefit from them financially. The good news is that it's possible to do both, and that's the future of the American health care system.

As the Cleveland Clinic's CEO has admitted, the ACA is pushing them to do what they do better:

The new federal provisions—which include cutbacks to Medicare payments and the creation of new health-insurance marketplaces for consumers—will test institutions like Cleveland Clinic, as will new forms of payment that swap the fee-for-service model for one intended to reward hospital systems for efficient, high-quality care. . .

WSJ: How does the health overhaul affect you?

Dr. Cosgrove: We knew that we had to reduce costs and we had to drive a more efficient health-care delivery system. [The law] just gave additional impetus to get that done.

Well, I don't have time to become an expert (because it isn’t my job to misinform on the internet), but from the little I can gather from your links, the "quality care" they are providing with an “Accountable Care Organization” is much like the HMO model used to be, with the addition of reminding and harping on patients to lose weight, stop smoking (tobacco use was in at least two of the metrics), make sure they take their medication, get flu shots, etc., and prevent MRIs for lower back pain. Several of the other metrics are based solely on the patient "experience". It may or may not reduce the costs but surely the ACO will seek the healthiest patients and then harass them into compliance in order to make money. This kind of "nanny medicine" may help seniors remember to take their medications by having people constantly reminding them, but when I think of “quality”, I think more in terms of ensuring access to cutting edge resources that increase the chance of surviving serious illness, not someone to wipe your nose and make you feel warm and fuzzy. My daughter has a serious condition and our primary care physician recommended a specialist in whom he had great confidence. My wife felt he was abrasive and told our doctor about it. His response was something like “You don’t have to make dinner plans with him, and his job is not to be your friend; his job is to make your daughter better, and he is the most qualified to do that.” I also don’t want him thinking about how much some high-tech treatment or diagnostic tool may be so that the quarterly income statement looks better; I want him thinking only about solving the problem.