Improving Healthcare Outcomes and Economics

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As you may be aware, Western Pennsylvania Hospital News is celebrating its 25th year. Rather than reflect on the past, we want to move forward and look ahead. Based on your own skillset and insights, what does the future hold for the healthcare industry and how will your practice or organization contribute? We’d love to hear your thoughts. Please email Harvey Kart at hdkart@aol.com and we’ll share your thoughts with our readers between now and the end of the year. 

Here’s the first of the Looking Ahead articles:

Ron Kocent

By Ron Kocent

Twenty five years and counting! I recall starting in rural Punxsutawney just after the Nixon Administration promoted the new concept of HMO’s. The PC was a dream, but we soon had green screens with a DOS prompt. Then the 5 pound “bag phone” emerged for portability—the time has gone by quickly and as we all know, the pace of technology has been astronomical.

I recall the early days of Hospital News, and a brief article published as we developed a provider owned HMO in Beaver County. Since that time the healthcare administrative field has advanced from basic cost saving measures to efforts to evaluate true clinical and economic benefits.

As we approach the next decade I believe healthcare will transition in many facets, improving outcomes and economics.

A wise local administrator used to open many meetings asking, “What’s the object of the exercise?” This question is an important foundation for any management decision, process or program development.

In the case of the future, I see short and long term objectives and evolution as healthcare leaders continue to focus resources on specific objectives. On a large scale, over the next decade, I believe several major elements will continue to incrementally improve healthcare outcomes and economics:

• There will be even more physician/hospital collaboration.

• Business technologies will advance for more precise measurement capability through a combination of advanced accounting programs and EHR based clinical data.

• Measurement of clinical and economic benefits will become more exact as variation in technologies is reduced and clinical pathways are more prevalent within facilites.

• Nano technologies, biologics, stem cells, pharmaceuticals and minimally invasive techniques will evolve to replace our current state-of the art care.

• Patients will have choices based on transparency with actual measured results.

In the short run I believe it’s imperative that revenue is captured as near to 100% as possible. Without the proper resources to operate, a practice of facility simply can not survive. A recent AMA publication once again noted that in 2010 the average rate of inaccurate claim payments by commercial insurers is 19.3%. After witnessing this in actual reviews I conducted over the past eight years, I intend to start my orthopedic and neurosurgical practice revenue review business in August. Healthcare Management Results will be launched, and I am confident that the average practice bottom line can be improved from between 10 to 20%. Using a combination of benchmarking, certified coding review and a proprietary software, new earned revenue will be captured.

As the eternal optimist, my belief is that our healthcare system will improve dramatically as the business tools improve and clinical professionals continue to strive for the best patient care possible.

Ron Kocent of Healthcare Economic Solutions can be reached at consultkocent@msn.com.