Friday, May 22, 2015

Brave hospitals, rising to the challenge of Obamacare

Acts of bravery take place in hospitals every day, when staff must communicate information about life-threatening illnesses or help grieving family members respect a patient's end-of-life wishes.

Brave hospitals, rising to the challenge of Obamacare

Acts of bravery take place in hospitals every day, when staff must communicate information about life-threatening illnesses or help grieving family members respect a patient’s end-of-life wishes.

But the Affordable Care Act (aka Obamacare) is also challenging hospitals to be organizationally brave, to tackle the goal of improving not just the health care they provide, but the overall health and well-being of their communities. And, at the same time, to reduce the growth in health care costs and spending.

The move away from the volume-based care model of the past to the value-based model encouraged by Obamacare demands that hospital leaders reassess where and to whom they provide services. The new value-based model is consumer-focused and concerned with maintaining overall health. That’s quite different from the provider-focused model, which emphasizes sick care when the patient is ill.

Because value-based reimbursement can produce lower levels of revenue, hospital decisions about capital investments, such as health care technology and facilities planning, are more difficult. Hospitals must also retool their workforces and develop new core competencies that reflect the needs of consumer-focused care.

Achieving these goals means hospitals must make big changes that will take bravery, such as -

  • Integrating a culture of quality into the entire organization with accountability by everyone for patient outcomes and satisfaction.
  • Creating patient and family committees that provide real and raw feedback about a hospital’s patient interactions and communications.
  • Taking definitive steps toward billing and price transparency.
  • Creating physician leadership opportunities and physician alignment strategies to drive change.
  • Making population health part of the hospital’s mission.

These changes require hospitals to adopt new ways of thinking and interacting with patients and to assume new kinds of risks and responsibilities. Right now, hospitals in Philadelphia and across the state are stepping out of their comfort zones to effect this transformation, taking on the uncertainty and insecurity that change always entails.

Hospitals are rising to these challenges because they believe the rewards—better health at lower overall cost—are worth the struggle needed to achieve them. And because the ultimate goal of every patient interaction and every hospital program or service is to make life better for the patients and communities that hospitals serve.


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President & CEO, The Hospital & Healthsystem Assoc. of Pa.
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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