Home From The Editor A chance for real reform?

A chance for real reform?

June 2009

Published in the June 2009 issue of Today’s Hospitalist

I’VE RECENTLY BEEN STRUCK by the level of interest in the Obama administration’s proposals to reform health care. In just the last 20 years, after all, I have seen lots of health care proposals come and go, many of them with little to show other than partisanship, hard feelings and bitterness.

But among many of the hospitalists I speak with, including those at the Society of Hospital Medicine meeting last month, there is a distinct sense that this reform effort may actually go somewhere ” and that it will have a real impact on hospitalists.

For now, many hospitalists are wondering what the government’s push to reduce readmissions “and related proposals to use “bundled” payments as a financial incentive to achieve that goal ” will mean for the specialty.

Several articles in this issue explore how hospitalists will be affected by the growing focus on reducing readmissions. If the conversations at the SHM meeting are any indication, the topic is on the minds of many of you.

One school of thought, for example, says that bundling could be a great opportunity for hospitalists. Their importance can only grow, the thinking goes, because they have the motivation and the skills to rein in readmissions. Hospital administrators have seen the gains hospitalists have made in controlling costs and improving quality, and they might turn to them once more.

But it’s also possible that specialists “like orthopedic surgeons and cardiologists “might decide that rather than split a payment bundle, they’d rather keep a bigger portion by managing their patients’ medical needs themselves.

Is any of this likely? It’s hard to say, at least until data from the pilot projects looking at bundled payments come in. But it’s got hospitalists talking about how to bring down readmission rates, which in itself should prove to be a good thing.

edoyleEdward Doyle
Editor and Publisher