tag:blogger.com,1999:blog-32053362.post7216459876161577796..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: I told you soPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-32053362.post-46753927251944958942009-06-19T14:40:11.035-04:002009-06-19T14:40:11.035-04:00It should come down to "pay or play".
Ho...It should come down to "pay or play".<br />Hospitals that provide graduate medical education really do not receive adequate benefit from the resources that they allocate to GME because the graduates do not all practice in their community. Hospitals that do not provide GME gain benefit from newly trained physicians moving into their area.<br />So, hospitals, and maybe managed care entities, are the beneficiaries of GME. My proposal would be to "tax" non-GME providing hospitals in a Medicare AHEC region proportionate to their hospital beds(and managed care organization "lives"?) to fund regional GME programs(maybe just primary care??). This could also better distribute residency graduates to areas of greatest need. BI and others could receive annual regional hospital "taxes" to support its GME programs.<br />..."pay or play" needs "traction"...76 Degrees in San Diegohttps://www.blogger.com/profile/14358630186174729315noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-33897738641777706702009-06-19T14:09:52.369-04:002009-06-19T14:09:52.369-04:00Right, Barry. As I have noted before, one person&#...Right, Barry. As I have noted before, one person's costs is another person's income.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-13345595423919696612009-06-19T14:08:07.894-04:002009-06-19T14:08:07.894-04:00While everyone seems to agree that the cost growth...While everyone seems to agree that the cost growth of the current healthcare system isn’t sustainable, I haven’t noticed any of the major stakeholder groups, especially doctors and hospitals, put forth any meaningful CBO scorable ideas that would contribute to a solution. In the case of hospitals, for example, where are they and the doctors who practice in them, on bundled pricing for expensive surgical procedures, shared decision making, palliative care in end of life situations and more widespread use of living wills and advance directives? Of course, lower utilization means less revenue and the need for fewer workers which, in turn, means painful and unpleasant adjustments would be necessary. It probably also means lower income for surgeons, oncologists and other highly compensated specialists. Then again, if it were easy, we would have fixed the system a long time ago.Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-44858901459546315312009-06-19T13:29:22.075-04:002009-06-19T13:29:22.075-04:00Academic centers aside, "they" don't...Academic centers aside, "they" don't get it yet. Simply trying to cut Medicare payments in selected areas, like they've tried with physicians for years (only to restore them every time) just isn't going to make it for a bill of this magnitude. Nothing less than wholesale payment reform will make this a viable bill. I am disappointed that all the smart people working on this seem unwilling or unable to deal with this incontrovertible fact.<br />Until someone comes up with something imaginative, like bundling hospital/dr. payments or something, nothing, and I mean NOTHING, will change.<br /><br />nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-56032028252323020352009-06-19T11:47:10.163-04:002009-06-19T11:47:10.163-04:00We don't need residency programs. Just a bunc...We don't need residency programs. Just a bunch kids with too much free time on their hands. They spend most of their residency falling-in-and-out-of-lust. Haven't you seen Grey's Anatomy? That's some insightful tee vee. Some of us get our ideas from tee vee instead of looking at peer-reviewed literature and the latest white-papers.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-7769068906647431152009-06-19T11:17:54.136-04:002009-06-19T11:17:54.136-04:00That NY Times graphic is great. As a fellow hospit...That NY Times graphic is great. As a fellow hospital administrator I understand where you're coming from--in fact I recently posted about the same thing on our blog http://srmcblog.com/2009/06/19/please-allow-me-to-step-onto-my-healthcare-reform-soapbox/<br /><br />We're just building Spotyslyvania Regional Medical Center now (near Fredericksburg, VA) and it will be interesting to see how everything plays out by the time we open our doors next year. <br /><br />I also have to say, your blog is great. It was a major inspiration for our team to get out there and blog about as you put it so eloquently in your title...Running a hospital.Nancy L.http://www.srmcblog.comnoreply@blogger.com