'How can our society expect healthcare costs to be reasonable when hospitals do not know their costs of production or reasonableness of the bills they send to patients and insurance companies? How do organizations realistically set prices, compete in the marketplace, and accurately plan for their own survival and growth?"
Dr. Barry P. Chaiken, Infor chief medical information officer, answers those questions in a guest column, 'Health IT & Quality: At All Cost?,' in Patient Safety and Quality Healthcare magazine.
He explains how the flawed model of volume-based reimbursement led to inflated healthcare charges, and how 'the passage of the Affordable Care Act (ACA) dramatically changed the healthcare marketplace and the economics driving it.
'No longer could provider organizations indiscriminately raise prices to increase revenue and cover their costs. The ACA set rules strongly encouraging provider organizations to take on risk and deliver measurable quality of care.
'… Additionally, ACA incented the formation of Accountable Care Organizations (ACO), whether for Medicare/Medicaid or group health beneficiaries, which require these organizations to accept financial risk for patient care. Under this environment both quality and cost matter like never before.'
'… healthcare organizations need a reliable, third-generation healthcare information technology tool that allows them to measure the true cost of care while linking it to their clinical outcomes. Only then will they be able to deliver the highest quality of care at a reasonable cost to a deserving American public.'
Visit Infor booth 3049 at HIMSS14, the Healthcare Information and Management Systems Society 2014 conference Feb. 23-27.