The Republican triumph in the midterm elections has given the GOP control of the House of Representatives. While many people think some parts of President Obama’s health-care reform legislation may be changed, no one believes it will be scrapped completely in the next two years. So a new world of costs and care is here, and the million-dollar question is, can providers survive it?
ALLAMBY
改革措施于三月份签署为法律，主要目标是涵盖未保险并扩大访问权限。但是，它也将改变提供医疗保健的方式，因为它集中于削减医疗成本并提高质量和安全性。新利18备用官网登录
One safe prediction is that reform likely will cost much more than anticipated. The hospitals and health-care providers that adapt to managing cost and reimbursement will be the ones that survive and thrive.
The reforms will move hospitals toward a system under which they receive a set amount, i.e., a bundled payment, for treating a patient’s overall condition, from diagnostics to treatment to rehabilitation. Reimbursement will be based on the care a patient receives from 72 hours prior to admission to 30 days following discharge. In cases where patients must be rehospitalized, health-care providers will not receive full reimbursement.
Under a bundled payment system, industry players will be forced to reinvent themselves as “accountable care organizations” with a much more integrated, coordinated and collaborative approach to patient care. It’s important to realize that this is an entirely different model. The process will have to be streamlined. It will no longer be sufficient merely to get the patient in and out of the hospital.
Health-care institutions already face numerous challenges, such as aging technological infrastructure, personnel shortages, quality of care, customer satisfaction and serving the uninsured. These challenges are compounded by a very competitive health-care delivery system.
该立法以一些新的方式影响医院收入。的确，随着未投保的减少的数量，医院和卫生系统将受益于减少慈善机构的报道和不良费用。
但是，这将被医疗补助和医疗保险报销的削减所抵消。在未来十年中，后者将被1550亿美元修剪，并有可能导致额外的医疗保险削减，以减少高成本市场上效率较低的医院。
Hospitals also will face more difficult negotiations with commercial and managed-care insurers who themselves will face increased scrutiny.
纠正我们的医疗机构中现有的缺陷并在新系统下重组将需要大量投资，以削减成本和提高护理质量。新利18备用官网登录
Hospitals with better ties to physicians and other care providers are likely to do better, but many stand-alone, not-for-profit community hospitals may struggle.
医院设计
Naturally, the new model of care resulting from reform will favor hospital design and layouts that optimize flexibility and operational efficiency. In addition to stronger physician relationships, hospitals will need to either strengthen partnerships with preventative or wellness providers and continue partnerships through post-acute care services or develop their own services. Existing facilities will be restructured and new buildings designed based upon this new patient-centric system in which patients are followed closely across the entire continuum of care.
同样，在急诊部门，诊断成像区域和手术室的人员配备和吞吐量方面，提供者将需要更有效。另外，他们将需要通过安排这些特定部门来增加吞吐量的数量，以便它们更加功能和高效。随着获得资本的下降，大型替代医院的趋势可能已经成为过去。
大多数医院应该能够在接下来的三年中相对毫发无损，因为许多关键规定要等到2014年才开始。而且，改革所带来的变化可能会不断发展。但是要做的事情要做很多，因此对于提供商即将开始计划是明智的。
