2014's Top Healthcare Policy Issues Center on Performance, Quality

The Hospitalist. 2014 January;2014(01):

January 1, 2014 | The Hospitalist

Whether you are for or against the changes produced by the Affordable Care Act, Dr. Siegal says the system “just became a lot less stable.”

“The tacit, quid pro quo had been that lost revenue from Medicare would, at least in part, [be] offset when 30-plus million Americans with newly minted insurance plans became paying healthcare consumers,” Dr. Siegal adds. “With this delicate balance suddenly jeopardized, my guess is that many health systems will circle their wagons until they know which way the wind will blow.”

All told, the healthcare landscape remains one that is pockmarked by generational reform that will require deft hands to navigate. But those who are still fighting reform and its expanded access provision might be missing the larger point.

“You could repeal the Affordable Care Act today, which is not going to happen obviously, but it wouldn’t change the fact that these emerging alternative payment methodologies are still going to occur,” Dr. Siegal says. “It’s beyond Medicare. The private payors are doing it. Physician groups and hospitals and other integrated healthcare organizations are gearing up to take those payments ... because staying in fee-for-service is untenable.”

Richard Quinn is a freelance writer in New Jersey.

Mr. Hospitalist Goes to Washington

A hospitalist is poised to become the nation’s doctor. President Obama announced late last year that Vivek Murthy, MD, MBA, an internal medicine hospitalist at Brigham and Women’s Hospital in Boston and an instructor at Harvard Medical School, was his nominee for Surgeon General of the United States. Dr. Murthy, the first Indian-American nominee, is a co-founder of Doctors for America.

“On behalf of SHM, its members, and hospitalists everywhere, we congratulate Dr. Murthy and support his nomination,” SHM President Eric Howell, MD, SFHM, says. “His nomination is a credit to his own personal achievement and the potential for hospitalists to rise up and truly change healthcare for the better. This is truly a milestone for the specialty. Just 17 years ago, the word ‘hospitalist’ was first published; now it was used in a White House press release.”

Indeed, Dr. Murthy’s ascension to national prominence is just the latest example of hospitalists joining the highest ranks of government.

Patrick Conway, MD, MSc, SFHM, is CMS’ chief medicalofficer. His current titles also include director of the Center for Medicare and Medicaid Innovation and director of the Center for Clinical Standards and Quality. He was previously a pediatric hospitalist and director of hospital medicine at Cincinnati Children’s Hospital Medical Center.

Kate Goodrich, MD, former director of the hospital medicine division at George Washington University Medical Center in Washington, D.C., is medical officer for the Office of the Assistant Secretary for Planning and Evaluation in the HHS.

Matthew Heinz, MD, a hospitalist from Tucson, Ariz., is the director of provider outreach at the HHS, a position the agency created specifically to educate the public on healthcare policies.

Kevin Larsen, MD, was appointed in 2013 as medical director of meaningful use at the Office of the National Coordinator for Health Information Technology. Dr. Larson is a longtime hospitalist who was previously chief medical informatics officer at Hennepin County Medical Center in Minneapolis.

— Richard Quinn