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Leading the Way in Health Care Reform

Physician Connection

Winter 2013

 

The Affordable Care Act (ACA) has accelerated the evolution of the health care industry in a number of ways that were anticipated by Rochester General Health System, allowing RGHS to innovate and lead the way in the Rochester region. Key national trends inspired or endorsed by the ACA, and examples of how RGHS already made significant progress in those areas, include:

Fulfilling increased expectations for patient safety. With reimbursements now linked to provable quality measures, providers have an even greater obligation to refine and enhance their pursuit of patient safety – and to show the link between those enhancements and measurable improvements in patient care.

RGHS Progress: Efforts to foster an unprecedented culture of safety have seen remarkable success in recent years. The RGHS Patient Safety Institute, comprehensive unit-based safety protocols (CUSPs) and other initiatives have created a heightened awareness of the importance and attainability of increased patient safety – and resulted in dramatically lower mortality rates, decreased incidents of falls and hospital-acquired infections, and other crucial indicators.

Incentivizing the shift toward outcome-based delivery models. To streamline a system that will see millions of new patients in 2014 – and to increase quality of care for all patients – the former fee-for-service model of health care delivery needed to change to one focused on outcomes. Many aspects of reimbursement are now linked to care quality.

RGHS Progress: The Care for Health agreement with GRIPA and Excellus BlueCross BlueShield was launched in January after several years of careful development; this represents the most significant example of leadership in this area. (See related story for details.)

Investing in technology. A critical component of the ACA is the ability to provide consistent care to patients from any location. But paper patient files increase the risk of delayed treatments or medical errors; and a shortage of specialty providers has made it difficult to deliver high-quality care to patients in rural or remote areas.

RGHS Progress: Our rollout of the Care Connect electronic medical record (EMR) network is nearly complete, and already creating a vital link within the health system for sharing up-to-the-minute patient data. Additionally, our advances in telemedicine are increasing access to highly qualified specialists among patients in remote areas around our region.

Improving efficiency and value, and eliminating fraud, waste and abuse. The rising cost of health care delivery was a prime motivator in the passage of the ACA. Providers are being challenged to provide care that is calibrated to each patient’s needs and free of fraud, waste and abuse that can inflate the shared cost of health care.

RGHS Progress: A patient-centered care initiative begun in 2009 has helped the RGH Emergency Department improve efficiency and quality of care for its patients. The RGH ED now handles a record number of patients annually, and is the highest-volume ED in upstate New York. Additionally, the new RGHS Ambulatory Care affiliate is re-shaping health care delivery, and the health system is aggressively observing NYS anti-fraud/waste/abuse compliance regulations.

Driving collaboration among regional providers. One indirect effect of the ACA is seen in stand-alone hospitals in smaller communities seeking alliances with larger regional health systems. By sharing resources, specialists and expertise, these hospitals can more easily comply with the letter of the ACA and improve service to their patients.

RGHS Progress: Our regional leadership has led to an increasing number of strategic partnerships and collaborations with smaller community hospitals, most recently Clifton Springs Memorial Hospital and Batavia’s United Memorial Medical Center. Additionally, the unique RGHS partnership with the Greater Rochester Independent Practice Association (GRIPA) provides support and organizational strength for more than 900 physicians in our region.