Rethinking the ways in which hospitals get reimbursed and removing barriers to patient centered care are just 2 ways in which hospitals can consider moving from volume to value, said Stephen Rosenthal, senior vice president of population health management at the Montefiore Health System.
Rethinking the ways in which hospitals get reimbursed and removing barriers to patient centered care are just 2 ways in which hospitals can consider moving from volume to value, said Stephen Rosenthal, senior vice president of population health management at the Montefiore Health System.
Transcript (slightly modified)
What do you think hospitals can do to ease the transition from volume to value?
Well, I think there needs to be a rethinking of how hospitals get reimbursed. So as you move to a value based program and many of the barriers that get put in place by regulation, like denials of payment for short stay cases, like the 2 midnight rule where a patients needs to stay in the hospital 2 midnights for that to be considered an appropriated admission. Remove those hurdles, those barriers, and allow the hospital to best manage the patient and change the way you pay the hospital.
So, if short stays are something you want to avoid, shift the dollar costs in a budget neutral way to those patients that truly need to be in the hospital who have a higher case weight or intensity of services needed so that the dollars are the same but there’s a focus on the individuals who need to be in the hospital versus perhaps moving those individuals out of the hospital setting, more into an ambulatory setting by changes in the way hospitals are reimbursed. Unfortunately, most organizations react to the financial constraints more quickly sometimes than some of the more social and/or population based strategy components.
Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
Listen
Redefining Long COVID Care With Personalized Treatment
March 20th 2025To mark the 5-year anniversary of the COVID pandemic, The American Journal of Managed Care® spoke with Noah Greenspan, DPT, PT, CCS, EMT-B, cardiopulmonary physical therapist and director of the Pulmonary Wellness and Rehabilitation Center in New York City.
Read More
How Mirdametinib Improves QOL for People With NF1-Associated Plexiform Neurofibromas
March 18th 2025Christopher L. Moertel, MD, University of Minnesota, discusses the trial data that helped get mirdametinib approved and what providers can do to keep measuring quality of life (QOL) improvements.
Read More