Cost-containment strategies for centers offering open heart product lines: one conceptual model.
Those hospitals currently offering cardiovascular service lines must look carefully at cost and outcome criteria. Certain considerations, such as the aging population, declining reimbursement rates, more critically ill patients and advances in healthcare technology, may be cause for many hospital administrators to rethink the viability of offering open heart services. The sometimes brutal competition in healthcare threatens the existence of many smaller programs. Some may argue that the corporate culture of healthcare is fast becoming more and more bottom-line oriented. True, the bottom line is important, but at what point is quality affected? The concept of managed care and capitated fees has, in effect, sent third-party payers into a "feeding frenzy" with respect to contract negotiations. This often results in the pitting of one hospital or doctor against another in what could be argued to be a calculated effort to drive down cost. Health-service organizations performing open heart surgery must understand a multitude of political and economic factors in order to provide cost-effective care. At the top of the priority list must be quality of care. Programs which experience low mortality/morbidity rates will be those facilities that consumers and payers choose. In fact, adjusted mortality/morbidity reports are already a reality in some states. Successful heart programs will be those known in the community (and, perhaps more importantly, to payers) as "centers of excellence," which offer customers high-tech and cost-conscious healthcare. Paramount to successful heart programs will be variables such as favorable managed-care contracts, program size, peer review and proactive case management.(ABSTRACT TRUNCATED AT 250 WORDS)
Vazquez
L T
LT
Psicor Inc., Diamond Bar, CA.
D006348:Cardiac Surgical Procedures / Q000191:economics*; D016507:Cardiology Service, Hospital / Q000191:economics*; D003363:Cost Control / Q000458:organization & administration; D006801:Humans; D010934:Planning Techniques; D011357:Product Line Management / Q000191:economics*; D014481:United States