Hospital Execs Assert They’re ‘Scared to Death’ by Reform Measures

By Shawn Kennedy, AJN interim editor-in-chief

On Friday, at the Association of Health Care Journalists (AHCJ) meeting in Chicago, I attended a session in which a panel of hospital executives discussed how their facilities would be affected by health care reform. They weren’t really sure of anything except that they’d probably lose money.

The panel included Richard Gamelli of Stritch School of Medicine and the Loyola University Health System, Jeffrey Hillebrand from NorthShore University HealthSystem, and Jim Skogsbergh from Advocate Health Care.

Skogsbergh was the most dire: “I’m scared to death about health care reform and I’m not sure how it will all shake out. The only thing I do expect is to that I’m going to get paid a lot less.” An attendee asked if hospitals would do better now that patients they cared for as charity patients would have health insurance under the new law. Gamelli answered that that depended on the insurance. Currently, he said, his facility is only reimbursed for 90% of costs incurred by Medicaid patients and 50% of those incurred by Medicare patients.

Where’s the innovation? The session was disappointing in that it was mostly about how these megahospital systems would deal with the financial implications. It would have been interesting to have a perspective from a small community hospital. And other than a program mentioned by Hillebrand to try to reduce hospital readmissions among patients with chronic disease, there seemed to be little focus on finding new approaches to cutting costs through improving quality.