Obama or Romney? Hospitals aren't waiting for election results

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With the November election only weeks away, our FierceHealthcare editors have been keeping an eye on how the presidential candidates would affect the future of healthcare.

We've talked to healthcare leaders and hospital executives to see how their organizations are getting ready to meet the new rules and regulations under the Affordable Care Act or if they're waiting to see if it will be repealed.

So what did we learn? No matter who's living at 1600 Pennsylvania Avenue next year, health reform-inspired initiatives already underway, such as accountable care organizations, medical home models and health IT programs, will proceed as planned.

Hospitals and health systems are moving forward with implementing several ACA provisions, having deemed a complete repeal of health reform as highly unlikely. "Organizational priorities will not be affected if health reform is repealed, which I do not believe will happen," Dartmouth-Hitchcock director of clinical services Sheila Johnson told FierceHealthcare.

And although hospitals can't expect to fix readmissions overnight, they will continue to "chip away at the process," according to Greg Maynard, clinical professor of medicine at the University of California, San Diego, and director of UCSD's Center for Innovation and Improvement Science.

To do so, hospitals have been implementing transitional care models, such as Maynard's Project BOOST or the Care Transitions Intervention. In fact, the intervention program has already cut 30-day readmissions by up to 50 percent, its developer Eric Coleman, professor of medicine and head of the healthcare policy and research division at the University of Colorado, told FierceHealthcare.

With or without reform provisions tying patient satisfaction to hospitals' incentive payments, patient experience will remain a top priority. "A lot of the activity really began before healthcare reform because the payers had already begun to focus on [patient experience]," Bob Sehring, CEO of ambulatory services at Illinois' OSF Healthcare, told FierceHealthcare.

Successful patient experience efforts won't hinge on who wins the election, as better patient experience comes from cultural change, not federal rules and regulations. "If the reason for doing patient experience is simply to get a better score on a test, you will fail," said Jeremy Tucker, medical director of MedStar St. Mary's Hospital in Maryland.

Moreover, hospitals continue to look toward technology to improve care and reduce costs despite election uncertainty, with many committed to meeting Meaningful Use Stage 2 and staying on track to make ICD-10 implementation a reality.

"Now that a firm implementation deadline has been set, the entire healthcare community has the certainty it needs to continue to move forward with implementation, testing and training," Lynne Thomas Gordon, CEO of the American Health Information Management Association, told FierceHealthIT. "By moving to ICD-10, we will have better quality of care through better health information," she said.

The upcoming election won't stop the shifting focus to primary care and preventive services, especially given the early success of some patient-centered medical homes and outpatient care clinics.

CareFirst Blue Cross Blue ­Shield's medical home saved $40 million in only 18 months, and the insurer already plans to bring Medicare beneficiaries into the program. "[Y]ou can prevent a lot of breakdowns, avoid unnecessary hospitalizations and even cut down the sheer number of drugs that people are on." CareFirst CEO Chet Burrell told FierceHealthPayer. Such a combination can lead to significant costs savings, he said.

Answering industry calls for better access to primary care, Florida's Lee Memorial created outpatient clinics to give people a place to seek care besides the emergency department. With lower ED utilization and inpatient admissions in less than a year, the system is going to increase the clinics' hours of operations and expand services, Scott Nygaard, M.D., Lee Memorial's chief medical officer for Physician Services, told FierceHealthcare.

Whoever wins the election, they can count on facing the same healthcare challenge--how to deliver more cost-effective, high-quality care. Although, judging by our various special reports and interviews, hospitals already are forging ahead to find their own solutions.

As you await the ultimate fate of the ACA during this election season, check out some of our recent special reports and original interviews:

How will the November election affect new payment and delivery changes already in place? Is your hospital moving ahead with reform-inspired initiatives or waiting to see what the election brings? Share your thoughts by leaving a comment below. - Alicia (@FierceHealth)