With federal officials investigating allegedly unnecessary cardiac procedures at the Hospital Corporation of America (HCA), the industry continues to look for ways to curb overuse.
Provisions in the recently upheld Patient Protection and Affordable Care Act may do just that, USA Today reported. For instance, under health reform, Medicare and Medicaid have more power to reject payments for medical procedures considered overused. The law also incentivizes the use electronic records to restrict unnecessary services.
"The healthcare law is helping us implement new incentives for doctors, hospitals and healthcare providers to provide better quality care and not just a greater quantity of services," Medicare spokesman Brian Cook told USA Today.
The ACA also drives the industry away from fee-for-service toward pay-for-performance, especially with Medicare's hospital value-based purchasing program, starting in October.
Moreover, the reform law's encouragement of accountable care organizations could help curb unnecessary procedures, according to a Washington Post blog post. Hospitals and physicians involved in ACOs aim to provide the most cost-efficient care so that they can reap part of those savings later.
But providers must still meet quality metrics to ensure they're not cutting back on tests and procedures only save money, noted USA Today.
Although reform provisions are still kicking in, providers and payers already have found the ACO quality pay model helps improve outcomes and reduce costs.
To learn more:
- read the USA Today article
- here's the Post blog post