ANDY CARTER / MICHAEL R. FRASER

Stepping up health care in Pennsylvania

Don’t endanger improvements with state or federal budget cuts

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In early November, Pennsylvania’s doctors and hospitals learned that fewer patients than ever are dying after heart surgery and fewer are having to return to the hospital because of incomplete care or other complications. These were among the conclusions in a Pennsylvania Health Care Cost Containment Council report, which examined more than 20,000 coronary artery bypass grafts and/​or valve surgeries performed between July 1, 2011, and Dec. 31, 2012.

This is great news for Pennsylvania patients, health care professionals and hospitals — and we celebrate these achievements as we simultaneously strive to drive the good numbers up and the bad numbers down even more. To further these improvements, however, it is important to know how and why we are where we are today.

First, we can attribute these successes to the outstanding skill, professionalism and caring shown by teams of physicians, nurses, pharmacists, allied health professionals, hospital administrators and others who fulfill the awesome responsibility to care for Pennsylvanians during tens of millions of patient visits each year.

Another key factor is the use of good data. PHC4 data collection and reporting, for example — on cardiac care, orthopedic care, HMOs, hospital performance, infections, finances and more — has helped hospitals and physicians provide outstanding, cost-effective care to our families, friends and neighbors. Physicians and hospitals also work closely with the Pennsylvania Patient Safety Authority to promote best practices and to identify and fix flaws that could result in patient harm.

Then there are the human elements. We see better communication and coordination among caregivers in smooth “handoffs” — from doctors to hospitals to rehab facilities, for example. We see it in simpler, clearer procedures in the operating room that reduce errors such as wrong-site surgeries and help ensure that we get it right every time. We see it in doctors, patients and families talking to, not past, each other, where members of the medical team value the wisdom and experience of patients and their families as much as the patients and families value the professional skill of the caregivers.

So what does this mean going forward?

We know that higher quality health care requires unprecedented levels of collaboration between physicians and hospitals — and between the medical community and the patients and families in need of our care, compassion, competence and communication.

For our organizations — the Pennsylvania Medical Society and The Hospital & Healthsystem Association of Pennsylvania — this means working with each other and across the continuum of care to improve outcomes and the patient experience as well as reduce health care costs.

Efforts to build on these achievements will be hampered, though, if budget cuts in Harrisburg and Washington target physician and hospital payments.

For physicians, Medicare payments are scheduled to be cut by as much as 24.7 percent due to a flawed formula known as the “sustainable growth rate” that is pegged to growth in GDP. For hospitals in Pennsylvania, Medicare cuts of $155 million already are in the pipeline. Our organizations will press Washington policy makers to eliminate this formula and shore up Medicare’s finances in others ways so as not to degrade health care.

Here at home, we’re encouraged by Gov. Tom Corbett’s Healthy PA plan to expand and reform Medicaid, but continued state budget deficits put critical Medicaid and other hospital and physician payments at risk — further ratcheting up the pressure on providers.

Our organizations are excited by our members’ patient-care successes, as documented in the recent PHC4 report. We will continue to work together to improve quality and value in health care, bringing together medical professionals and hospital leadership to build a health care system that works for all. And we will continue to encourage lawmakers in Harrisburg and Washington to adopt that same collaborative spirit as they set the public policy that guides Pennsylvania health care in the years to come.

Ultimately, though, future progress in health care means never forgetting that ours is a fundamentally human endeavor, regardless of the political, financial, and technological landscape. Pennsylvania’s hospitals and doctors will keep that in the forefront of everything we do.

Andy Carter is president and CEO of The Hospital & Healthsystem Association of Pennsylvania and Michael R. Fraser is executive vice president of the Pennsylvania Medical Society.


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