Panelists Say Quality Improvement Offers Economic Benefits

How can quality improvement initiatives help hospitals bend the cost curve? A Panel Session addressed this question at Clinical Congress yesterday.

Panelists Bruce L. Hall, MD, PhD, MBA, FACS, Zara Cooper, MD, FACS, and Rachel R. Kelz, MD, FACS, reviewed current and forthcoming quality improvement programs, including cutting-edge technological approaches to increasing quality while reducing costs.

“We spend more money on healthcare than any other country,” said Dr. Hall, a surgeon from Washington University in St. Louis, Missouri, acknowledging that the transition to value-based care, which pays hospitals based on outcomes rather than the number of services performed, has been underway for years.

Highlighting the Centers for Medicare & Medicaid Services (CMS) and Vizient, he described a complicated environment that includes a proliferation of programs that link payment to quality and the overlapping metrics and systems of rating, risk, penalties, and rewards associated with each. “The programs are going up in complexity. The payment and assessment periods are overlapping with each other,” he added.

Dr. Cooper’s talk also highlighted a climate of intensifying pressure. She began by describing a current demographic shift in the US, in which elderly people are now on track to outnumber small children by 2034, and detailed the intricacies of Medicare’s Merit-Based Incentive Payment System and other value-based care programs, saying, “We need to squeeze more and more out of a rock.”

Despite the difficulties, Dr. Cooper, who is affiliated with the Brigham and Women’s Hospital in Boston, Massachusetts, noted that the Michigan Surgical Quality Collaborative has significantly reduced complications and offered one example of how quality improvement can cut costs.

Drs. Hall and Cooper both described a forthcoming program: the newly finalized CMS alternative payment model, Transforming Episode Accountability Model (TEAM), which is specific to surgical procedures in acute care hospitals for Medicare patients. Dr. Hall expressed a need to set up programs to help hospitals comply with this mandatory program, while Dr. Cooper noted that TEAM is starting with more than 700 hospitals and likely will expand.

Dr. Kelz, of the University of Pennsylvania in Philadelphia, took a different tack. She explained how the use of artificial intelligence (AI) may increase quality while reducing costs. “We have to find a way to use technology to extend ourselves beyond what we are being asked to do,” she said.

Her methods include ambient listening technology, which can create clinical notes without a doctor needing to type. She shared this had saved her own healthcare center $4 million in a single year. She also spoke of AI technologies to optimize OR scheduling and predict times for safe discharge, both of which may reduce costly, frustrating lag times.

“Although the environment is daunting, there are opportunities for us as caregivers to be more efficient and deliver better care,” Dr. Hall concluded.

This session is available for on-demand viewing, and ACS staff members are onsite in San Francisco for attendees who want to know more about the ACS Quality Programs and how they can help hospitals reduce costs, increase their bottom line, improve outcomes, and even meet regulatory requirements.