How Are Hospital Incentives Changing?

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I personally reject the concept that hospitals have had an incentive to no distance incentive to keep people healthy and get them out of the hospital. I mean maybe there are some violators of that principle but not too much. But I think the general concept in hospitals especially hospitals like ours for years was when doctors in the community came to a patient that they couldn't manage, it was very complex.

They'd refer the patient to us. We'd start over we'd do everything to the patient that we thought was necessarily, give them the transplant, do the surgery and then we'd refer them out the other side and we'd look for the next patient to come in and we took basically no real responsibility for continuity of care for those people patients we were very episodic.

And we often repeated work that had been done in the past and we did not spend time with those to whom we referred the patient to ensure that the patient stayed on the path to not revert to the fundamental problem, it's a very common problem in heart failure. Heart failure patients have to manage their diet very carefully, to manage the sodium, they come in to the hospital they get to nap, they're discharged and if they have one high sodium meal, they can end up back in the hospital.

What are we doing? What's our ownership responsibility that, we took very little of that historically in healthcare. And today we have a whole different view of that, we're trying to see ourselves as part of the system, still got a long way to go. But I think one of the great legacies of ObamaCare is it has really stimulated us to say, how can we better steward resources across the system? How can we be a partner with that primary care physician who lives in the rural community? How can we be a partner with that community hospital, and then with us, and then with the skill nursing facility or the rehab facility or even the hospice.

How do we play a role there that makes the patient's experience's better, reduces cost and improves communication across that continuum?.