With residents eligible to sign up for federal health insurance known as “Obamacare” this week, local healthcare CEOs are preparing for an influx of patients while trying to keep costs down.
There are 1.3 million uninsured residents in New Jersey, of which 900,000 are eligible under the federal plan.
With the impending influx of additional insured, five Mercer County healthcare executives recently gathered for a CEO Roundtable at Mercer County Community College.
The Sept. 24 Healthcare Symposium was organized by the Princeton Regional Chamber of Commerce.
The panel included Skip Cimino, president and CEO of Robert Wood Johnson Hamilton, Darlene Hanley, president and CEO of St. Lawrence Rehabilitation Center in Lawrence, Jerry Jablonowski, president and CEO of St. Francis Medical Center in Trenton, Al Maghazehe, president and CEO of Capital Health in Trenton and Barry Rabner, president and CEO of Princeton HealthCare System in Plainsboro.
Rabner said there are pressures on hospitals to reduce costs: pressure from employers, insurance companies and the federal government.
To that end, hospitals are striving to become more efficient.
At UMCPP, efficiency is often calculated by the number of salaried hours paid to treat a patient through his or her hospital discharge, Rabner said
One year ago, that number was 136 hours. As of September, that number was down to 98 hours.
Why the improvement? The hospital has changed its operations, increased productivity and eliminated some positions. In addition, the hospital adjusts its staffing levels during each shift based on its numbers of patients.
But there’s more work to be done, Rabner said, noting that one area for improvement has to do with insurance reimbursement.
Medicare and commercial insurance reimbursement is usually paid based on each unit of care: certain fees for medication, doctor’s visit, surgery, etc. As the units of care increase, so does the reimbursement.
Rabner believes the system should be overhaule so that hospitals are paid one lump sum to treat a patient’s condition, with penalties for those hospitals that have readmissions within 30 days of discharge. That would lead healthcare professionals to focus on outcomes, not endess treatments
“They’ll figure out how to be more efficient,” Rabner said.
Meanwhile 400,000 undocumented workers in New Jersey will be ineligible to sign up for Obamacare. In Mercer County, most of that population lives in Trenton, so local hospitals have already been addressing how to minimize the stress to local emergency rooms.
Capital Health in Trenton partners with the Trenton Health Team, working with the local population to use the walk-in clinic and helping connect patients to primary care doctors who can work on preventative care.
At St. Francis Medical Center in Trenton, the walk-in clinic is located directly next to the emergency room, to which patients can be easily redirected for non-emergencies. St. Francis also works with the Trenton Health Team.
At UMCPP, there were 21,000 free care visits last year at the The Bristol-Myers Squibb Community Health Center and free transportation for those who needed it, Rabner said. Most of clinic's users were undocumented immigrants, he said. And at in the emergency room, patients are evaluated through a triage process that determines the urgency of care needed.