Iowa Specialty Hospital

Making the Rounds

December 7, 2017

The Shell Game

As I write this I am at a conference for our Accountable Care Organization (ACO), Caravan Health.  This is the organization that helps our organization (and many other rural organizations) manage population health and navigate the constant changes that occur in the delivery of healthcare in our nation.  The rules and regulations that shape the way we are reimbursed for the services we provide are truly “mind-numbing”.  As medical director for the Iowa Cohort of our ACO, I have had the opportunity to meet physician leaders from across the country.  I am heartened that not only are we in Iowa providing excellent healthcare, that provision is in good hands all across the nation.  The rest of it (the financial part) is merely a shell game.  We don’t have to provide better healthcare, we just have to prove that we already do it.  As one speaker put “we have to show our work” just like we are in a chemistry or math class.  We can’t merely show the answer.  That is quality reporting in a nutshell.  Being in an ACO is beneficial to us because it helps us in the manipulation of the “shells” in the game.  

What’s enlightening to me is that for several years now we have been told that we are going to be judged on “quality”.  The initial take is that we must have to improve our quality or that it is lacking.  On this trip I’ve come to the conclusion that we are (and always have) been providing excellent quality healthcare and all we really have to do is “show our work” and that should be pretty easy for a bunch of “good students” like us.

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