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Premier: Providers Projecting Significant Inpatient to Outpatient Admission Shift in 2013

April 29, 2013
by Rajiv Leventhal
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Hospitals and health systems nationwide are projecting a significant shift in 2013 admissions from inpatient to outpatient settings as they transition toward new care delivery models, according to Charlotte, N.C.-based Premier healthcare alliance’s spring 2013 Economic Outlook.

Only 35 percent of 530 survey respondents—primarily hospital C-suite, and materials and practice area managers—are projecting an increase in inpatient volume in 2013 compared to 2012, a 30 percent decrease from predictions a year ago. Respondents projecting a decrease in inpatient volume in 2013 compared to 2012 rose 28 percent over the same period.

Accordingly, 69 percent of respondents are projecting an increase in 2013 outpatient volume compared to 2012.

This trend is likely being driven by healthcare legislation and mandates, cited by a third of respondents as the biggest driver of healthcare costs.

“With reimbursement cuts and changes in care delivery threatening today’s status quo, healthcare providers face a significant change imperative as they transition toward more accountable, value-based care models,”  Premier Chief Operating Officer Mike Alkire said in a statement. “Ensuring patients are cared for in the most efficient manner—without compromising quality—is key to success. This means more care is being shifted to less intensive and expensive outpatient care sites, with lower reimbursement rates.”

Additionally in the report, when asked where the largest capital investment is expected to be made over the next year, almost 43 percent of respondents cited healthcare information technology/telecommunications, up 21 percent from two years ago.

Still, 32 percent reported being unable to share data across the continuum of care, which is essential for effective care coordination.

“We need to know everything we can about a patient’s care – what has gone on before and what’s coming up,” said Eric Bieber, M.D., chief medical officer, University Hospitals (Cleveland), said in a statement released by Premier. “Otherwise, we have variation and redundancies that may degrade care quality and efficiency. The closer we can get to real-time information and get it in the hands of providers, the more likely the right things will be done and opportunities won’t be missed.”

Premier’s Outlook also reported that almost 22 percent of respondents are in an accountable care organization (ACO), with 55 percent planning to be by the end of 2014. Nearly 27 percent currently do not have plans to pursue the ACO model, and may choose other forms of clinical integration such as bundled payment, care management fees or pay-for-performance.

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