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COUNTERING FINANCIAL THREATS TO ACADEMIC DEPARTMENTS OF NEUROLOGY TIMOTHY A. PEDLEY, MD The Neurological Institute of New York Columbia University Medical.

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Presentation on theme: "COUNTERING FINANCIAL THREATS TO ACADEMIC DEPARTMENTS OF NEUROLOGY TIMOTHY A. PEDLEY, MD The Neurological Institute of New York Columbia University Medical."— Presentation transcript:

1 COUNTERING FINANCIAL THREATS TO ACADEMIC DEPARTMENTS OF NEUROLOGY TIMOTHY A. PEDLEY, MD The Neurological Institute of New York Columbia University Medical Center and President American Academy of Neurology Association of University Professors of Neurology October 12, 2013 New Orleans, LA

2 FINANCIAL THREATS TO ACADEMIC DEPARTMENTS OF NEUROLOGY – CONSIDERATION OF POSSIBLE SOLUTIONS I. Maximizing patient-related revenues Patient issues Physician issues Billing issues Institutional support Ancillary services II. Graduate Medical education III.Research Funding IV.Case studies

3 THE ALPHABET SOUP OF HEALTHCARE PAYMENT AND REGULATION - 1 AAPCCAdjusted Average Per Capita Cost ADUAccessory Dwelling Unit ALJAdministrative Law Judge AWVAnnual Wellness Visit ACOAccountable Care Organization AHRQAgency for Healthcare Research and Quality APCAmbulatory Payment Classification APRNAdvanced Practice Registered Nurse ASCAmbulatory Surgical Center CCCMComplex Chronic Care Management Services CG-CAHPSClinician and Group Consumer Assessment of Healthcare Providers and Systems CMSCenter for Medicare and Medicaid Services CPCComprehensive Primary Care CYCalendar Year DSHDisproportionate Share Hospital EPEligible Professional GPROGroup Practice Reporting Option

4 THE ALPHABET SOUP OF HEALTHCARE PAYMENT AND REGULATION - 2 HCAHPSHospital Consumer Assessment of Healthcare Providers and Systems IVRInteractive Voice Recognition system MEIMedicare Economic Index MPFSMedicare Physician Fee Schedule MSSPMedicare Shared Savings Program NQFNational Quality Forum OIGOffice of the Inspector General OPPSOutpatient Prospective Payment System PAPhysician Assistant PCMHPatient-Centered Medical Home PCORPatient-Centered Outcomes Research PCORIPatient-Centered Outcomes Research Institute PEPractice Expense PPAPAPatient Protection and Affordable Care Act PQRSPhysician Quality Reporting System QRURsQuality Resource and Use Reports

5 THE ALPHABET SOUP OF HEALTHCARE PAYMENT AND REGULATION - 3 RUCRelative Value Update Committee RVURelative Value Units TAPTechnical Advisory Panel VBPMValue-based Payment Modifier

6 PER CAPITA HEALTHCARE COSTS FOR WESTERN INDUSTRIALIZED NATIONS Source: OECD Health Data - 2010

7 GROWTH IN MEDICARE AND MEDICAID SPENDING IN RELATION TO TOTAL NATIONAL HEALTH CARE EXPENDITURES 1980 - 2011 Source: OECD Health Data - June 2010

8 FEDERAL SPENDING FOR ALL HEALTH PROGRAMS AS PERCENTAGE OF TOTAL FEDERAL EXPENDITURES 1980 - 2011 Source: White House Office of Management and Budget - 2014

9 Source: GAO Citizen’s Guide 2007

10 CURRENT COSTS ARE UNSUSTAINABLE SOURCE: 2010 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. Number of Beneficiaries (in millions)Number of Workers Per Beneficiary

11 WE CAN’T COMPETE GLOBALLY Source: OECD Health Data 2011

12 HEALTHCARE SPENDING PER CAPITA VS. GDP PER CAPITA Source: Henry J. Kaiser Foundation - 2008

13 PER CAPITA COSTS AND 30-DAY HOSPITAL READMISSIONS Source: Dartmouth Atlas – “Report on US Hospital Readmissions” - 2013

14 AUSCANGERNETHNZUKUS OVERALL RANKING (2010)3641527 Quality Care4752136 Effective Care 2763514 Safe Care 6531427 Coordinated Care 4572136 Patient-Centered Care 2536174 Access6.553142 Cost-Related Problem 63.5 2517 Timeliness of Care 6721345 Efficiency2653417 Equity4531627 Long, Healthy, Productive Lives1234567 Health Expenditures/Capita, 2007 $3,357$3,895$3,5883,874$2,454$2,9927,290 OUTCOMES ARE POOR

15 QUALITY INDICATORS IN SELECTED INDUSTRIALIZED COUNTRIES Commonwealth Fund-2012

16 www.AAN.com


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