Healthcare reform may have accelerated what is already one of the fastest growing medical specialties in the country: hospital medicine. The specialty appeared in the early 1990s, with the term "hospitalist" coined in a 1996 New England Journal of Medicine article. There are now up to 40,000 hospitalists practicing today, and many medical experts consider them to be perfect fits within accountable care organizations as they serve as the advocate for both the patient and the hospital. Here are six facets of accountable care organizations that can be particularly strengthened through hospitalists.
1. Readmissions and length of stay. One of the largest financial drivers of hospitalists is their ability to shorten length of stay without affecting quality. Hospitalists reduce the length of stay, on average, by slightly more than 16 percent, according to a study in the Journal of the American Medical Association. The Society of Hospital Medicine, for instance, developed Project BOOST — a nationally collaborative program for hospitals to improve care coordination for patients, identify patients at risk for readmission, follow-up with patients after discharge and mentor staff.
2. Hospital acquired infections. Hospitalists are considered leaders within the hospital when it comes to quality improvements and they are often the providers to perform initial patient history, exam and other admission work. Thus, hospitalists find themselves in the best position to document present-on-admission indicators and ensure the hospital is paid correctly. Through day-to-day contact with patients, hospitalists are heavily involved in documentation and can help hospitals maintain payments by properly noting whether a condition or infection was pre-existing.
3. Continuum of care. "Hospitalists position themselves to manage through the entire spectrum and episodes of illness," says R. Jeffrey Taylor, president and COO of IPC The Hospitalist Company. "That skill set and continuity of care will be crucial for ACOs." Along with their presence in the hospital setting, hospitalists are extending their care to other service lines as well, such as perioperative consultation, observation units and palliative care, according to Chad Whelan, MD, director of the division of hospital medicine at Loyola University Medical Center in Maywood, Ill. Also, Mr. Taylor says IPC The Hospitalist Company is extending its reach by involving hospitalists in skilled nursing or assisted living facilities. "Those patients still need care after they're discharged from the hospital. There's this whole episode of illness, and we're in a position to manage and move the patient through that entire spectrum of care."
4. Hospital-physician alignment. Roughly a third of hospitalists are employed by hospitals, leaving them more aligned with the hospital's vision, mission and culture. Also, physicians earn up to 40 percent less for time spent with a hospitalized patient than one in the office, according to a report in Health Affairs. Hospitalists do not face these conflicts of interests. "Hospitalists treat patients in the hospital. — and they are there everyday," says Mr. Taylor.
5. Patient experience. Early on, when hospitalist medicine was still gaining momentum, patients seemed to recognize a trade-off in receiving care from hospitalists compared to their primary care physician. That trend is now subsiding, according to Dr. Whelan. "Some studies have examined patient satisfaction and hospitalists, and there's not a major — or even minor — decrease in patient satisfaction or experience compared to non-hospitalists," says Dr. Whelan. A 2000 study in the American Journal of Medicine, for instance, revealed no difference in patient satisfaction when patients received care from hospitalists and primary care physicians.
6. Collaborative skill sets. ACOs have redirected the spotlight on teamwork within the healthcare industry, with concepts such as coordination, integration and accountability peppering nearly every ACO discussion. Since hospital medicine is still a growing field, many hospitalists are younger and offer unique skills and traits, such as finding enjoyment in working as a team, not becoming entrenched in a hospital hierarchy and finding work-life balance through regular hours.
Read more about hospitalists:
- 17 Statistics on Hospitalist Workload, Pay and Benefits
- Study: Hospitalists Reduce Hospitalization Costs by $1,400 Per Stay
- Aligning With Your Outsourced Hospitalists: A Ten-Point Road Map
1. Readmissions and length of stay. One of the largest financial drivers of hospitalists is their ability to shorten length of stay without affecting quality. Hospitalists reduce the length of stay, on average, by slightly more than 16 percent, according to a study in the Journal of the American Medical Association. The Society of Hospital Medicine, for instance, developed Project BOOST — a nationally collaborative program for hospitals to improve care coordination for patients, identify patients at risk for readmission, follow-up with patients after discharge and mentor staff.
2. Hospital acquired infections. Hospitalists are considered leaders within the hospital when it comes to quality improvements and they are often the providers to perform initial patient history, exam and other admission work. Thus, hospitalists find themselves in the best position to document present-on-admission indicators and ensure the hospital is paid correctly. Through day-to-day contact with patients, hospitalists are heavily involved in documentation and can help hospitals maintain payments by properly noting whether a condition or infection was pre-existing.
3. Continuum of care. "Hospitalists position themselves to manage through the entire spectrum and episodes of illness," says R. Jeffrey Taylor, president and COO of IPC The Hospitalist Company. "That skill set and continuity of care will be crucial for ACOs." Along with their presence in the hospital setting, hospitalists are extending their care to other service lines as well, such as perioperative consultation, observation units and palliative care, according to Chad Whelan, MD, director of the division of hospital medicine at Loyola University Medical Center in Maywood, Ill. Also, Mr. Taylor says IPC The Hospitalist Company is extending its reach by involving hospitalists in skilled nursing or assisted living facilities. "Those patients still need care after they're discharged from the hospital. There's this whole episode of illness, and we're in a position to manage and move the patient through that entire spectrum of care."
4. Hospital-physician alignment. Roughly a third of hospitalists are employed by hospitals, leaving them more aligned with the hospital's vision, mission and culture. Also, physicians earn up to 40 percent less for time spent with a hospitalized patient than one in the office, according to a report in Health Affairs. Hospitalists do not face these conflicts of interests. "Hospitalists treat patients in the hospital. — and they are there everyday," says Mr. Taylor.
5. Patient experience. Early on, when hospitalist medicine was still gaining momentum, patients seemed to recognize a trade-off in receiving care from hospitalists compared to their primary care physician. That trend is now subsiding, according to Dr. Whelan. "Some studies have examined patient satisfaction and hospitalists, and there's not a major — or even minor — decrease in patient satisfaction or experience compared to non-hospitalists," says Dr. Whelan. A 2000 study in the American Journal of Medicine, for instance, revealed no difference in patient satisfaction when patients received care from hospitalists and primary care physicians.
6. Collaborative skill sets. ACOs have redirected the spotlight on teamwork within the healthcare industry, with concepts such as coordination, integration and accountability peppering nearly every ACO discussion. Since hospital medicine is still a growing field, many hospitalists are younger and offer unique skills and traits, such as finding enjoyment in working as a team, not becoming entrenched in a hospital hierarchy and finding work-life balance through regular hours.
Read more about hospitalists:
- 17 Statistics on Hospitalist Workload, Pay and Benefits
- Study: Hospitalists Reduce Hospitalization Costs by $1,400 Per Stay
- Aligning With Your Outsourced Hospitalists: A Ten-Point Road Map