ACA Prompts Shift in Hospitals’ Approach to Chronic Disease Care

Payment reforms and new delivery models under the Affordable Care Act have shifted the way U.S. hospitals treat chronic conditions, changing the focus from reacting to conditions to determining ways to prevent them, the Philadelphia Inquirer reports.

Individuals with chronic diseases generally require more health care services, tend to have higher hospitalization rates and visit the emergency department more frequently. Rates of chronic disease also increase as individuals grow older, a point that is particularly relevant to Medicare.   

In the past, Medicare paid a set amount for each hospital admission, regardless of the length of stay or patient outcome. The program also picked up the cost for readmitted patients.

However, under the ACA, hospitals are rewarded or penalized based on their performance on 30-day readmissions, infection control and patient satisfaction levels.

As a result, hospitals have begun looking at ways to prevent such readmissions.

Jonathan Maner, senior vice president of Langhorne Physician Services at St. Mary Medical Center in Pennsylvania, said, "We're placing a greater emphasis on prevention and early detection," adding, "The cheapest way to manage diabetes is to never have it, to manage heart disease by monitoring blood pressure, weight and cholesterol, and teaching patients how to manage their conditions."

Results Still Up in the Air

Uwe Reinhardt, a professor of economics and public affairs at Princeton University, said while individual hospitals might experience improved care and cost reductions, it is still unclear whether this preventive care model for chronic diseases will save the U.S. health system money. He said, "The process doesn't work this quickly," adding, "We will probably need 10 years to determine its effectiveness" (Taylor, Philadelphia Inquirer, 7/7).