Effect of Obamacare's impact on Hospitals
Written by Angie Mansfield
According to the U.S. Census Bureau, as of 2011 more than 260 million people were covered by insurance. Of those, 32% were covered by government-sponsored insurance such as Medicare or Medicaid.
If the Affordable Care Act works as promised, every U.S. citizen will have coverage, adding 46.5 million patients -- a major financial boost to the healthcare system.
But will the ACA work that way? Or will hospitals see the opposite -- reduced profits forcing them to compromise their care?
Readmissions Reduction Program
One of the more controversial points of the ACA, the Readmissions Reduction Program will be able to levy serious penalties on hospitals that readmit certain patients within 30 days of discharge.
This part of the bill raises many questions among hospital administrators. Because some readmissions are unavoidable (especially in cases of elderly and noncompliant patients), administrators question whether hospitals can really be held accountable for them.
Penalties can be levied against hospitals for patients readmitted for heart failure, myocardial infarction, pneumonia, and hip and knee replacements.
Opponents to this part of the bill point out that many factors leading to readmission -- including patients not following doctor recommendations for medication schedules and limited activity -- are largely out of the hospital's control.
The Obamacare plan seeks to reduce Medicare spending by $716 billion in 10 years (according to the nonpartisan Congressional Budget Office). That means reductions in reimbursement to hospitals, insurers, and the Medicare Advantage Program.
On the other hand, a pay-for-performance measure ties patient satisfaction to a possible break in those Medicare cuts. Under the program, hospitals give patients a questionnaire that assesses patient satisfaction along with hospital procedure metrics.
High-performing hospitals will receive a Medicare "bonus"; low-performing facilities will have to take the full reimbursement cut.
According to a 2010 survey of 2,400 physicians for the Physicians Foundation, 40% of respondents would retire, look for a non-clinical healthcare job, or find a job unrelated to healthcare within the next three years.
It's important to note that the survey was conducted during the height of national debate over Obamacare. But with the U.S. already feeling the pinch from a doctor shortage, any physicians pushed to leave their careers due to tenets of the law will cause even more pain.
The Association of American Medical Collegespredicts that by 2015 the country will need 60,000 more doctors than it's predicted to actually have. With 37 million more people becoming insured, that doctor shortage could cause bigger problems.
One thing those on both sides of the healthcare debate can agree on is that the face of healthcare in the country could undergo a serious change under the new law.
Whether that change is positive or negative remains to be seen in 2014 (when the bill officially goes into effect) and beyond.
About the Author
Freelance blogger Angie Mansfield covers a variety of subjects for small business owners. From business growth to marketing to Cecilia Ibru, her work will give you tips to keep your business running smoothly.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.