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DIALOGUE
22
MAY / JUN 2014
I
Healthcare Journal of new orleans
are partnered with a number of other states
through the American Hospital Association
around key improvement areaswithinhospi-
tals andwehave seen real improvements in the
last couple of years.Weprobablyhaven’t done
a good job of taking credit for some of that.
We have strategies to try to continue doing
that what I call “feet on the street”work. This
is not just adopting policies; we actually
have staff that is out with hospitals work-
ing on specific things and improvements
and we’ve seen great results. Louisiana is
actually a leading state in the improvement
area around readmissions. You’ve heard the
state talk about early elective deliveries. We
are seeing great success in reducing read-
missions along with infection rates within
hospitals and those sorts of things. You will
probably see us tout those things a little bit
more in the future and take credit for some
of the savings that come along with those
improvements.
Editor:
How big of an operational impact will
ICD-10 have?
Paul Salles:
I don’t think anybody knows. It’s
interesting that CMS is just now testing some
of the new coding. I think there is a lot of
concern that folks aren’t ready. Some of the
testing is really just now commencing at the
federal level on some of this. It’s a huge train-
ing issue; it’s a huge potential impact to reim-
bursement, which is a bit of the unknown. I
think folks are trying to determine, based on
some of the testing, what kind of information
are they getting? What are the changes that
are being seen? I don’t know that we have
any real good information yet.
The one impact I would say is it is certainly
going to be an increased resource cost for
providers, not just hospitals, but physician
offices. A higher level of expertise is clearly
needed on some of this. So when we talk
about trying to reduce administrative costs
in healthcare, things like this don’t always
coincide with that. You are potentially going
to have more coders or higher level coders
to deal with some of the details of ICD-10.
Editor:
How does LHA measure its own
effectiveness?
Paul Salles:
We have specific goals that we set
with our boards and others around some of
the quality initiatives, around some of the
things that we try to do legislatively, and
from an advocacy perspective. We also cre-
ate goals around some education. We have
a whole education series around ICD-10, for
example. So trying to make sure our mem-
bers are prepared through some of the edu-
cation and outreach that we do on some of
those key issues is really what we focus on.
Editor:
How important is quality standardiza-
tion among hospitals?
Paul Salles:
With some of the quality initia-
tives that we are undertaking I think that is
key. In fact we just convened a new commit-
tee of the association around quality. That’s
something we hadn’t done historically, but
we have members that participate in our
quality committee and that’s one of the ini-
tial things that theymade reference to. There
are so many different measures, so many
different groups out there, measuring dif-
ferent ways; using different source informa-
tion to measure, that I am not sure anybody
really knows what the real best measure is
for something. You have hospitals that score
very well in one consumer group and they
are not even listed in another. It’s because
there are some inconsistencies in how those
measures are done. Actually in our initial
committee discussion that was really one
of the major issues that was discussed –can