In my 35 year career in healthcare, I always thought of healthcare as a crossword puzzle, albeit, a crossword puzzle with an ever changing set of rules. Nonetheless, with a little ingenuity one could successfully solve the puzzle. For instance, early on, the rule changes were often due to medical advances; a new more powerful antibiotic or perhaps a new medical technique. To correctly solve the puzzle one just needed the correct new word to substitute for the old one that no longer solved the puzzle.........think laproscopic surgery or cephalosporins! (What a simpler time!) Things became slightly more complicated, but winnable, as the next set of changes involved new parameters......think of the birth of the medical malpractice field. “Defensive medicine” became the buzzword. Paperwork increased as did the number of medical tests ordered. Still, the puzzle could be solved once a new vocabulary was learned and implemented. This was followed by further modifications aimed at the financing of healthcare to control sky-rocketing medical costs. Revisions like a new improved modifier to a CPT code (or so “they” claimed) or increasing documentation to substantiate a patient’s observation status. Okay, no problem, still with a little enterprising cleverness, just some new words could be found to substitute for the old ones that didn’t work anymore...viola, puzzle solved!
Well, my friends, in this era of Healthcare Reform, the rules to the crossword puzzle are not changing. Yes, you read that correctly. The rules to the healthcare crossword puzzle are not changing because the rules have yet to be determined! In the Affordable Care Act there are greater than 1000 directives yet to be determined by the Secretary of the Dept. of Health and Human Services........1,145 to be exact! So, as we undergo healthcare reform, think about a totally new language to solve the puzzle of health care transformation, whereby the payment model will move from “paying for quantity” (fee-for-service) to “paying for quality” (value-based purchasing). The old tried and true ways of adapting and successfully solving the crossword puzzle will simply not work. Think about learning and adapting an entirely new language that will be needed to solve the puzzle. As the 1000+ regulations are created, the new language will reveal itself and this blog will serve as a forum to help successfully solve the Healthcare Crossword Puzzle.
