Maimonides Medical Center Grapples With Health Care
Giant aquariums now soothe pediatric patients at Maimonides Medical Center in Brooklyn. It has added welcome signs in 10 languages, a state-of-the-art cardiac operating room and programs to keep chronically ill adults safely at home.
But as Pamela S. Brier, the chief executive, was walking to the main entrance last week, she spotted a rain-soaked plastic bag on the front steps.
Millions of dollars in revenue now depend on improving patients’ perceptions of the hospital. “I can’t stand it,” Ms. Brier muttered, and she darted over, her cream chiffon dress fluttering, to scoop up the litter herself.
It was the first Monday in June, counting down to a United States Supreme Court decision that could transform the landscape of American health care. But like hospitals across the country, Maimonides is not waiting around for the verdict.
Win, lose or draw in court, administrators said, the policies driving the federal health care law are already embedded in big cuts and new payment formulas that hospitals ignore at their peril. And even if the law is repealed after the next election, the economic pressure to care differently for more people at lower cost is irreversible.
“If the Supreme Court overturns this law - I pray it won’t - the world will go on changing,” Ms. Brier said. “In some ways, we’ve changed ahead of it.” But she added, “Trying to manage all these different aspects of the health care system as they are changing does make you crazy.”
The century-old hospital, at the Borough Park crossroads of Hasidic, Asian, Caribbean and Hispanic neighborhoods, is often cited by state regulators as an example of good management and community service.
It has been in the black since 1996, after Ms. Brier took charge of operations, and has increased patient volume every year while achieving some of the nation’s best clinical outcomes, including exceptionally low mortality rates for pneumonia, heart failure and heart attacks.
Yet even in a city with notoriously cranky consumers and cramped spaces, Maimonides’s patient satisfaction scores are abysmal - especially in its maternity units, which deliver 8,000 babies a year.
And starting next year, under “value-based purchasing” contracts mandated by the health care law and already entrenched in Medicaid and Medicare rules, failure to improve the satisfaction of surveyed patients will cost hospitals.
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