Archived Publications 5 Reasons - An Interview with Sheryl Vacca | Page 4

3
Alternative Forms of Care Are Increasing
There is an entire field of alternatives in
providing care that is opening up, including
telehealth, non-acute environments, and beyond,
and Providence St. Joseph Heath is adjusting to
the changing arena. “We are very oriented to
delivery systems that are outside the hospital
walls because we are trying to bring the services
to the consumer where the consumer is,” Vacca
says. “One of our key priorities is to try to keep
individuals from seeking care in the ER or in the
hospital. We hope to be in the community so
that we’re easy to access, we’re affordable, and
we’re seeking preventative care options by
looking at the consumer’s overall health.”
Vacca explains that this perspective is a very big
shift for compliance professionals, especially
when one is trying to look at billing and coding as
one of the primary risk areas. She continues,
“Looking outside the hospital is such a new
delivery focus, that in some cases the billing and
coding, from the government perspective as a
payer, are not oriented to preventative care. As
a result, some things that we want to do we may
not receive funding for as we did in the past.”
Additionally, when care is moved outside of the
hospital, compliance demands change. Vacca
emphasizes that the priority becomes how the
services are being delivered. “First of all,
individual care still needs to be a primary focus
of what we’re doing, rather than doing what
works best for the mass consumer,” Vacca
explains. “We have to assure that what we’re
providing is something that maintains the quality.”
Secondly, Vacca points out that particular
patients need to be case-managed because of
their diagnosis, and ongoing and continual
monitoring keeps them out of the hospital. She
adds, “What this means is that we want to
assure that every one of those monitoring
mechanisms that we’re using is consistent and
utilized in a manner that is appropriate. Here we
have to pay particular attention to how we are
delivering those services—the settings we’re
delivering them in may be changing for an
organization, and that’s where we must check to
see if there is a regulatory requirement.”
“First of all, individual care still needs to be a primary focus of
what we’re doing, rather than doing what works best for the mass
consumer. We have to assure that what we’re providing is
something that maintains the quality.”
HealthStream.com/contact • 800.521.0574 •