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By ANGELA CHILDERS, a freelance writer based in Chicago

With healthcare reform looming large, healthcare risk managers revealed in a recent survey that nonpayment of hospital-acquired conditions, the ability to better integrate risk management, quality and patient safety, and healthcare reform are their top three challenges for 2010.

Members cited "nonpayment for hospital-acquired conditions" as their top challenge for the coming year. Since the decision in October 2008 by the Centers for Medicare and Medicaid Services to expand the list of hospital-acquired conditions it would not compensate, risk managers have struggled with the new regulation, Wallace said.

The concerns risk managers shared about integrating risk management, quality and patient safety (the number two challenge identified in the survey) was striking, she added.

"I see that risk managers and quality are struggling with how they align themselves in the organization," she said. "We're seeing more efforts to try to coordinate those activities ... how to rally risk management and quality resources to improve patient care."

The respondents' fourth- and fifth-ranked concerns for 2010--"demonstration of risk management value" and "decline in risk management resources"--underscored the economic fears shared by the vast majority of the U.S. population.

"Risk managers, like all of us, are aware of the 10 percent unemployment rate out there and they're seeing cutbacks in their organizations," Wallace said. "And risk management departments are not revenue generating, like surgical service or cardiology."

But follow-up interviews that Wallace conducted with survey participants revealed several strategies that healthcare risk managers were using to demonstrate their value, including making themselves more visible, showing statistically the value of their positions and their affect on patient care, and using data to demonstrate savings through lower fall rates, a reduction in litigation and other metrics.

Roberta Carroll, senior vice president of the healthcare risk management consulting service Aon Healthcare, said that she was not surprised that the results of the survey were so economically driven in light of the fact that no one knows how healthcare reform is going to affect any organization. To add to the challenges, new mandates continue to shower down, pulling risk managers in many different directions.

"Whether or not a mandate is in their purview, risk managers have to make sure an organization is complying," she said. "As the economy changes, it's going to put a different complexity on it."

To download a complete copy of this survey, visit https://www.ecri.org/Press/Pages/Top_Risk_Management_Challenges_2010.aspx. (Registration required.)

December 15, 2009

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