Changing News Archive - August, 2009

A new study is generating talk about the value of hospitalists and what they actually do for quality. Hospitalists, or hospital physicians dedicated to inpatient care, serve clinical positions, and oftentimes administrative, teaching, and leadership roles. Researchers at Massachusetts General Hospital, Brigham and Women's Hospital, and Harvard University in Boston found that hospitals with hospitalists performed better than hospitals without.

Chaplains and doctors have said requests - from both religious and nonreligious patients and families - are growing in part because hospitals are caring for sicker patients who are more often grappling with questions about aggressive care and death.

There is a growing belief that providing for spiritual needs increases patient and family satisfaction and may even provide medical benefits. Doctors and nurses are so busy, and chaplains can fill the void, gleaning information they pass on to the medical team.

ANN ARBOR, MI – Consumer confidence in their healthcare spending has grown 12 percent since March, according to a new report by Thomson Reuters.

Consumers were asked about their ability to pay for medical care and the likelihood they would postpone or cancel care during the next three months due to economic concerns.

HHS Secretary Kathleen Sebelius issued a new report, America's Seniors and Health Insurance Reform: Protecting Coverage and Strengthening Medicare. The report highlights the problems with the status quo that leave seniors paying escalating costs for their health care while outlining how health insurance reform will strengthen Medicare and protect coverage for seniors.

Need a colonoscopy? That'll be $1,354 at Olmsted Medical Center in Rochester -- or just $402 at Hennepin County Medical Center in Minneapolis.

For the first time in the nation, a Web tool is offering health care shoppers a glimpse into what insurance companies pay on average for 103 common medical procedures, Gov. Tim Pawlenty announced Wednesday.

The 110 providers included in the comparison tool provide about 85 percent of the primary care in Minnesota. More providers and procedures are expected to be added.

The tool was developed by MN Community Measurement, a collaborative of state health care providers that collected the data from insurance companies. The payment information supplements quality data already available on the collaborative's website, mnhealthscores.org.

Since he was elected in 1962, Sen. Edward Kennedy (D-MA), who died Tuesday, has been a tireless fighter for healthcare reforms. But with his passing, will the reforms he had long sought become reality without his leadership? Maybe—but the atmosphere of bipartisanship that he had promoted with earlier legislation will be likely frayed without his presence.

He introduced his first bill calling for universal health coverage in 1970. In 1980, healthcare reform became central to his presidential campaign—underscoring the idea that not just coverage but escalating health costs could impact family and national budgets. In 1993, he took up the cause again when President Clinton called for reforms to the healthcare system.

WASHINGTON (Reuters) - The chief executives of the biggest U.S. health insurance companies were called to testify about industry practices before a congressional hearing examining coverage, costs and claim denials.

U.S. Representative Dennis Kucinich sent letters dated Wednesday to Aetna Inc, Cigna Corp, Humana Inc, UnitedHealth Group Inc and WellPoint Inc, among others.

The Health Access and Health Professionals Supply Act of 2009, or SB 790, would increase the number of healthcare professionals, including nurses and nurse practitioners, in the rural parts of the country through financial assistance and incentives.

The bill would, among other things, provide grants to nursing schools enabling them to increase enrollment in their doctoral programs, create a U.S. Public Health Sciences track at certain higher-education institutions to train healthcare workers and assist rural hospitals in establishing community-based training for healthcare workers in underserved areas.

LONDON -- About half of Hong Kong's health workers would refuse the swine flu vaccine, new research says, a trend that experts say would likely apply worldwide. In a study that polled 2,255 Hong Kong health workers this year, researchers found even during the height of global swine flu panic in May, less than half were willing to get vaccinated.

Most said they would pass on the swine flu shot, which is not yet available, because they were afraid of side effects and doubted how safe and effective it would be.

J. James Rohack, MD, is the 164th president of the American Medical Association, but he is the first one to have his own blog.

"It won't be like, 'Today, I woke up and had oatmeal,'" jokes the senior staff cardiologist at Scott & White Clinic in Temple, TX. Rather, since his job entails spending 200 days a year traveling and hearing voices from the House of Medicine expressing concern about how the system does and doesn't work, he decided it is important to share what he hears with those who care.

And this social media venue seemed worth a try. "It's something we [at the AMA] have been talking about for awhile. Of course, each president has a different comfort level with e-mail.  What we wanted was something that would allow a different form of communication."

Despite the positive news from a Thomson Reuters study last week, which found that hospital margins had rebounded in the first quarter of 2009, the troubles of the last 12 months may not be behind anyone just yet. Moody's Investors Service for one, doesn't hold out much hope for a strong financial performance for either the for-profit or the nonprofit hospital sectors in the coming months given that the business climate is likely to remain weak. In a report released last week from the credit rating agency, Moody's analysts say the outlook for both the for-profit and nonprofit hospital sectors is expected to remain negative over the next 12 to 18 months.

After a medical error, hospitals’ traditional approach has been to retreat behind a wall of silence, on the advice of risk managers and attorneys. But some hospitals are taking a different approach, fully disclosing medical errors, apologizing and offering financial compensation up front – and inviting patients and families to participate in patient safety improvement efforts.

If the political world has a cliché as tired as marketing's "Nothing kills a bad product like good advertising," it's probably the somewhat related "Governing is not the same as campaigning."

Barack Obama and his team of political operatives -- named Marketer of the Year in 2008 -- have learned that even tired clichés have large elements of truth.

The healthcare reform ad wars continue to heat up, with the estimated total spending for the past six months hitting $57 million.

In my last two columns I wrote about both the pro-reform campaigns (Pro-Healthcare Reform Ads Suffering an 'Identical Crisis') and the anti-reform campaigns (Scare Tactics the Standard for Anti-Healthcare Reform Ads).

I thought the anti-reform ads were dramatic and attention-grabbing, but also filled with half truths, outright lies, and scare tactics. (For example, one online ad claimed that in Massachusetts, if you don't have the right healthcare insurance, you could go to jail.)

WASHINGTON-- President Barack Obama continued to confront critics of his health-care overhaul proposal in his Saturday radio and Internet address, charging them with making "phony claims meant to divide us."

Mr. Obama appealed to Americans to summon "what's best in each of us to make life better for all of us," and support the plan, which Republicans in their response called a "government takeover" of the U.S. health-care system.

WASHINGTON — Senate Democrats said Sunday that they were fleshing out plans to pass health legislation, particularly the option of a new government-run insurance program, with a simple majority, instead of the 60 votes that would ordinarily be needed to overcome a filibuster.

SUNRISE, Fla. — It was karaoke night at the Sunrise Lakes retirement village, and 76-year-old Shirley Scrop, wearing a T-shirt commemorating her granddaughter’s bat mitzvah, was laying down a rap about health care.

“I walk in the morning and I swim in the pool, I go to the doctor because I’m no fool,” she chanted, swaying like Ray Charles in a tennis skirt. “At the doctor’s office, I don’t want to stay, but I sit and I sit and I sit all day.”

But truth be told, Ms. Scrop admitted after taking her bow, she would not change a thing about her health care. Only two months ago, she had surgery to remove a breast tumor, and Medicare and her supplemental policy covered the cost, while allowing her a broad choice of physicians.

Patients who leave the hospital against medical advice (AMA) may be at increased risk for adverse health outcomes.1 Also, patients who leave AMA have significantly higher readmission rates compared to other patients.1 Patients may leave the hospital for various reasons, including financial considerations and stresses, family emergencies, self-assessment of their health status, or dissatisfaction with their treatment.1

Understanding the characteristics of hospital stays that result in patients leaving AMA is critical to designing strategies to prevent premature hospital departures that could result in adverse health outcomes.

WASHINGTON (Reuters) - The U.S. government on Thursday announced grants of almost $1.2 billion to help hospitals and healthcare providers implement and use electronic health records.

The Obama administration has made the overhaul of the $2.5 trillion U.S. healthcare system the centerpiece of its domestic agenda, including the use of technology to improve efficiency and cut costs.

New regulations requiring health care providers, health plans, and other entities covered by the Health Insurance Portability and Accountability Act (HIPAA) to notify individuals when their health information is breached were issued today by the U.S. Department of Health and Human Services (HHS).

These “breach notification” regulations implement provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of American Recovery and Reinvestment Act of 2009 (ARRA).

WASHINGTON (Reuters) - The recession appears to be easing for U.S. hospitals, although close to a third of hospitals remain in the red, according to a study published on Wednesday.

The median profit margin of U.S. hospitals rose from 0.17 percent in the third quarter of 2008 to 3.1 percent in the first quarter of 2009, the analysis from Thomson Reuters found.

Demonstrations being conducted by the Centers for Medicare & Medicaid Services (CMS) continue to provide strong evidence that offering financial incentives for improving for delivering high quality care increases quality and can reduce the growth in Medicare expenditures.

WASHINGTON (Reuters) - Lawmakers debating an overhaul of the U.S. healthcare system are focusing on proposals that would form healthcare cooperatives to help provide medical coverage.

The co-op idea gained currency this week after statements from senior White House officials that the Obama administration might be willing to drop its insistence on a government-run health insurance option in favor of nonprofit co-ops.

The CMS said all 10 doctor groups that participated in the Physician Group Practice Demonstration achieved benchmark performance on 28 of the 32 measures in its third year. The CMS will pay $25.3 million in incentive payments to five physician groups that helped generate $32.3 million in savings overall.

The agency also said 560 of 610 participating small and solo physician practices are being rewarded for performance on 26 quality measures under the new, health information technology-based Medicare Care Management Performance demonstration. Under that demonstration, which tracks the quality of preventive care and care given to the chronically ill, the agency will dole out $7.5 million in bonus dollars to groups in Arkansas, California, Massachusetts and Utah.

Buying equipment and training nurses for safe patient handling costs money. But done well, such efforts can save cash through reduced sick days and workers' compensation claims.

With this in mind, it behooves CEOs to keep an eye on the regulatory horizon, because several developments point to safe patient handling becoming an increasing focus of regulators.

HHS Deputy Secretary Bill Corr today announced the release of $13.4 million for loan repayments to nurses who agree to practice in facilities with critical shortages and for schools of nursing to provide loans to students who will become nurse faculty.  The funds were made available by the American Recovery and Reinvestment Act (ARRA), signed Feb. 17, 2009, by President Obama.

The battle for public opinion on a health care overhaul appears to be at a stalemate - even as conservative activists swarm congressional town halls to register their opposition and as the White House steps up its sales pitch.
A Gallup Poll released yesterday found that support for President Obama’s handling of the issue has stayed status quo over the past three weeks during the protests. In a poll conducted Aug. 6-9, 49 percent of Americans said they disapproved of the president’s handling of health care and 43 percent approved - compared to 50 percent disapproval and 44 percent approval in a survey done July 17-19.

In a new report, “Coverage Denied: How the Current Health Insurance System Leaves Millions Behind,” the U.S. Department of Health and Human Services examines the insurance company practice of denying coverage to or discriminating against Americans who have pre-existing medical conditions. A recent national survey found that 12.6 million non-elderly adults -- 36 percent of those who tried to buy insurance on the private market -- were discriminated against in the past three years because an insurance company deemed them ineligible for coverage because of a pre-existing condition, charged them a higher premium, or refused to cover their condition. Another survey found 1 in 10 people with cancer said they could not get health coverage, and 6 percent said they lost their coverage because of their diagnosis.

PORTSMOUTH, N.H., Aug. 11 -- President Obama began a personal effort Tuesday to reclaim momentum for his health-care initiative with a direct rebuttal of what he called "scare tactics," rumors and misrepresentations.

The consumer activist group Public Citizen says it has 10 basic patient safety reforms that could save 85,000 lives and $35 billion annually.

The report "Back to Basics," analyzes the results of several studies of treatment protocols for chronically recurring, avoidable medical errors. Most of the reforms in Public Citizen's report involve fundamentals as simple as practitioners consistently washing their hands, sufficiently tending to patients to prevent bed sores, and following simple safety checklists to prevent infections and complications stemming from operations.

WASHINGTON (Reuters) - President Barack Obama delivered a pep talk to a bipartisan group of senators negotiating a healthcare overhaul on Thursday as the U.S. Senate headed on vacation without a deal on his top domestic priority.

At the Capitol, Obama adviser David Axelrod also coached Senate Democrats on how to deal with angry opponents of the healthcare proposals during a monthlong August congressional recess that has both sides gearing up for a public relations battle.

Senate negotiators are inching toward bipartisan agreement on a health-care plan that seeks middle ground on some of the thorniest issues facing Congress, offering the fragile outlines of a legislative consensus even as the political battle over reform intensifies outside Washington.

Senate Finance Committee negotiators fashioned a legislative provision that would effectively replace the Medicare Payment Advisory Commission, or MedPAC, with a new panel that would have expanded say over payment decisions with limited involvement from Congress.

Under a proposal discussed among a bipartisan team of senators, recommendations made by the so-called Medicare Preservation Commission would be implemented unless Congress actively moves to overturn them.

Roughly one in four children and adults under age 65 in all income brackets had no health insurance of any kind in Texas, New York, Louisiana, and Florida. And roughly one in five had no coverage in Alaska, Arizona, Arkansas, California, Colorado, Georgia, Mississippi, Nevada, and Oregon.

Heads up, healthcare providers: Connolly Healthcare, the RAC for Region C, has posted the first set of issues eligible for RAC review on its Web site.

The issues are approved for outpatient hospital and physician providers in South Carolina. But even if you aren't located in South Carolina, if Connolly is your RAC, prepare for these issues in your state as well, says Nancy Beckley, MS, MBA, CHC, of the Bloomingdale Consulting Group, Inc.

The CMS has reversed course on its plans to lower payments for acute-care hospitals, giving them instead a 2.1% increase in their reimbursement rates rather than a 1.9% reduction for fiscal 2010.

In a proposed rule released earlier this year, the CMS said it would take into account so-called “upcoding” that is likely to occur as hospitals transitioned from one coding system to a newer one, known as the Medicare severity diagnosis-related groups, or MS-DRGs.