Changing News Archive - March, 2010

ANN ARBOR, MI – Thomson Reuters has released its annual study identifying the 100 top U.S. hospitals based on overall organizational performance. The study reveals that even in tough economic times, top hospitals show a profit while raising the bar on patient care.

The "Thomson Reuters 100 Top Hospital: National Benchmarks" study, released Monday, evaluates performance in 10 areas: mortality, medical complications, patient safety, average length of stay, expenses, profitability, patient satisfaction, adherence to clinical standards of care and post-discharge mortality and readmission rates for acute myocardial infarction, heart failure and pneumonia. The study has been conducted annually since 1993.

Senate Republicans have successfully identified two minor violations of reconciliation rules in the final piece of the health-care package. The violations will force the Senate to change the reconciliation bill and ship it to the House of Representatives for final passage.

But Democratic leaders said the provisions that will be struck -- from the part of the bill dealing with Pell Grants for college students -- do not significantly affect the student loan program or the health-care bill overall.

The corrected legislation most likely will not be subjected to additional challenges when it is sent back to the House, Democratic staffers said, and is expected to receive final approval before the weekend.

ARLINGTON, VA – The American Association for Homecare says provisions in the new health reform law will harm homecare patients and providers.

According to AAH officials, the provisions aimed at the home medical equipment sector could reduce the ability to provide the level of services that homecare patients and physicians expect in Medicare.

"Unfortunately, this health reform bill contains several provisions that will hurt homecare providers and patients," said AAH President Tyler J. Wilson. "We will continue to work with Congress in the weeks and months ahead to correct these problems."

NEW YORK – Women aged 55 and older are projected to make up 30 percent of the nation's direct-care workforce by 2018 – up from 22 percent 10 years ago, according to PHI's recent analysis of employment demographics for direct-care workers.

By 2018, there will be 1.2 million nursing home assistants, home health aides and personal and home care aides (known as direct-care workers) over 55, according to Dorie Seavey, PhD, director of policy research at PHI.

President Obama signed a landmark health-care bill into law Tuesday, enacting a sweeping overhaul of the nation's $2.5 trillion health system after a year-long effort that he said shows the United States "faces its challenges and accepts its responsibilities."

"The bill I am signing will set in motion reforms that generations of Americans have fought for and marched for and hungered to see," Obama said before putting his signature on the legislation. While he said it would take four years to fully implement some of the law's provisions, he highlighted measures that take effect this year.

WASHINGTON -- U.S. health officials told pediatricians Monday to temporarily quit using one of two vaccines against a leading cause of diarrhea in babies, after discovering that doses of GlaxoSmithKline's Rotarix were contaminated with bits of an apparently benign pig virus.

Glaxo's vaccine has been used in millions of children worldwide, including 1 million in the U.S., with no signs of safety problems - and the pig virus isn't known to cause any kind of illness in people or animals, said Dr. Margaret Hamburg, commissioner of the Food and Drug Administration.

But vaccines are supposed to be sterile, and because there is a competing vaccine against diarrhea-causing rotavirus that has tested clean - Merck's RotaTeq - the FDA decided to err on the side of caution.

By any account, 2009 was a watershed year in which politics, the economy, public sentiment and the media all played a significant role in framing a new environment for health care over the next decade. With tumultuous challenge to the first significant overhaul of our nation’s health care system since the introduction of Medicare in the mid-1960s, health systems are still trying to determine the likely impact of payment reform initiatives on health system strategy. Here is a round-up of the most significant market forces that will shape strategic discussions over the next year, and most likely for the foreseeable future.

PRINCETON, NJ – Without significant reform to the healthcare system, the number of uninsured Americans could grow by 10 million in five years, according to the Robert Wood Johnson Foundation.

A RWJF report projects that by 2015, there could be as many as 59.7 million people uninsured, and that number could swell to 67.6 million by 2020. An estimated 49.4 million individuals were without health coverage in 2010. The report also shows that spending on government healthcare programs for the poor could more than double by 2020.

STRONGSVILLE, Ohio -- With a decisive vote on his health-care overhaul possible within days, President Obama declared repeatedly Monday that "we need courage" from elected leaders to pass the far-reaching package, as he made an impassioned pitch in northeastern Ohio, where unemployment runs high and insurance coverage is never a certainty.

"I don't know about the politics, but I know what's the right thing to do," Obama said in a speech at a senior center here, nearly shouting as the crowd cheered. "And so I'm calling on Congress to pass these reforms -- and I'm going to sign them into law. I want some courage. I want us to do the right thing, Ohio. And with your help, we're going to make it happen."

SAN FRANCISCO – Episode payments – case rates for major acute interventions and chronic conditions – are the best approach for payment reform, according to a University of California economist.

“We can’t, as a country, bend the cost curve if we don’t go to where the dollars are,” said James Robinson, Kaiser Permanente Professor of Health Economics at UC Berkeley’s School of Public Health. Robinson was the closing keynote speaker at the 5th National Pay for Performance Summit last week.

The healthcare industry needs to better manage the cost of cancer drugs, implantable devices and imaging, which is where most of the cost increases can be found, Robinson said.

WASHINGTON – The Senate voted on Wednesday to delay a 21 percent Medicare physician pay cut until Oct. 1. If the House joins the Senate in passing the measure, this will be the third time Congress has postponed the cut that was mandated to take place Jan. 1, 2010.

J. James Rohack, MD, president of the American Medical Association said the Senate's action delays solving the problem.

WASHINGTON – Health and Human Services Secretary Kathleen Sebelius has asked the CEOs of top health insurance companies to justify proposed health insurance premium hikes.

In a letter addressed to executives at the UnitedHealth Group, WellPoint, Aetna, the Healthcare Service Corporation and CIGNA HealthCare – with whom she met last week at the White House – she wrote, "...it’s time for these insurance company CEOs to do their part to make the system more transparent for the American people. If insurance companies are going to raise rates, the least they can do is tell us why.”

Renewing a populist attack on big insurers, Obama accused the companies of making a calculation with a strategy of increasing premium charges. He said the companies were aware that many people would be priced out of the market by the increases, but they believe they could make more money by raising premiums on existing customers.

Obama and other administration officials have sought to draw a link between the insurers and another political foil -- big Wall Street companies -- by emphasizing their profit-hungry culture.

ENGLEWOOD, CO – The changes in practice operations necessary to meet the 25 “meaningful use” criteria proposed as part of the federal electronic health record (EHR) incentive program would lead to decreased provider productivity, according to research conducted by the Medical Group Management Association.

Respondents to MGMA’s questionnaire were asked to estimate the change in provider productivity resulting from the implementation of all 25 of the meaningful use criteria, not including the temporary decrease in productivity that occurs with any implementation of a new EHR. More than two-thirds of respondents (67.9 percent) said that physician productivity would decrease, with 31 percent stating that physician productivity would decrease more than 10 percent.