Changing News Archive - August, 2010

WASHINGTON – Health and Human Services Secretary Kathleen Sebelius has announced the expansion of the Centers for Medicare & Medicaid Services’ Rural Community Hospital demonstration program.

Made possible through the Affordable Care Act, up to 20 small rural hospitals in selected states will be eligible for enhanced reimbursement for inpatient services, in addition to the 10 hospitals already participating in the program.

“Improving healthcare for rural Americans is a top priority in the Affordable Care Act,” said Sebelius. “One in five Americans lives in a rural area and small community hospitals are often their only source of care. This demonstration project and other important investments in hospitals, infrastructure and the healthcare workforce will help ensure that Americans living in rural communities can get the quality health services they need.”

LOUISVILLE, KY – Kindred Healthcare, one of the nation's leading long-term care hospital companies, is acquiring five acute care hospitals in California and three nursing homes in Texas in two separate deals totaling $218 million.

The Louisville, Ky.-based company has signed a definitive agreement to acquire five acute care hospitals in California from Vista Healthcare, LLC in a $180 million cash transaction.

The deal with Vista, which is based in Rancho Cucamonga, Calif., involves four free-standing, long-term care hospitals and one hospital-in-hospital with a total of 250 beds, all located in southern California. The assets being acquired currently generate annualized revenues of approximately $150 million.

In a separate deal, Kindred subsidiaries have signed a definitive agreement to acquire three recently constructed nursing and rehabilitation centers in the Dallas-Fort Worth market for $38 million in cash.

NEW ORLEANS – One of the nation’s largest healthcare IT companies has pledged $2 million to help develop school-based healthcare centers in rural Louisiana.

The GE Foundation, the philanthropic arm of GE, announced the grant Tuesday to the Louisiana Public Health Institute, which will use the money to underwrite a program led by the School Health Connection in Orleans Parish, La., to launch school-based health centers

Five years after Hurricane Katrina, Orleans Parish is still working to stabilize access to healthcare for its residents and 38,000 students. LPHI officials say the grant, combined with other investments, will go toward health centers that provide comprehensive preventive, primary care and primary mental health services for enrolled school students.

NEW YORK – The U.S. Department of Treasury's Community Development Financial Institutions Fund has awarded $750,000 to the Primary Care Development Corporation to expand primary care capacity in New York state.

The funding is expected to help health centers that are looking to expand services and facilities, yet face challenges in obtaining commercial financing – a problem that has worsened in the current credit crisis.

"Under the new federal health reform law, more than one million New Yorkers are projected to gain health insurance and they will expect good, affordable healthcare. But if we don't have enough primary care in our communities, we could all face higher costs and less access," said Ronda Kotelchuck, the PCDC's executive director. "The healthcare reform law sets a bold course for expanding primary care, including doubling the number of patients served by health centers."

Nurses in Duluth voted overwhelmingly to reject a new labor contract, setting the stage for a 24-hour strike.

More than 90 percent of nurses who voted from St. Mary's Medical Center and SMDC Medical Center, and more than 86 percent of those from St. Luke's Hospital voted to reject the contract offer primarily because it did not include language that would allow them to close a unit to new admissions if they felt overwhelmed.

"The hospitals left us with no choice," said Steve Strand, a registered nurse at SMDC Medical Center. "We can't handle another three years of one nurse taking care of eight, nine or even 12 patients at once. Neither can our patients. How many more patients have to sit in their own stool because nobody can answer their call light?"

The Minnesota Nurses Association had recommended that the 1,320 nurses who work for the three hospitals in Duluth reject the contract.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today released an examination of the federal government’s system to produce medications, vaccines, equipment and supplies needed for a health emergency, known as medical countermeasures. The Public Health Emergency Medical Countermeasure Enterprise Review: Transforming the Enterprise to Meet Long Range National Needs reviews the process and makes recommendations for a better approach.

Even before Congress in March passed the landmark law designed to make health care more affordable and expand coverage, an aging population and doctors' increasing preference for higher-paying specialties set the stage for a primary care shortage. And what many believe to be an outdated reimbursement system — one that drives doctors to schedule office visits when a quick phone call or e-mail might do — doesn't help.

The shortage of primary care doctors could lead to longer waits not only for primary care, but also for specialty care as well as greater use of expensive emergency rooms for non-emergencies, researcher Walt Zywiak of Computer Sciences Corp., an international consulting company headquartered in Falls Church, Va., noted in a July report.

But some innovative programs provide a glimpse of what the future of primary care — a future in which a one-on-one visit at the doctor's office takes a back seat — could look like.

Four Massachusetts community hospitals are investigating how thousands of patient health records, some containing Social Security numbers and sensitive medical diagnoses, ended up in a pile at a public dump.

The unshredded records included pathology reports with patients’ names, addresses, and results of breast, bone, and skin cancer tests, as well as the results of lab work following miscarriages.

A Globe photographer discovered the records July 26 when he was dumping his trash at the Georgetown Transfer Station. When he got out of his car, he said, he saw a huge pile of paper about 20 feet wide by 20 feet long. Upset that the paper wasn’t being recycled, he looked more closely.

"Our medical system in this country is focused on illness. What we are doing is helping people when they're sick," said Jennifer Bennet, executive director of the Family Van, which is backed by Harvard Medical School.

"It would be a lot less expensive and people's quality of life would be vastly improved if we as a society and as a country start to look at addressing these problems long before they get to that acute stage."

The United States spends some $2.5 trillion on health care each year. That works out to about 15 percent of gross domestic product, considerably higher than any other developed economy, according to a Kaiser Family Foundation analysis.

Across Texas, hospital systems are scooping up physician groups and solo practitioners, scrambling to create the kinds of coordinated medical teams that federal health care reform puts a premium on.

The sweeping health care reform bill signed this spring offers hospitals and doctors incentives, in the form of funding and pilot programs, to change their payment models from the traditional and costly fee-for-service system to one that rewards efficiency and savings. One of these models is the Accountable Care Organization, or ACO, a touted partnership between specialists, hospitalists and primary care providers where everyone is responsible for the patient’s outcome and, presumably, everyone shares in the cost savings.

Preventable medical errors cost the country $19.5 billion in 2008 — or roughly $13,000 for each avoidable case, according to a report published Monday by the Society of Actuaries (SOA).

And that number is likely low, according to consultants at Milliman, who crunched the data.

"We used a conservative methodology and still found 1.5 million measureable medical errors occurred in 2008," says Jonathan Shreve, an actuary for Milliman who co-authored the report. "This number includes only the errors that we could identify through claims data, so the total economic impact of medical errors is in fact greater than what we have reported."

More than half of those costs were associated with just five avoidable medical injuries: pressure ulcers; post-op infections; mechanical troubles with devices, implants or grafts; post-laminectomy syndrome; and hemorrhages.

ARMONK, NY – Payers aren’t always in the loop when when physicians and patients get together to map out a healthcare regimen. IBM is looking to the clouds to change that.

The Armonk, N.Y.-based technology giant announced Thursday morning a collaboration with one of the nation’s largest payers to launch a cloud computing and clinical decision support solution that links physicians – whether they’re in a hospital or their own clinic – with patients and payers. The new platform is designed to help round out the patient’s electronic medical record, giving physicians the information they need at the point of care and helping patients and payers make sure that care is properly administered and billed.

The Collaborative Care Solution was unveiled by executives from IBM and ActiveHealth Management, a New York-based, independent subsidiary of Aetna. The solution combines IBM’s cloud computing platform with ActiveHealth’s CareEngine clinical decision support system to pull together not only medical records, medication and lab data, but claims information as well.

The large-scale free clinic was the first of its kind in the District. By 2 p.m., more than 700 people had been treaded and line grew longer. The treatment was underwritten by 44,000 donors who contributed $300,000.

CAMBRIDGE, MA – The New England Healthcare Institute says the quality and efficiency of primary care could be dramatically improved through the use of team-based care. The organization has called for fundamental changes in the training of health professionals to implement this model.

According to the NEHI, shifting to a team-based model is hindered by an education system that traditionally trains health professionals in silos, with little to no emphasis on preparing students in medicine, nursing, pharmacology or other fields to share responsibilities or even work together.

"The education system for health professionals must implement farsighted changes” if the primary care workforce of the future is to learn how to work in care teams, NEHI officials say in an article published in the August edition of Health Affairs. This will require a “revolution’’ in how medical professionals are educated, the officials said.

Provisions under the 4-month-old health reform law that hit the provider and payer communities the most are expected to save Medicare $7.8 billion through 2011 and $418 billion over the next decade, according to a report released by the CMS.

“Because we began making changes right away, the savings from Medicare add up fast,” HHS Secretary Kathleen Sebelius said during a conference call with reporters.

The report focuses primarily on the scores of measures aimed at changing how care is delivered and paid for, and which made up the spine of the massive legislative package passed this year.

Programs meant to reduce the number of hospital readmissions, reshape how hospitals and doctors are reimbursed and those that target fraud and abuse are expected to reduce Medicare spending by tens of billions of dollars.