Changing News Category: Archive

Bemidji, Minn. — Even rural hospitals that chose not to enroll in the scaled back GAMC program will lose millions of dollars this year providing charity care for the state's poorest adults. That's because those hospitals are no longer reimbursed.

A growing number of hospitals are taking unusual steps to cut their losses and still provide care for the poorest of the poor.

Tri-County Hospital in Wadena projected it would lose about $850,000 each year providing health care no longer covered by GAMC. This summer, the hospital began an experiment.

Working through Wadena County, the hospital started paying insurance premiums so that about 100 GAMC patients could shift over to the more comprehensive MinnesotaCare insurance program.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced the award of $16.8 million to support 27 Public Health Training Centers (PHTC) at schools of public health and other public or non-profit institutions across the country.  The PHTC Program helps improve the public health system by enhancing skills of the current and future public health workforce. Institutions accredited to provide graduate or specialized training in public health are eligible for funding.  Most of the funding – $15.4 million – is made available by the Prevention and Public Health Fund included as part of the Affordable Care Act.

“Today’s awards represent a dramatic increase in support for Public Health Training Centers,” said Secretary Sebelius.  “Investing in prevention and public health is the foundation for improving the health and well-being of all Americans.”

The new class of medical students is being weaned away from pencil and paper to digital learning.

Stanford’s medical school joins a small but growing group of educational institutions across the nation experimenting with iPads as a way to lighten the load of textbook-toting students, and to learn how best to teach an extremely tech-savvy generation of students who’ve grown up in a wired world.

The National Institutes of Health has awarded a 1.5 million dollar grant to the University of Louisville for a new oncology program.

The program focuses on palliative care, which combines medicine, nursing, social work and religious education to provide broad care for cancer patients. Students in each discipline will be required to take new courses in palliative medicine so they can better work together to treat patients.

“Palliative medicine includes, but is not limited to, the traditional view of end-of-life care and hospice work. Palliative care starts the day of cancer diagnosis for all patients, focusing on the alleviation of symptoms in the bio, psychosocial, and spiritual realms,” says U of L Chief Medical Officer Mark Pfeifer. ”It meets [patients] at their symptoms, their goals, their worries, their environment, their family. It combines everything, then, from advanced, invasive pharmaceutical procedures, to prayer and music.”

The grant will be paid out over five years as the program is developed.

WASHINGTON – Employment in the U.S. healthcare sector continued its rise in August, increasing by approximately 28,200 jobs. The healthcare industry has added an average of 20,000 jobs per month this year, about in line with the average monthly job growth in 2009.

According to the latest employment report from the Bureau of Labor Statistics, the biggest healthcare job gains continued to be in ambulatory care services, where 16,900 jobs were added in August.

Hospitals also gained jobs, adding 8,600 in August. These numbers are a welcome turnaround after three straight months of job losses in that sector.

The dominant job growth area in ambulatory care is in physician offices, which added 5,300 jobs. Home healthcare services added 2,800 jobs, while outpatient care centers saw an increase of 2,700 jobs.

State leaders and health care professionals are launching Wednesday a new federal high-risk health care program that will insure those previously denied coverage because of pre-existing conditions.

The Maryland Health Insurance Plan currently operates a state-funded high-risk pool program and was chosen by the Maryland Health Care Reform Coordinating Council to carry out the federal program.

The Patient Protection and Affordable Care Act of 2010 allocates $5 billion nationally for the creation of a new high-risk health plan to be administered by either the U.S. Department of Health and Human Services or individual states.

MHIP, which will now be called MHIP Federal, received $85 million of those federal funds and began accepting applications for the new insurance plan through the federal pool in August.

Total patient visits to physician offices were down 7.3% in July from the July 2009—the fourth consecutive month to post negative growth in physician visits, according to researchers with the North American offices of Deutsche Bank Securities. Overall, primary care visits were down by 5.7% for the month.

July appeared even weaker than June (with a 4.1% decline in visits) and the previous second quarter, with a 4.6% decrease in visits.

The average American hospital barely breaks even. But some are enormous profit centers. Forbes' first-ever survey of America's most profitable hospitals reveals that some American hospitals make 25 cents or more for every $1 in patient revenue they take in.

The list, done by the American Hospital Directory, is based on operating income figures that hospitals must report to the federal Medicare program each year. It found that 24 hospitals in the country with over 200 beds make an operating margin of 25% or more. That kind of profit margin compares favorably to drug giants like Pfizer ( PFE - news - people ), who are often vilified for charging too much for their drugs. It easily beats the operating profit margin that General Electric ( GE - news - people ) reported last year.

The most profitable hospital in the country, 235-bed Flowers Medical Center in Dothan, Ala., recorded an incredible 53% operating margin. It is part of the big for-profit Community Health Systems ( CYH - news - people ) chain in Brentwood, Tenn. Del Sol Medical Center in El Paso snared second place with an astronomical 45% operating margin. It's part of the big HCA chain, based in Nashville. Neither hospital returned calls asking for comment. After this story came out, Flowers Hospital disputed the figures in an e-mail. It says it overstated its revenue by an astonishing $180 million in its official report to Medicare and that its actual margin is 12%.

Doctors already use traditional forms of telemedicine -- teleconferencing and videoconferencing -- but Sikka said "mHealth" goes further, eliminating the need for scheduling conference rooms and reserving equipment.

MHealth could especially benefit patients living in isolated areas and those who don't want to spend the time, money and energy waiting for evaluation of a superficial injury, Sikka added.

"For emergency medicine," Sikka said, mHealth "allows us to reach out into the community and provide a service that crosses that whole issue of time and space."

Nine large North Texas employers have formed a partnership to help each other get a grip on rising health care costs. The group announced Thursday a three-year effort called the Texas Health Strategy Project to help the partners create better health benefit packages for their workforces.

They'll do this by collecting more detailed employee health data, reorganizing how they manage benefits and purchasing only the most needed health options to keep workers healthy and out of doctor offices.

California lawmakers advanced several bills Tuesday that would help the state implement national health care reform, over the objection of Republicans.

The state Senate narrowly approved two bills to set up an insurance exchange that would allow people to shop for health insurance. The exchange would let people compare insurance plans and buy coverage through a consumer-friendly website.

Republicans who opposed the bills said the measures could create unaccountable bureaucracy.

HHS Secretary Kathleen Sebelius announced today more than $32 million in FY 2010 funds to increase access to health care for Americans living in rural areas.  The funds reach across seven programs administered by the Office of Rural Health Policy in HHS’ Health Resources and Services Administration (HRSA).

“These funds reflect the priorities spelled out by President Obama in providing the best health care possible to rural Americans,” said Sebelius. “The ultimate goal is to build healthier rural populations and communities.”

“The grants will strengthen partnerships among rural health providers,” said HRSA Administrator Dr. Mary Wakefield Ph.D., R.N.  “Funds will be used to recruit and retain rural health care professionals and modernize the health care infrastructure in rural areas.”

Beginning in 2014, Medicaid greatly expands under the new health-care law to include adults without children, who generally have been excluded.

The Medicaid expansion also will enable agencies that serve the homeless to divert resources now spent on medical care to other services such as finding housing and jobs. The new law provides another boost through a five-year, $11 billion expansion of the community health center system that treats many in this population.

These benefits and President Obama's recently announced plan to prevent and end homelessness mark a watershed moment in federal efforts on this issue, advocates say. Among its goals, the plan calls for greater coordination among housing, medical care and behavioral health programs to help end chronic homelessness in five years and homelessness for families and children over the next decade.

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.

DULUTH, MN – More than 900 nurses in Duluth, Minn., are being encouraged by union leaders to authorize a one-day strike at SMDC Medical Center over the issue of adequate staffing.

The nurses, represented by the Minnesota Nurses Association, have not been able to reach a contract agreement with SMDC and have no more negotiating sessions scheduled with management. The nurses will vote Aug. 18 to ratify their current contract offer or authorize a one-day strike.

"The bottom line is the executives at the bargaining table have made it clear to us that management does not trust its nurses with the well-being and safety of our patients," said Steve Strand, an RN at SMDC. “We are not asking for anything costly, outrageous or unusual."

WASHINGTON – Despite a bitter partisan battle over federal spending, Congress has passed a six-month, $16.1 billion extension to federal matching funds for Medicaid.

The FMAP extension was passed last week by the Senate and on Tuesday by the House as part of H.R. 1586, an amendment to the Teacher Jobs and State Fiscal Relief bill. It will provide a phased-down enhanced federal match of 3.1 percent beginning the first calendar quarter of FY2011, then dropping to 1.2 percent in the second calendar quarter.

The funding will bolster state coffers following the expiration of a $90 billion boost to Federal Medical Assistance Percentage (FMAP) payments provided in 2009 under the stimulus package. The new extension will extend the help to states through June 2011.

WASHINGTON – Congress will consider changing how hospitals are paid under the meaningful use rule, allowing each hospital in a multi-hospital campus to earn incentives. 

Rep. Zack Space (D-Ohio) and Sen. Charles Schumer (D-N.Y.) have introduced bills that would allow hospitals in multi-campus organizations to apply separately for millions in incentives.

Under the Electronic Health Record Incentives for Multi-Campus Hospitals bill (H.R. 6072), introduced on July 30, and its matching Senate bill (S 3708), introduced on Aug. 5, health systems would be able choose whether to receive base payments for each campus and one per-discharge sum or one base payment for the entire organization with additional per-discharge amounts for each campus.

Under the meaningful use rule of the American Recovery and Reinvesment Act, the hospital EHR incentive payment formula incorporates both a $2 million base amount annually and a $200 per discharge amount for the 1,150th to 23,000th discharge for the entire hospital campus.

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.

The average return on investments for 85 nonprofit healthcare organizations reviewed by the Commonfund Institute improved to 18.8% in Fiscal Year 2009. It was the best year for investments in nearly a decade.

The Commonfund Benchmarks Study of Healthcare Organizations results for FY2009 represent a dramatic improvement over average losses of -21.2% reported for FY2008.

The 2009 return was the highest in the eight years the study has been conducted, and came in the year following the poorest return of the eight studies. The 85 participating organizations represented $76.8 billion in investable assets and $26.8 billion in defined benefit plan assets as of Dec. 31, 2009.

Radiologists and anesthesiologists remain among the best paid physicians, but internists received large pay increases in the past year, according to the 2010 LocumTenens.com Physician's Salary Survey.

The survey, conducted this spring, received responses from 1,703 physicians and Certified Registered Nurse Anesthetist (CRNAs).

It found that internists' salaries in 2010 averaged $191,864, a 6.6% increase over the $179,958 average salary in 2009. However, internists' annual salaries remain well below that of subspecialists like radiologists, who reported an average salary of $398,571 in 2010, up 5.1% from the 379,140 average reported in 2009.

The Senate confirmed Elena Kagan Thursday as the 112th justice to the Supreme Court, making her the fourth woman ever to sit on the high court.

On a 63-37 vote, Kagan, 50, became President Obama's second lifetime appointment to the court in the past year -- the vote was held 365 days after Sonia Sotomayor won 68 votes for her confirmation as the court's first Latina justice.

Washington Hospital Center nurses will call a one-day work stoppage at a future date to protest the firing of 18 registered nurses and the disciplining of several others who stayed home during Washington, D.C. area February snow storms.

About 42% of the hospital's 1,600 registered nurses participated in online voting between Thursday and Saturday and 80% voted for the labor action, says Stephen Frum, shop steward for the Nurses United of the National Capital Region.  Frum says the nurses have not yet decided what day to call for the work stoppage.

According to a statement from the labor union, 526 voted yes, 147 no, and 2 abstained. The majority vote surpasses the 2/3 majority required for approval.

The nurses organization said in its statement: "These firings and disciplines were handed out in violation of WHC?s written snow emergency policy to nurses who made every effort to get to work during the storm, including some who missed work during the first storm but slept at the hospital to be available during the second storm."

Each state is eligible to receive up to $1 million in federal grants to establish competitive health insurance exchanges that will become available by 2014 under health reform legislation.

"With most states struggling to keep their budgets in balance, these grants will give them the resources to conduct the research and planning needed to build the health insurance marketplace of the future," U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday.

More than 1,600 registered nurses at the 900-bed Washington Hospital Center, the largest non-profit hospital in the Washington, DC, area, will vote over the weekend on whether to go on strike. At issue is the hospital's decision last winter to fire 18 nurses and discipline several more following severe snow storms in the region.

Following a membership meeting on Thursday, the nurses will begin onsite voting throughout the weekend on whether they will stage a one-day work stoppage. The action coincides with the arrival of a new president (John Sullivan) this week, and the recent departure of the hospital's senior vice president for human resources and the chief nursing officer.

The law Congress adopted this spring to reshape the nation's health-care system will be especially beneficial to women, because they traditionally have relied on health care more than men, faced more insurance problems and had greater difficulty paying medical bills, according to a new analysis.

The Commonwealth Fund found that women will be helped in particular by central aspects of the legislation designed to improve and expand access to insurance. Commonwealth was a major supporter of the legislation. At a time when some Republicans and other conservatives continue to challenge the law, the study on women is part of a series of reports the foundation is planning to demonstrate the law's relevance to different groups of people.

Once the insurance expansion occurs, starting in 2014, about 15 million of the nearly 17 million U.S. women who currently are uninsured will be eligible for coverage with federal financial help, the report predicts. Slightly more than half of them will qualify to join Medicaid, and the rest will qualify for government subsidies to buy private coverage through new insurance "exchanges" that will be run by states.

Social media tools aren't just about sharing links or chatting with friends; they can also be a valuable tool in health care. Hospitals are starting to harness that potential to better assist patients in making informed choices, and doctors in connecting with patients.

To that end, the Mayo Clinic has created the Center for Social Media, an initiative aimed at both health care professionals and patients.

Some of the services of the center include training for health care employees, consulting and coaching for organizations that want to engage in social media activities, information resources, and conferences and other events.

In September, Mayo Clinic will announce more details of a social media network to engage other members of the health care community. This will be a "learning network" of organizations dedicated to making social media helpful for patients, said Dr. Victor Montori, endocrinologist at the Mayo Clinic, who helped launch the social media efforts.

The center builds on the initiatives that Mayo Clinic has already taken in the social media world. The clinic has a popular  YouTube channel and thousands of followers on Twitter and Facebook. It also has 12 different blogs that focus on topics such as cancer, pregnancy, and safe sex.

WASHINGTON – The Centers for Medicare and Medicaid Services will make available $2.25 billion in state grants to support community-based alternatives to institutional long-term care.

According to Monday's CMS announcement, the grants will extend the "Money Follows the Person Rebalancing Demonstration" (MFP) with funding from the Affordable Care Act.

"The Money Follows the Person Rebalancing Demonstration has been critical to our efforts to deliver on the promise of the Americans with Disabilities Act and expand access to community living services," said Health and Human Services Secretary Kathleen Sebelius.

Baylor Heart and Vascular Hospital, for the second year in a row, had the lowest readmission rate for heart failure patients in the country, a key quality indicator that says the facility did the job right the first time.

The U.S. Centers for Medicare and Medicaid Services is expected to publicly release Baylor's quality scores in the coming weeks, along with those of more than 4,000 other hospitals across the nation. Hospitals were informed of their results this week; Baylor shared them with The Dallas Morning News on Friday.

Baylor Heart and Vascular's readmission rate is 17.3 percent, while the national average is 24.5 percent. The agency has pointed to Baylor as a national example of superior quality for other hospitals to follow.

WASHINGTON – Today, the Obama Administration is announcing both new regulations to empower consumers to appeal decisions made by their health plans or insurance companies and the availability of resources that will be used to help give consumers more control of their health care decisions.  These provisions of the Affordable Care Act will help support and protect consumers and help end some of the worst insurance company abuses.

The new appeals regulations were issued by the Departments of Health and Human Services (HHS), Labor, and the Treasury.  Consumers in new health plans in every State will have the right to appeal decisions, including claims denials and rescissions, made by their health plans.  This includes the right to appeal decisions made by a health plan through the plan’s internal process and, for the first time, the right to appeal decisions made by a health plan to an outside, independent decision-maker, no matter what state a patient lives in or what type of health coverage they have.

HHS Secretary Kathleen Sebelius today announced the award of $88 million in grants, provided under the Affordable Care Act, to support evidence-based home visiting programs focused on improving the wellbeing of families with young children.  Through the Maternal, Infant, and Early Childhood Home Visiting Program, nurses, social workers, or other professionals meet with at-risk families in their homes, evaluate the families’ circumstances, and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn - such as health care, developmental services for children, early education, parenting skills, child abuse prevention, and nutrition education or assistance.

HIPAA privacy and security concerns with the government's EHR certification program are so great that hundreds of practitioners have called for the program's cancellation, the Department of Health & Human Services (HHS) announced in its final rule on meaningful use released Tuesday.

The final rule, issued through the Centers for Medicare & Medicaid Services (CMS), defines "meaningful use" for the first two years (2011 and 2012) of a long-term financial incentive plan through Medicare and Medicaid under the Health Information for Economic and Clinical Health (HITECH) Act, signed into law by President Barack Obama February 17, 2009.

HHS released a second final rule the same day, through the Office of the National Coordinator for Health Information Technology (ONC). It establishes an initial set of standards, implementation specifications, and certification for EHR technology for vendor products.

WASHINGTON – Overall healthcare prices remained flat for the third consecutive month of price stability, according to data from the federal Bureau of Labor Statistics.

According to the BLS' Producer Price Indices, which measure average changes in selling prices received by domestic producers for their output, prices across the range of healthcare industries remained flat from May to June, although prices were 2.8 percent higher than a year ago.

The PPI translates into actual or expected reimbursement for a sample of treatments or services. While healthcare prices were steady from May to June, prices increased across the industry from June 2009 to June 2010.

WASHINGTON – Republican members of the House Ways and Means Committee are calling on their leader to set a confirmation hearing for the man who has taken the reins of the Centers for Medicare & Medicaid, which has an $800 billion annual budget.

President Barack Obama bypassed the hearing process when he put Harvard Medical School Professor Donald Berwick, MD, in charge of CMS during an official recess of Congress. Berwick was sworn in on July 12.

The Departments of Health and Human Services (HHS), Labor, and the Treasury issued new regulations today, requiring new private health plans to cover evidence-based preventive services and eliminate cost sharing requirements for such services.  The new rules will help Americans gain easier access to services such as blood pressure, diabetes, and cholesterol tests; many cancer screenings; routine vaccinations; pre-natal care; and regular wellness visits for infants and children.

“Today, too many Americans do not get the high-quality preventive care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs,” said HHS Secretary Sebelius.  “From the Recovery Act to the First Lady’s Let’s Move Campaign to the Affordable Care Act, the Administration is laying the foundation to help transform the health care system from a system that focuses on treating the sick to a system that focuses on keeping every American healthy.”

WASHINGTON – Federal officials released the final rule on meaningful use Tuesday, making it easier for providers to qualify for funding for the adoption of electronic health records.

The 864-page final rule, published in the New England Journal of Medicine several weeks later than anticipated,  outlines the qualifications providers must meet to achieve the meaningful use of electronic health records.

Physicians who provide Medicaid services are eligible for up to $63,750 in incentives over the next six years, while Medicare physicians can earn a maximum of almost $44,000. Hospitals can earn up to $2 million a year. Providers who hope to collect the maximum incentives available must begin collecting data using the new requirements beginning this October, with payments beginning in 2011.

BOSTON – The 2010 National Governors Association Annual Meeting, held July 9-11 in Boston, focused on implementing healthcare reform laws and achieving a sustainable healthcare system.

"With the enactment of federal health reform, governors and states are in the process of restructuring and putting necessary components in place to move forward with implementation," said the NGA's chairman, Vermont Gov. Jim Douglas, at Friday's opening plenary session.

With the appointment this week of Institute for Healthcare Improvement President and CEO Don Berwick, MD, as administrator of the Centers for Medicare and Medicaid Services, the Cambridge, MA-nonprofit has named its executive vice president and chief operating officer, Maureen Bisognano, as its new head.

Since joining IHI in 1995, Bisognano has been a frequent speaker at major conferences on quality improvement, and had travelled globally to work with healthcare leaders. Before joining IHI, she was senior vice president of The Juran Institute, where she consulted with senior management on the implementation of total quality management in healthcare settings. Before that, she served as CEO of the Massachusetts Respiratory Hospital in Braintree, MA, where she participated in the National Demonstration Project, the precursor to IHI.

The winners in the 7th annual HealthLeaders Media Top Leadership Teams in Healthcare Awards program use words like “accountability” and “decisiveness” to describe the values that makes their senior leadership teams succeed. Yet these winning teams also realize they will need to hone those values and others to prepare for the rapidly-shifting challenges ahead in healthcare.

The Top Leadership Teams in Healthcare Awards program, sponsored by GE Healthcare, celebrates the outstanding teamwork that occurs in healthcare organizations each day, shares what makes top leadership teams successful, and encourages other healthcare leaders to learn more from the best practices of top leadership teams.

WASHINGTON – President Barack Obama is expected on Wednesday to put Donald Berwick, MD, at the helm of the Centers for Medicare & Medicaid Services while Congress is in recess.

White House Communications Director Dan Pfeiffer wrote on the White House blog Tuesday night that "many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points."

WASHINGTON – A new poll shows the public is moving toward support of the Patient Protection and Affordable Care Act, enacted last March. The June Kaiser Health Care Tracking poll found that public support for the bill has risen over the last month to 48 percent, while 41 percent are against reform. That's an increase from 41 percent favorable and 44 percent unfavorable in May.

According to Kaiser officials, the poll tested 17 different provisions in the new law, with 16 of 17 receiving majority support.

WASHINGTON – The Department of Health and Human Services has unveiled a new Pre-Existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain healthcare coverage because of pre-existing health conditions.

According to HHS Secretary Kathleen Sebelius, the PCIP will provide a new option for those who have been uninsured for at least six months, are unable to get health coverage because of a health condition and are a U.S. citizen or residing in the U.S. legally.

New proposals from hospitals were offered overnight, as 12,000 nurses prepared for a Tuesday strike. Doctors are working to reassure patients.

With a week to go before Twin Cities nurses could walk off the job in a massive strike, doctors are rescheduling surgeries, patients are reworking their calendars and everyone in the health care community is studying the lessons of previous nursing strikes.

SCHAUMBURG, IL – Two recent surveys by the Society of Actuaries suggest that more transparency within the U.S. healthcare system is the key to bending the cost curve downward.

The SOA surveyed more than 600 members of its health section and hosted an online survey of 1,000 Americans to understand what consumers believe would help them control their own healthcare costs.

Healthcare actuaries believe that creating more transparency between doctors and patients, as well as between the provider community and patients, would be at least somewhat effective at bending the healthcare cost curve downward. For example, 86 percent recommend making prices for treatments more visible and available for patients, while 79 percent recommend educating consumers and providers on the efficacy of care.

In a new proposed rule, the Centers for Medicare and Medicaid Services (CMS) has included a provision that could mean an additional reduction by 6.1% in physician service payment rates starting Jan. 1 2011, under the sustainable growth rate (SGR) formula adopted by Congress. This reduction would be added to a projected 23.5% cut that is scheduled to take effect Dec. 1 --unless Congress works to change or eliminate the current SGR formula.

WASHINGTON – For the three million veterans living in rural areas, access to healthcare remains a major barrier – but wireless technology shows promise.

That opinion was delivered Wednesday by Rep. Michael F. Michaud (D-Maine), chairman of the House Committee on Veterans' Affairs Subcommittee on Health.

"It is no surprise that our rural veterans have worse health outcomes compared to the general population," Michaud said. "This is where I see the great potential of innovative wireless health technologies."

LAS VEGAS – While there is much talk of the potential stress hospitals may face over healthcare reform, one expert at the Healthcare Financial Management Association's ANI conference in Las Vegas this week, said getting back to financial basics will help a hospital weather changes ahead.

In a Tuesday session on how community health systems can ensure the affordability of their hospitals' strategies, Jason Sussman, CPA and a partner at Kaufman, Hall and Associates conceded, "there is a lot of doom and gloom out there on healthcare reform. We don't know 90 percent of the answers."

"Current industry stresses require rigorous, comprehensive financial planning," he said. "There can't be any more shooting from the hip. Hospitals will need real, analytical work just like they'd look for in a fortune 500 company."

On April 15, 2010, the President issued a Presidential memorandum to HHS calling for the initiation of rulemaking that would ensure that hospitals that participate in Medicare or Medicaid respect the rights of patients to designate visitors, regardless of whether the visitors are legally related to the patients. The President’s directive clearly instructed HHS to propose that a participating hospital not deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability. In advance of this proposed rule, Secretary Sebelius sent a letter late today to leaders of major hospital associations asking them to encourage their member hospitals to not wait for the formal rulemaking process to run its course before they review their current visitation policies.

For the second time in five weeks, Twin Cities nurses have voted to go on strike.

And this time, the walkout could last longer than 24 hours.

Members of the Minnesota Nurses Association turned out by the thousands Monday to authorize an open-ended strike at 14 hospitals. No date has been set, and union officials have said they would hold off on giving the required 10-day notice if the two sides were in "productive negotiations." At the earliest, a strike could begin in early July.

Physicians would see a 2.2% increase in Medicare payment—but only through November—under a long-stalled package of tax provisions and safety-net health spending that the Senate strained to pare back in order to gain enough votes for passage.

The revised package could come up for a vote as early as Thursday. 

Peter W. Carmel, MD, a pediatric neurosurgeon from New York City, was named president-elect of the American Medical Association today, and will become AMA president in June 2011.

"I am honored to be elected to lead the nation's most influential physicians' organization," Carmel said in a media release. "As AMA president-elect, I pledge to serve as a strong voice and dedicated advocate for patients and physicians on the pressing issues confronting our healthcare system."

Nearly half—45%—of hospital employees say they're disengaged, disempowered, and unhappy on the job, with younger workers, and those at the patients' bedside expressing the most discontent, according to according to the 2010 Hospital Pulse Report: Employee and Nurse Perspectives on American Health Care  from Press Ganey Associates.

The award recognizes healthcare CEOs who demonstrate leadership and a commitment to using information technology to advance their organizations' strategic goals.

The two recipients for 2010: David Bernd, CEO of Sentara Healthcare in Norfolk, Va., and Peter Fine, president and CEO of Banner Health in Phoenix.

A five-judge panel consisting of three CEOs chosen by Modern Healthcare and two chief information officers chosen by HIMSS selected Bernd and Fine from the pool of nominees. The judges reviewed the nominees using three criteria: 1) The CEO demonstrated leadership and commitment to using IT to advance his or her healthcare organization's strategic goals. 2) The CEO helped achieve measurable results through leadership and commitment to IT in his or her organization. 3) The CEO shared his or her healthcare organization's IT experiences to benefit peers and other members of the healthcare industry.

Under a law passed after breaches of celebrity medical records, such as those of the late actress Farrah Fawcett, health officials yesterday levied six fines totaling $675,000 against five California hospitals where employees and others gained unauthorized access to sensitive information in patients' electronic medical records.

State officials did not name any of the patients involved, but one of them was said to be Michael Jackson, whose records were reportedly accessed illegally at Ronald Reagan UCLA Medical Center in Los Angeles after his death.

"These facilities failed to prevent unauthorized access to confidential patient information," Kathleen Billingsley, deputy director of the Center for Health Care Quality, California Department of Public Health, said during a briefing yesterday.

WASHINGTON – The Premier Healthcare Alliance bestowed 21 of the nation's top hospitals and three health systems for their commitment to outstanding patient care and operational efficiency with the 2010 Premier Award for Quality (AFQ) at an award dinner Wednesday night in Washington, DC.

There was a year of hearings, speeches and protests. Three bills passed in the House to complete the process, and two in the Senate. President Obama held several events to commemorate signing the legislation into law.

But the two parties are still arguing about health-care reform.

One point of contention is a newly released brochure to Medicare recipients. Democrats say it explains how the new law works, but Republicans cast it as government-funded propaganda. Republican congressmen talk regularly about trying to repeal the law, while Democrats accuse them of being tools of the health insurance industry.

Lately, Republicans have been attacking the nomination of Donald Berwick to run the Centers for Medicare and Medicaid Services -- using Berwick's praise of the British health-care system to say that Obama favors European-style health care, an argument the GOP made repeatedly during the debate in this country.

In the meantime, routine studies about Medicare, Medicaid and other government health-care programs that are traditionally released with little fanfare are now turning into proxy fights over the new law, even if the studies barely mention it.

Under the Senate substitute amendment to the jobs bill (HR 4213) unveiled Tuesday, physicians would get some relief from the 21% cut in Medicare and TRICARE physician reimbursements now in effect.

Using the same language found in the jobs bill passed by the House 10 days ago, physicians would see an increase in payment rates of 2.2% for the remainder of 2010 and a 1% increase in 2011. Rates would return to present law after 2011.

At a "tele-town" meeting with seniors on Tuesday, President Obama did provide some recognition of the physicians' current plight by noting that "temporarily, we've got to make sure that your doctor is getting reimbursed so that they can stay in business and keep their doors open."

"We've got to fix this permanently," Obama said. "What we shouldn't do is have this guillotine hanging over their heads every year where they're having to figure out: 'Am I am going to get reimbursed or is suddenly my income going to drop by [21%]?'"

WASHINGTON – The American Medical Association announced Thursday it will launch a multi-million-dollar national advertising campaign to push Congress to prevent a 21 percent Medicare physician payment cut mandated to start June 1.

AMA President J. James Rohack, MD, said the pay cut would cause physicians to drop out of Medicare, making access problems worse for seniors. An AMA physician survey, he said, indicates many are already limiting the number of Medicare patients they treat.

According to Rohack, the AMA's online survey of 9,000 Medicare physicians confirms that seniors are already being hurt by "Congress' mismanagement of the Medicare program."

A group of physician-owned hospitals plans to file a lawsuit today asking a federal court in Tyler to halt the new health care law's ban on Medicare and Medicaid reimbursements to future doctor-owned facilities.

Physician Hospitals of America, including the Texas Spine and Joint Hospital in Tyler, provided a copy of the suit. A spokesman said the suit would be filed this morning. The Dallas-Fort Worth area has more than 22 physician-owned hospitals. Nationwide, there are 265, with an additional 29 set to open before Dec. 31, when the new law bars federal payments.

The law would also withhold federal reimbursements to physician-owned hospitals that expand after the end of the year – which would disrupt work under way at Texas Spine and Joint Hospital. Congressional supporters of the measure said federal Medicare spending rises when doctors refer patients to hospitals where they have ownership. Traditional hospital trade associations support the move and say doctor-owned facilities siphon off well-insured patients.

HHS Secretary Kathleen Sebelius and Institute of Medicine President Harvey Fineberg today launched a national initiative to share a wealth of new community health data that will drive innovation and lead to the creation of new applications and tools to improve the health of Americans. 

To help citizens, clinicians and local leaders use data to improve health and value of health care, the Community Health Data Initiative (CHDI) is turning to Web application developers, mobile phone applications, social media, and other cutting-edge information technologies to “put our public health data to work.”

“Our national health data constitute a precious resource that we are paying billions to assemble, but then too often wasting,” Secretary Sebelius said. “When information sits on the shelves of government offices, it is underperforming. We need to bring these data alive. If made easily accessible by the public, our data can help raise awareness of health status and trigger efforts to improve it. The data can help our communities determine where action is most needed and what approaches might be most helpful. As a nation, we can and should harness the exploding creativity in our information technology and media sectors to help us get the most public benefit out of our data investments.”

COLUMBIA, SC – BlueCross BlueShield of South Carolina’s large-group customers will be offered assistance in setting up onsite employee health centers.

The clinics will integrate with BlueCross’ health management programs.

BlueCross is collaborating with Reston, Va.-based Comprehensive Health Services, which establishes, staffs and operates worksite clinics. The arrangement will allow employers to integrate clinic information and patient care with BlueCross' health management programs.

BlueCross will link its accounts directly with CHS to establish clinics to provide such services as occupational healthcare, non-work related acute care and preventive services. While treating employees, CHS clinic staff are expected to use the opportunity to educate and guide patients with chronic diseases, including referrals to area primary care and specialist physicians.

The federal government will bear virtually the entire cost of expanding Medicaid under the new health-care law, according to a new study by the Kaiser Family Foundation that rebuts governors' protests about the impact on strapped states.

Roughly half of the increase in health insurance coverage under the new law is expected to come from expanding Medicaid in 2014 with a new nationwide eligibility threshold of 133 percent of the poverty level -- $14,400 for a single adult or $29,300 for a family of four, under the current guidelines. A disproportionate share of the 16 million people expected to enroll in the expanded Medicaid live in states in the South and West that have stringent eligibility rules for low-income adults.

Governors of many of those states predict fiscal calamity, and some have cited the Medicaid expansion in the lawsuits they have filed against the new law, saying it violates their states' rights. But the Kaiser study released Wednesday predicts that the increase in states' spending will be relatively small when weighed against the broad expansion of health coverage for their residents and the huge influx of federal dollars they will receive.

An ugly and very public fight between the prestigious City of Hope Medical Center and its 187-member group of cancer specialists threatens the reputations and stability of both as it has frightened many of the patients in their care.

The American Medical Association yesterday released its new Code of Conduct, a list of dos and don'ts that it says all health insurers should enforce.

The physician group says it hopes to publish a scorecard showing which plans play by these rules in a few years, in time for the launch of health exchanges enabled by health reform legislation.

WASHINGTON – The Premier healthcare alliance is launching two collaboratives designed to help hospital systems prepare and qualify to participate in accountable healthcare organizations (ACOs).

The ACO Implementation Collaborative and the ACO Readiness Collaborative will include 19 health systems in 15 states, involving 70 hospitals, more than 5,000 physicians and 1.2 million patients, according to Premier President and CEO Susan DeVore. The development of ACOs is supported by the healthcare reform law and is one of the latest ideas for promoting efficient quality healthcare, said Sen. Max Baucus (D-Mont.) at a press conference Thursday.

DeVore called the ACO movement "the next layer in healthcare."

Non-profit hospital chiefs who think they've been dragged through the wringer with the credit crunch and the recession should not think the worst is over, according to a new Moody's Investor Service report, which could be summed up in short:

Brace yourselves for more bad news and changes for many years ahead.

"The degree of change facing hospitals under healthcare reform and other industry structural shifts is even more fundamental" than the change hospitals experienced with the DRG payment transition in the 1980s, Moody's says, "touching all aspects of hospital operations and capital strategies."

SEATTLE – The average total 2010 medical spending for a "typical American family of four" reached $18,074, an increase of $1,303 over last year, according to new research by actuarial firm Milliman, Inc. The total-dollar increase is the highest in the history of this study.

The Milliman Medical Index (MMI) tracks the changes in average yearly healthcare costs when the family of four is covered by an employer-sponsored preferred provider organization (PPO).

A Smyrna urgent-care clinic has a new vending machine in its waiting room, but don't expect to get a bag of chips or can of soda.

This machine is for acute-care prescription medications — antibiotics, inhalers and other short-term medicines — for sick patients who don't want to wait in line at a pharmacy.

Tennessee Urgent Care Associates installed the ATM-like medication dispenser about two months ago to become the second urgent-care clinic in the state to offer prescription medications in a vending machine.

Urgent Care, which has four locations in the Nashville region, is piloting the device at its Smyrna location, but if patients use it, the company will expand it to every clinic.

President Obama plans to nominate Solicitor General Elena Kagan to be the 112th justice of the Supreme Court, sources said late Sunday night.

Obama is expected to make the announcement mid-morning Monday in the East Room, accompanied by Kagan. He informed his advisers about the choice on Sunday, after spending nearly a month looking at candidates. But he settled relatively early on Kagan, whom he had considered during the last Supreme Court vacancy, said sources familiar with the process, who spoke on the condition of anonymity because the decision has not been announced.

A compromise state health plan for the very poor, on the verge of collapse just a few days ago, was rescued this week when the Pawlenty administration changed course and negotiated with participating hospitals to limit the number of patients each will see.

As a result, Hennepin County Medical Center and three other metro hospitals will participate in a slimmed-down version of General Assistance Medical Care (GAMC), a health plan for thousands of Minnesota's poorest and sickest residents. The four hospitals serve about 47 percent of the current 36,426 enrollees, none outstate. The remaining 144 Minnesota hospitals will treat patients and dip into a $20 million fund for that purpose.

WASHINGTON – Health and Human Services Secretary Kathleen Sebelius has written to governors and state insurance commissioners urging them to re-examine any WellPoint health insurance rate increases in their states.

The letter comes after Anthem Blue Cross, a WellPoint affiliate, withdrew its plan to raise premiums in California by as much as 39 percent when auditors found the rate hikes were based on unreasonable assumptions about the rate at which medical costs are increasing.

LifePoint Hospitals, Brentwood, Tenn., announced the proposed acquisition of a bankrupt four-hospital system in northern Tennessee just days after the investor-owned operator confirmed the purchase of another hospital in Kentucky.

The 49-hospital LifePoint announced today it intends to purchase Sumner Regional Medical Center, which is based in Gallatin, Tenn., and owns a critical-access hospital and three larger acute-care providers. Sumner declared bankruptcy on April 30, which means the purchase will be governed by a court-directed bidding process and subject to a judge's approval. LifePoint hopes to finish the deal by the end of the summer.

After months of negotiating that left thousands of patients in insurance limbo, Crozer-Keystone Health System and Keystone Mercy Health Plan signed a contract Friday afternoon, hours before the old one was set to lapse.

Independence Blue Cross will offer $47 million in pay raises for primary care physicians in its southeastern Pennsylvania provider network, including $33 million to incentivize better patient outcomes, the Philadelphia-based health insurer announced today.

IBC said the added money will allow the 1,800 primary care physicians in that network to double their incentive earnings over last year's program by providing better care to IBC's commercial and Medicare Advantage HMO and Point-of Service members. The changes in reimbursement will attract and retain high-performing primary care physicians, IBC added. At the same time, IBC said it is “modifying” reimbursements for costlier, episodic, specialty care services, which the insurer said can often be avoided with regular, effective preventive care.

WASHINGTON – AstraZeneca will pay $520 million to resolve allegations that it marketed the anti-psychotic drug Seroquel for uses not approved as safe and effective by the Food and Drug Administration.

Such unapproved uses are known as “off-label” uses because they aren't included in the drug’s FDA-approved product label. AstraZeneca allegedly illegally marketed Seroquel between January 2001 and December 2006, promoting it to psychiatrists and other physicians.

NEW YORK – St. Vincent’s Hospital Manhattan is poised to close for good at the end of April. But what will happen to its 3,500 employees when the hospital ceases to exist?

Senate Democrats are inching closer to approving an amendment that would finally reinstate physician Medicare payment rates to the March 31 level—at least until June 1.

An amendment proposed by Senate Finance Committee Chairman Max Baucus (D-MT) was approved in a 60-40 vote Wednesday night that would stop—at least temporarily—the 21% cut in physician reimbursements mandated by the sustainable growth rate (SGR) formula.

The cost of hospital services, which grew by 1.1% in March and 8.6% in the last 12 months, almost quadruple the 2.3% increase in the overall Consumer Price Index for the same period, the Bureau of Labor Statistics announced today.

A further breakdown shows that the cost of hospital inpatient services rose 1.6% in March and 9.5% for the past 12-months, while the cost of hospital outpatient services rose 0.6% in March and 7.4% for the past year. Seasonally adjusted CPI data for all urban consumers also show that the overall cost of all medical services grew by 0.3% in March and 3.8% in the last 12 months.

CHICAGO – Approximately three in four respondents to a survey of healthcare organizations said the recession has negatively impacted their balance sheets more than the 2001 recession.

Completed in February by the Chicago-based credit agency TransUnion, the survey represents 46 healthcare organizations and operations in all 50 states.

According to the survey, 96 percent said their healthcare organization is experiencing a rise in the uninsured/underinsured patient population. More than 41 percent of healthcare administrators said that increase  is the most important issue facing their organization.

Henry Amoroso, 50, president and CEO of St. Vincent Catholic Medical Centers, the New York health system swamped in $700 million in debt, has resigned, effective immediately. Mark Toney, the system's chief restructuring officer, will continue as top executive for St. Vincent, a spokesman said.

HHS Secretary Kathleen Sebelius issued the following statement on new reports on health care quality and health care disparities faced by racial, ethnic or income groups. The new reports –  the 2009 National Healthcare Disparities Report and the National Healthcare Quality Report – were released today by the Agency for Healthcare Research and Quality.

“Today’s reports demonstrate why passing health reform was so critical,” said Sebelius. “In 2009, healthcare associated infections increased and minorities were less likely to have insurance and less likely to get the treatments they needed. In a reformed system, more Americans will get the care they need, regardless of their race or ethnicity and the quality of care will improve. The numbers we saw today are troubling, but ultimately, reform will help turn these numbers around."

WASHINGTON – The Centers for Medicare & Medicaid Services has issued an intermediate sanction against the Aetna Insurance Company for what CMS officials said are violations in administering the Medicare drug benefit.

According to CMS officials, the sanction would become effective April 21 and would prevent Aetna from marketing to and enrolling new beneficiaries until it corrects the violations and "they are not likely to recur."

The American College of Radiology announced it will launch a Breast Magnetic Resonance Imaging Accreditation Program on May 10.

The program was developed by the ACR Committee on Breast MRI Accreditation. It will provide peer-review assessment of facilities' breast MRI services equipment, processes, and the quality of their images. For facilities that offer only breast imaging services, the accreditation program fulfills accreditation requirements under the Medicare Improvements for Patients and Providers Act of 2008.

"This program will help patients and their providers identify practices that provide high-quality breast MRI," said Constance Lehman, MD, chair of the ACR Committee on Breast MRI Accreditation, in a news release. "This accreditation program sets quality standards for breast MRI providers and helps them continuously improve patient care by evaluating the qualifications of personnel, equipment performance, effectiveness of quality control measures, and image quality,"

NEW YORK – A new report issued by PricewaterhouseCoopers (PwC) suggests that the healthcare industry will be a promising place in which to work and invest over the next decade.

PwC's "HealthCast" report, which analyzed the influence of consumerism, genomics and the Internet on healthcare, concludes that healthcare jobs – including new positions such as healthcare navigators, health educators and care coordinators – will be in high demand. There should also be an increasing need for primary care physicians, nurses and physician's assistants, according to researchers.

"From a business/economic perspective, PwC is extremely bullish on prospects for dramatic improvements in healthcare,"  a PwC spokeswoman said. "The healthcare system is really getting 'wired up' and will provide major cost savings in the very near term."

Nearly two months after being acquired by Kroger supermarkets, The Little Clinic doc-in-the-box operation has closed 20 locations, including one in Franklin at Williamson Square. Little Clinic locations in Kroger stores in Indianapolis; Houston; Toledo, Ohio; Richmond, Va.; and Detroit also have closed, as have three storefronts in Columbus, Ohio, and one in Phoenix.

Meghan Glynn, a spokeswoman with Cincinnati-based Kroger, said the affected retail clinic locations hadn't done so well financially. "We want to strengthen the business model and then revisit expansion," she said.

SAN DIEGO – The University of California, San Diego has announced plans to build a state-of-the-art medical center on UC San Diego's east campus in La Jolla, Calif. The new Jacobs Medical Center project is expected to cost $664 million, with about $350 million coming from external financing, $131 million from philanthropy and the remainder from state bonds, reserves and capitalized leases.

The healthcare sector created 26,800 jobs in March and the overall economy created 162,000 new jobs, according to Bureau of Labor Statistics preliminary data released this morning.

The national jobless rate remained steady at 9.7%.

When it comes to the physical security of hospital buildings and the well-being of workers, healthcare reform brings with it the likely risk of increased traffic into the nation's ERs.

ERs are among the top locations in medical centers for violence between patients and staff, generally because ERs act as funnels into the rest of the facility.

As Congress left the Capitol for a two-week holiday over the weekend, the American Medical Association took the occasion to blast lawmakers for the "unconscionable" action of not acting on the "doc fix"—slated to expire on April 1.

Earlier this month, the Senate voted to delay the physician pay cut of 21.2% in Medicare reimbursement until Oct. 1. But the House did not take up the action, and as a result, the previous decisions by both chambers still stand. And that's April 1.

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.

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.

WASHINGTON—The U.S. Senate began debate Tuesday on legislation combining the last pieces to the Democratic overhaul of the health-care system and a shake-up to the student-loan industry, commencing what promises to be a contentious few days.

President Barack Obama signed into law the main health-care bill earlier Tuesday. It was passed by the Senate on Christmas Eve and then by the House late Sunday by a razor-thin margin.

The Senate is now debating a series of corrections demanded by House lawmakers in order for their support for the main health-care bill.

NEW YORK, March 18 /PRNewswire/ -- iVillage today announced the results of a new online survey conducted in February on its behalf by Harris Interactive®, which illustrates how heavily online women(1) rely on the Internet as a health resource – before turning to a family member or visiting a doctor. The survey findings were unveiled by Jennifer Barrett, Health Editor for iVillage, and coincide with the launch of iVillage.com/Health.

WASHINGTON – Without Republican votes, the House voted late Sunday night to approve a healthcare reform package passed by the Senate on Christmas Eve.

The bill, approved by a vote of 219-212, could be signed into law as early as Tuesday. No Republicans voted in support of the bill, while 34 Democrats voted against it.

According to House Speaker Nancy Pelosi (D-Calif.), the new law will make healthcare coverage available to 32 million uninsured Americans and establish healthcare exchanges where consumers can purchase healthcare insurance at a lower rate. She also said the new law would "hold health insurance companies accountable."

OAKBROOK TERRACE, IL – The Joint Commission has approved revisions to Medical Staff Standard MS.01.01.01, formerly known as MS.1.20, that addresses the Medical Staff's self-governance and its accountability to the governing body for the quality and safety of patient care.

The Medical Staff Bylaws are a written set of documents that describe the medical staff's organizational responsibilities and how the medical staff and governing body will work together.

Standard MS.01.01.01 provides the framework for constructing, writing and implementing these bylaws.

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.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced awards to help states facilitate health information exchange and advance health information technology (health IT).  Funded by the American Recovery and Reinvestment Act of 2009, today’s  awards are part of the $2 billion effort to achieve widespread meaningful use of health IT and provide use of an electronic health record by every citizen by the year 2014.  Every state and eligible territory has now been awarded funds under this program.

A key House committee voted Monday to advance President Obama's plan to overhaul the nation's health-care system, clearing the way for the House to vote on the measure later this week.

The House Budget Committee voted 21 to 16 to send the health care legislation to the House Rules Committee. That panel is expected to meet Thursday to draft new language for the reconciliation bill, compiling a package of fixes to the $875 billion measure that passed the Senate on Christmas Eve.

Two Democrats voted with all 14 Republicans to reject the effort to proceed with the Democratic strategy. Rep. Chet Edwards (Texas) and Allen Boyd (Fla.) both voted against the House health care bill last fall.

Leading provider groups used the last day of a public comment period to urge CMS to scale back the proposed rule establishing meaningful use criteria for electronic health records incentive programs. The Englewood, CO-based Medical Group Management Association asked CMS to formally request a one-year legislative extension of Stage 1 of the incentive program from Congress.

MGMA President/CEO William F. Jessee, MD, said in a 43-page letter to CMS Acting Administrator Charlene Frizzera that a failure to substantially modify the proposal would risk meeting the goals for health information technology adoption under the $21 billion stimulus package.

March 8, 2010 (St. Louis, Missouri) – Navvis & Company (St. Louis Missouri), a leading consultancy in the health services industry, announced today the acquisition of Tampa-based Physician Executive Management Center (PEMC). 

Schedule H, the Internal Revenue Service's new method of quantifying nonprofit hospitals' charity care and community benefit, fails to meet its goal and should be changed, the American Hospital Association said.

Instead of giving American taxpayers a view of the value of hospital contributions that individual hospitals and hospital systems provide, Schedule H on Form 990s, will tell only a portion of the story, said Melinda Reid Hatton, AHA senior vice president and general counsel.

ST. LOUIS, MO – BJC HealthCare, one of the largest nonprofit healthcare organizations in the United States, intends to automate and standardize its charge description master and pricing.

The 13-hospital health system has selected chargemaster management and pricing management solutions from Atlanta-based MedAssets. The St. Louis-based health system wants to bring all of its facilities together on a corporate chargemaster.

The American Medical Association is making progress on its plan to be the electronic platform physicians use to upgrade their practices with the latest technology.

Chicago-based AMA has formed a partnership with UnitedHealth Group's Ingenix subsidiary to "help physicians adopt and implement electronic health records," the two groups said in a statement provided to the Tribune. As part of the deal, the AMA will offer Ingenix CareTracker, a Web-based medical record system, through its Web site.

The AMA said Ingenix will be part of a yet-to-be-named larger platform being created on its site to help physicians develop new technologies to enhance their practices and improve their day-to-day work environment. The group said multiple options will be given to doctors beyond the Ingenix technology.

WASHINGTON – At a White House healthcare summit held Thursday, President Barack Obama urged Republican congressional leaders to consider working on several areas of common interest in the healthcare reform package, giving them a rough 6-week deadline before Democrats may consider using alternative measures to pass the plan.

Obama named health insurance reform, the purchase of health insurance across state lines and medical liability reform among the top three areas where agreement could possibly be reached.

Republicans argued they wanted to scrap all proposals on the table and rework a set of smaller steps to reform healthcare.

NEW YORK – GE, athenahealth, and Sermo are among the top 10 innovative healthcare companies named by Fast Company. Kaiser Permanente is the sole healthcare provider on the list.

GE was recognized for its Healthymagination initiatives, athenahealth for its work on the physician billing, practice management and medical records front, and Sermo for its online physician community.

WASHINGTON – As Congressional leaders prepare for Thursday's White House summit on healthcare reform, President Barack Obama has released his own version of a healthcare reform plan.

Obama said his plan would put American families and small business owners in control of their own healthcare and build on legislation passed by the House and Senate last year, with a focus on providing health insurance reform "that lowers costs, guarantees choices and enhances quality healthcare for all Americans."

As yet another indication that 2009 was a horrible year for nearly all aspects of the economy, Moody's Investors Service reported today that the year featured "high downgrade activity" in the not-for-profit healthcare sector.

In fact, Moody's reported 54 downgrades compared to 21 upgrades in 2009, which contrasts to 53 downgrades and 27 upgrades the previous year. In other words, the downgrade-to-upgrade ratio increased from a 2 to 1 ratio in 2008 to a 2.6 to 1 ratio in 2009, said Moody's.

Grant Awards to Help Make Health IT Available to Over 100,000 Health Providers by 2014, Support Tens of Thousands of Jobs Nationwide

WASHINGTON, DC - Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis today announced a total of nearly $1 billion in Recovery Act awards to help health care providers advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future. The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology. This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers.

ANDREWS, Texas -- A Texas nurse who was brought up on criminal charges for filing an anonymous complaint accusing a doctor of unethical conduct was acquitted by a jury Thursday in a case that watchdog groups warned could have a chilling effect on health care workers and patients.

Prosecutors have said personal - not professional - reasons motivated nurse Anne Mitchell to file the complaint against Dr. Rolando Arafiles with the Texas Medical Board. She was indicted in June on a count of "misuse of official information" after Arafiles filed a harassment complaint with the Winkler County Sheriff's Department.

A "home-to-hospital" program in use at MassGeneral Hospital for Children uses real-time video communication that enables an on-call attending physician, from their home, to personally examine patients and communicate directly with staff, other specialists, and even the patients' relatives.

Through the Connected Pediatric Critical Care program, six Pediatric Intensive Care Unit physicians from MassGeneral currently have the videoconferencing units in their homes. When they are need to consult patients and families while away from the hospital, they can videoconference in from home to a portable telemedicine station at the patient's bedside.

The U.S. Department of Health and Human Services (HHS) today awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking-the four most important actions for combating chronic diseases and promoting health. This money supports the one of several components in the Department’s comprehensive prevention and wellness initiative, Communities Putting Prevention to Work, which is funded under the American Recovery and Reinvestment Act of 2009.

WASHINGTON – The American Hospital Association’s Certification Center has launched the Certified Healthcare Constructor (CHC) credential for professionals in healthcare construction.

The American Society for Healthcare Engineering (ASHE) has endorsed the new certification. The ASHE is an AHA personal membership group.

KENNEBUNK, ME – Between September 2008 and September 2009 the nation's top eight health insurance plans saw membership decline by 1.7 million. Those losses are continuing in both the fully-insured and administrative services only (ASO) segments, according to Mark Farrah Associates, a Kennebunk, Maine-based provider of market data and intelligence solutions. The recession and high unemployment are being blamed for the losses.

Health plan membership decreased by 1.3 percent, from 133.2 million in 2008 to 131.5 million for 2009. ASO enrollment decreased 1.1 percent and risk enrollment declined 1.6 percent for these plans.

CORPUS CHRISTI, TX – National Surgical Hospitals, an owner of surgical hospitals and surgery centers in partnership with local physicians, has opened its newest facility in Corpus Christi, Texas.

The new hospital, which NSH will operate in partnership with a group of 55 area physicians, is the company's 15th surgical hospital to open nationwide and its fifth in Texas.

"By accelerating the construction process by more than 90 days, we completed this facility well ahead of schedule and have already received accreditation from the Joint Commission, which enables the hospital to participate in Medicare and Medicaid programs and positions it to grow and thrive in the current regulatory environment," said John Rex-Waller, president of NSH.

The amount of care required by hospitalized patients seems to grow every year, and many nurses in the field question whether recently-graduated nurses are sufficiently prepared to take on the demanding task.

The National Council of State Boards of Nursing (NCSBN) considers this a major issue and recently raised the passing standard on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to ensure new nurses are sufficiently ready to take on the growing needs of sicker patients.

LONG BEACH, CA – Southern California residents struggling to find healthcare will soon be able to take advantage of a telemedicine project being piloted by Cisco, Molina Healthcare and the state.

The California Telemedicine Pilot Project, launched last week on the Cisco HealthPresence telemedicine platform, will allow physicians at 15 sites in and around San Diego to make use of audio, video and data-sharing services to create what officials call a “patient care experience similar to the common medical encounter when patients visit their healthcare providers.

White House and Congressional leaders passed another important signpost Thursday on the road to completing the healthcare reform bill. Following marathon negotiations with labor union leaders all week, a new deal was reportedly hammered out over the issue of taxing employees' high-cost or "Cadillac plans."

The provision, which originated in the Senate bill, will remain, but the threshold at which the 40% tax would kick-in with the high-cost plans would change. The threshold would now be for families whose plans' value reach $24,000—up from $23,000; for individuals, the $8,500 threshold is likely to remain the same.

Although the House and Senate negotiators are still hammering out their plans for healthcare reform, lawmakers and healthcare stakeholders are playing a numbers game: carefully eyeing when specific projects are to be implemented and gauging how they can meet the deadlines.

Under the proposed healthcare reforms before the House and the Senate, both have differing expectations, as well as differing deadlines, with some to take effect this year and others to continue through at least 2018.

WASHINGTON (Reuters) - With President Barack Obama urging them on, congressional Democratic leaders met for eight hours at the White House on Wednesday and reported significant progress on finding a final healthcare compromise.

The United Nations health agency will review the way it dealt with the outbreak of swine flu once the pandemic has subsided, WHO spokeswoman Fadela Chaib told a news briefing.

"Criticism is part of an outbreak cycle. We expect and indeed welcome criticism and the chance to discuss it," she said, adding the WHO's review would involve independent outside experts and its results would be made public.

WASHINGTON – A new report shows that healthcare reform could create up to 4 million new jobs.

The report, released Friday by the Center for American Progress and the Leonard D. Schaeffer Center at the University of Southern California, combines data from David Cutler of the Center for American Progress and Neeraj Sood of the Leonard D. Schaeffer Center for Health Policy and Economics to forecast the job-creating effects of healthcare reform.

“One important way to create jobs is to slow the growth of medical spending,” the report said. “If healthcare cost increases slow down, then businesses will find it more profitable to expand employment, and workers will more readily move into those new jobs.”

Senate Democrats received some good news/bad news from two new studies issued by the Centers for Medicare and Medicaid Services (CMS) on the "Patient Protection and Affordable Care Act" passed by the Senate on Dec. 24.

First, a Jan. 8 memo from CMS Chief Actuary Richard Foster finds that an additional 34 million people would be covered by 2019 from proposed reforms in the Senate healthcare reform bill—up from the 31 million projected last month by the Congressional Budget Office (CBO).

Washington (CNN) -- Top Democrats are prepared to short-circuit the traditional legislative process and exclude their Republican counterparts during final congressional health care deliberations, senior Democratic sources have told CNN.

Democrats are trying to prevent the Republicans from using Senate rules to slow the push for final passage of a comprehensive reform bill, the sources added.

WASHINGTON (Reuters) - U.S. healthcare spending rose at the lowest rate on record in 2008 due to the recession, but still reached $2.3 trillion and devoured 16.2 percent of the U.S. economy, government analysts said in a report on Tuesday.

WASHINGTON – Physicians and privacy advocates aren't pleased with the newly proposed "meaningful use" requirements with which providers will likely have to comply to gain bonuses under the American Recovery and Reinvestment Act of 2009.

The Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology proposed the rules on Dec. 30, and will take comments for 60 days before issuing a final rule.

The Medical Group Management Association said the requirements "are overly complex" and that medical groups will confront significant challenges trying to meet them.

Even as Democrats seek the biggest expansion of health coverage in decades, as many as 23 million people could still be without insurance by 2018, illustrating the complexity of achieving the long-held Democratic goal of universal health care.

The legislation that the Senate passed Christmas Eve, which is expected to resemble closely the final bill that is hashed out between the House and Senate over the next month, would leave about 8 percent of the population under age 65 without health insurance, according to the nonpartisan Congressional Budget Office. It would extend insurance to 31 million of an estimated 54 million who would have no coverage without the legislation.

WASHINGTON – The government has launched two grant programs totaling $38 million for the training and development of a skilled workforce to support adoption and use of healthcare information technology.

The funding, announced Wednesday, adds to $80 million announced earlier this year. Authorized by the American Recovery and Reinvestment Act (ARRA), the grants are designed to help strengthen and support the health IT workforce.

ARMONK, NY – IBM’s financing arm has announced partnerships with four healthcare IT vendors in an effort to push electronic health records to providers ahead of the government’s incentive program.

IBM Global Financing, the lending and leasing business segment of Armonk, N.Y.-based IBM, has announced financing agreements with Siemens Healthcare, Lavender & Wyatt Systems, Healthcare Management Systems and Soft Computer. The deals are designed to allow the four developers of electronic medical record systems to offer their provider clients low-rate private financing to adopt EMRs.

WASHINGTON -- President Barack Obama pressed Senate Democrats to close ranks quickly behind a deal that has disappointed some liberals, saying Tuesday lawmakers are "on the precipice of an achievement that has eluded Congresses and presidents for generations."

Standing with senior Democrats in the Roosevelt Room of the White House, Mr. Obama said there is "broad consensus" on the core of the bill, which would create tax breaks to help people purchase insurance and bar insurers from denying coverage to those with pre-existing conditions, among other things.

Some differences remain, notably on abortion. But Mr. Obama -- who campaigned on the promise of expanding health-care coverage -- suggested it was time to compromise.

"The final bill won't include everything that everybody wants. No bill can do that," he said. "We simply cannot allow differences over individual elements of this plan to prevent us from meeting our responsibility to solve a longstanding and urgent problem for the American people."

JACKSONVILLE — Mayo Clinic Florida and St. Andrew’s Lighthouse say they are partnering to build an $8.8 million extended-stay facility to house cancer and organ transplant patients and their families.

The Gabriel House of Care, a 30-bedroom hospitality house, will be built on a 4.5-acre lakeside site on Mayo Clinic’s campus in Jacksonville. It will be leased to and managed by St. Andrew’s Lighthouse, a Jacksonville not-for-profit that provides extended-stay housing to patients visiting local hospitals for specialized medical treatment.

WASHINGTON – The National Committee for Quality Assurance has made changes to its disease management accreditation and certification requirements, adding voluntary performance reporting for five chronic conditions.

Employers, health plans and medical groups have developed disease management programs to alleviate the effects of chronic conditions and slow disease progression and reduce healthcare costs. NCQA’s accreditation and certification standards help purchasers select the most effective programs.

ANN ARBOR, MI – A recent survey shows CIOs are concerned about their ability to implement the standards recommended by the Health IT Standards Committee in time to meet currently established deadlines.

The survey, conducted by the College of Healthcare Information Management Executives (CHIME), drew 176 responses, nearly 13 percent of CHIME’s 1,400 members who make up CIOs or top information executives of provider organizations.

With few exceptions, most respondents reported that their organizations are early in the process of implementing applications that are based on standards under consideration by the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services.

While discussion in the Senate during the past few days has focused on how health insurance premiums will be impacted under the Patient Protection and Affordable Care Act, another area expected to gets its fair share of attention on the Senate floor is how the $848 billion reform bill—through savings and taxes—will be paid for over the next decade.

BOSTON – Swine flu, health reform and restrictions on industry gifts to doctors are among the top 10 health stories identified by the Harvard Health Letter in its annual list.

Among the top stories of 2009 is the national effort to curb healthcare costs via reform legislation, mandated coverage and tighter regulation of health insurers. "Chances are that legislation, if it does become law, won't do nearly enough to control costs," the list's authors said.

Walgreens has reduced its prices by nearly 20% and CVS nearly 10% for a scarce liquid form of the H1N1 drug Tamiflu amid state investigations into potential price gouging.

Connecticut Attorney General Richard Blumenthal still questions whether the pharmacy chains and others are charging fair prices. "I'm delighted they are reducing their prices, but they may have an obligation to reduce them even further," Blumenthal said Monday. He sent investigative letters Nov. 23 to Walgreens, CVS and Rite Aid and said his investigators are interviewing independent pharmacists.

ATLANTA - Swine flu infections seem to be dropping, but the number of children who died with the illness rose by about 30, according to a government report released Monday.

Widespread infections of swine flu were reported in 32 states as of Nov. 21, down from 43 states the week before.

ST. LOUIS, MO – Two leading operators of long-term acute care hospitals in the United States have completed a merger.

The St. Louis-based RehabCare Group has joined with Triumph HealthCare Holdings of Houston. RehabCare is a provider of post-acute services, managing rehabilitation programs in more than 1,250 hospitals and skilled nursing facilities in 41 states and owning and operating 33 rehabilitation and long-term acute care hospitals.

Cuts in Medicare reimbursements that are likely to be part of any healthcare reform legislation could adversely impact credit ratings for hospitals and health systems across the country, particularly in urban areas, according to new analysis by Moody's Investor Service.

The study noted the conflicting goals of healthcare reform—expanding access to care while simultaneously reducing costs—could have significant negative implications for many high-cost urban hospitals, even if the number of insured patients increases.

CHARLOTTE, NC – With 100,000 nursing positions currently unfilled and the shortage expected to climb to 340,000 nurses by 2020, healthcare systems need a strategy to reduce nurse turnover.

Healthcare systems should shift their focus from why nurses leave to why they stay, said David Rowlee, vice president of research services for Moorehead Associates, an employee survey and research firm.

WASHINGTON (Reuters) - The U.S. House of Representatives voted on Thursday to boost Medicare payments to physicians in a move that could help shore up support from doctors for a sweeping Democratic-backed healthcare overhaul.

The House voted 243-183 for the bill that would stop a 21 percent Medicare pay cut for doctors next year and put in place an updated payment formula that would better reward primary care physicians and reflect the sharp increase in healthcare costs.

Washington (CNN) -- Senate Majority Leader Harry Reid on Wednesday unveiled a sweeping health care bill that would expand health insurance coverage to 30 million more Americans at an estimated cost of $849 billion over 10 years.

Reid and other Senate Democrats cited an analysis by the nonpartisan Congressional Budget Office for the coverage and cost figures.

LOS ANGELES – Six Los Angeles-based health foundations, health plans and healthcare providers are urging the University of California Regents to reopen the Martin Luther King Jr./Drew Medical Center.

A proposal has been made that the medical center partner with the University of California to re-open by 2012.

CHICAGO (Reuters) - Sweeping new U.S. breast cancer guidelines released on Monday recommend against routine mammograms for women in their 40s, but several groups immediately rebelled against the recommendations.

The new guidelines by the U.S. Preventive Services Task Force, an influential panel of independent experts, would sharply curtail the number of breast mammograms done in the United States, sparing women the worry of false alarms and the cost and trouble of extra tests.

U.S. cancer experts argued the altered schedule may mean more women will die from breast cancer.

WASHINGTON – The healthcare retail clinic market has grown approximately 15 percent in the past two years, according to the Deloitte Center for Health Solutions. That growth will likely slow to as little as 10 percent from 2010 through 2012, Deloitte officials said, before accelerating above 30 percent from 2013-2014.

WASHINGTON – A new report by the Business Roundtable indicates key components of healthcare reform could slow the growth of healthcare costs.

The report, released Thursday, said "the right reforms" could slow healthcare growth from its current 10 percent a year to 4 percent, on pace with the Gross Domestic Product. The report shows that effective reforms could slow healthcare costs by as much as $3,000 per employee in 2019.

WASHINGTON – A new poll by the Trust for America’s Health and the Robert Wood Johnson Foundation indicates 71 percent of Americans favor increased investment in disease prevention and that disease prevention is an integral part of healthcare reform.

According to the poll, 44 percent strongly favor investing more in prevention.

WASHINGTON – Employment in the U.S. healthcare sector increased by approximately 29,000 jobs in October, while the national unemployment rate grew to 10.2 percent, according to recent data from the federal Bureau of Labor Statistics.

The biggest healthcare job gains were in ambulatory care and hospitals. Approximately 12,500 of the 29,000 new healthcare jobs were in the ambulatory care sector and 10,000 in hospitals.

Overall employment in nursing and residential care facilities increased by approximately 6,000 jobs in October.

St. Joseph's Hospital of Elmira and Guthrie Healthcare System of Sayre have called off plans to unite the two facilities under the Guthrie banner.

The two organizations are still committed to working together, as demonstrated by the number of Guthrie physicians on St. Joseph's staff, St. Joseph's spokesman Denis Sweeney said Tuesday afternoon.

"But both organizations have agreed that now is not the time to move ahead because of the economic climate and the uncertainty of the reimbursement changes in New York state and Pennsylvania," he said.

PLYMOUTH, MA – Jordan Hospital, a not-for-profit hospital in Plymouth, Mass., has installed a new denials management tool and is now using a complete revenue cycle solution product suite in its business office.

"We plan to improve our workflow by eliminating several manual processes," said Janet Wright, director of patient accounts at Jordan Hospital. "This tool gives us the real-time data we need while providing integrated workflow functions to not only fix our denials but also prevent them from happening again."

Late Wednesday, a bill that Republicans expect to offer as an alternative to the Democratic package received its assessment from congressional budget analysts, who concluded that the proposal would barely dent the ranks of the uninsured.

The measure would cover 3 million additional people at a cost of $60 billion through 2019, according to an analysis by the nonpartisan Congressional Budget Office. The Democrats' bill, by comparison, would cover far more -- 36 million additional Americans -- at a much higher cost -- $1.055 trillion through 2019, the CBO has said.

CHICAGO (Reuters) - Americans are more likely than people in 10 other countries to have trouble getting medical treatment because of insurance restrictions or cost, an international survey of primary care doctors released on Wednesday found.

While the United States spends more than twice as much as other developed countries on healthcare, it lags well behind in key measures of quality, the annual survey found.

WASHINGTON — As the House moved toward climactic votes on legislation to remake the health care system, the Congressional Budget Office said Monday that middle-income families might be required to pay 15 percent to 18 percent of their income on insurance premiums and co-payments under the proposal.

Democrats cited the figures as evidence that the legislation would reduce premiums for many low- and middle-income families who currently lack affordable coverage.

Federal officials -- who list healthcare workers among those at greatest risk for H1N1 flu -- had promised California 6.2 million doses by now. But the state has received just 2.7 million doses due to manufacturing shortages, said Mike Sicilia, a spokesman for the state Department of Public Health. It is the same story nationwide, where only about 27 million of an expected 40 million doses are available.

Among the five highest-priority groups, Sicilia said California ranks healthcare workers third, after pregnant women and caregivers of children under 6 months old. But officials here, unlike some in Ohio, New York and Wisconsin, have not set aside vaccines for healthcare workers.

An uncommon type of MRSA called USA600 appears much more lethal when it infects the bloodstream than more common strains of methicillin-resistant Staphylococcus aureus.

That's the finding from a preliminary study presented Saturday at the Infectious Disease Society of America's annual meeting in Philadelphia.

GENEVA (Reuters) - Only one dose of vaccine is needed for protection against pandemic H1N1 flu and the jabs have so far proved to be safe, the World Health Organization said on Friday.

Health experts have been debating whether one or two shots are necessary to protect against H1N1, known as swine flu. The number of doses required is key to estimating how many vaccines are needed in total.

WASHINGTON – The House health reform bill unveiled on Thursday includes a provision for implementing a unique device identification system that healthcare providers say could save $16 billion a year.

Blair Childs, senior vice president for public affairs at the Premier healthcare alliance, based in Charlotte, N.C., said Premier is urging passage of the provision.

"The distressing reality is that we can identify and remove tainted peanut butter and dog food from the market before reaching consumers, but in healthcare patients risk having a recalled medical device used in their treatment because there is no way to quickly and reliably locate a recalled device," Childs said.

House Speaker Nancy Pelosi (D-Calif.) unveiled a health-care reform bill Thursday that includes a government insurance option and a historic expansion of Medicaid, although sticking points involving abortion and immigration remain unresolved.

The bill includes a version of the "public option" preferred by moderates and raises Medicaid eligibility levels to 150 percent of the federal poverty level for all adults, a steeper increase than in earlier drafts.

“Small businesses drive our economy and create jobs, but they are struggling as health care costs continue to rise,” Secretary Sebelius said. “The high cost of care is making it difficult or impossible for these businesses to offer care or grow their business. Health insurance reform will bring costs down and give small businesses the relief they need.”

PRINCETON, NJ – According to the 2004 Health Resources and Services Administration’s National Sample Survey on the registered nurse population, the nursing shortage is expected to hit 1 million by 2020.

The Robert Wood Johnson Foundation’s (RWJF) New Careers in Nursing provides scholarships to under-represented minorities to attend nursing schools. To date, the program has awarded 700-plus scholarships, according to Sue Hassmiller, RN, senior adviser for RWJF.

CDC director Dr. Thomas Frieden said 22.4 million doses were now available to states, which can get them a day after they order them.

"One of the messages for states, localities and health providers is not to reserve vaccine that they have available, to give it out as soon as it comes in, because more is on the way."

Hillcrest Medical Center is part of an experiment testing a new "bundled" payment system. Medicare makes a single reimbursement for all the hospital and doctor care for heart and joint procedures, rather than making separate payments to the facility and physicians.

Such combined payments are getting close attention during the health care debate as a way to encourage hospitals and doctors to work together to hold down costs and improve care.

WASHINGTON -- Top Senate Democrats are close to finalizing their health bill and could unveil a measure as soon as early this week that would include stiffer penalties on employers who fail to provide health coverage.

Senate leaders plan to submit the bill to the Congressional Budget Office for a cost estimate as soon as Monday, and make the legislation public as soon as Tuesday, according to a person familiar with the negotiations.

MISSOURI CITY, TX – UT Physicians, the medical group practice of The University of Texas Medical School at Houston, has entered into a lease agreement that will allow it to expand its clinic space in Missouri City, Texas.

WASHINGTON – Unless Congress passes a healthcare reform overhaul, employees who work for small businesses are at risk of losing their healthcare coverage, according to a new report.

Health and Human Services Secretary Kathleen Sebelius and Small Business Administration Administrator Karen Mills, who released the report on Tuesday, said it underscores the financial difficulties small businesses face in providing health insurance to their employees.

WASHINGTON (Reuters) - A single doctor, nurse or technician with dirty hands can undo all the good work of an entire hospital staff trained to carefully wash their hands to prevent the spread of infection, French researchers reported on Monday.

This may be especially likely to happen just at the worst time -- when a hospital is overwhelmed with a disaster or a pandemic of infectious diseases and staff are reassigned to cope, the team at France's National Institute of Health and Medical Research or INSERM said.

On the Senate side, the closed-door healthcare reform negotiations by representatives from two committees—Finance and Health, Education, Labor, and Pensions (HELP)—remained for the most part uneventful on Monday.

However, Finance Chairman Max Baucus (D-MT), in a reporter teleconference call, said earlier in the day that the public insurance option—which was not included in the Finance bill—"was alive" and they are "still looking at it," he said. "We're trying to see what makes the most sense."

Most U.S. health care workers don't get flu shots. They never have, despite 28 years of jawboning by the Centers for Disease Control and Prevention.

But that's going to change this fall in New York state. A new regulation there aims to stop health care workers from passing the flu to patients. By the end of this month, all hospital and clinic workers are supposed to get vaccinated against seasonal flu. By Nov. 30, they are required to get the swine flu vaccine.

WASHINGTON - A second Republican senator signaled Wednesday she's open to voting for sweeping health care legislation this year, putting President Barack Obama closer to a historic achievement that has eluded generations of Democratic leaders.

But Sen. Susan Collins, R-Maine, told The Associated Press that the bill approved Tuesday by the Finance Committee needs substantial improvements to make coverage more affordable, contain costs, and protect Medicare. Nevertheless, she joined her Maine GOP colleague Sen. Olympia Snowe in endorsing the goal of far-reaching changes.

"My hope is we that can fix the flaws in the bill and come together with a truly bipartisan bill that could garner widespread support," Collins said in an interview.

Nearly 90% of more than 1,000 emergency physicians say they have concerns about their emergency department's ability to care for an influx of H1N1 flu patients, according to a new Internet poll by the American College of Emergency Physicians. Only 16% of emergency physicians in the poll believe the federal government is doing everything it can to provide them the resources needed to respond to a severe flu outbreak.

WASHINGTON (Reuters) - Most of the people who have died from the new pandemic H1N1 flu had underlying conditions such as asthma, but 45 percent seemed healthy, according to the largest study yet of U.S. cases.

Children with sickle cell and other blood diseases have a special risk from the swine flu, just as they do from seasonal influenza, Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention said on Tuesday.

CHICAGO (Reuters) - Once swine flu patients are sick enough to need hospital care, they decline very fast, requiring ventilators and advanced treatments that quickly strain scarce hospital resources, several teams reported on Monday.

The first doses of the H1N1 vaccination have arrived in the United States, with a nurse being one of the first Americans to receive the vaccine. Holly Smith, pediatric nurse with two daughters, works at Le Bonheur Children's Medical Center in Memphis, TN.

Le Bonheur, which has been on the front lines of the epidemic since late August, has received 100 doses of nasal spray vaccine. The vaccines were given to healthcare workers working in an outdoor tent set up to treat children with flu symptoms. Recently, the hospital has already seen at least 3,000 children with flu symptoms.

WASHINGTON (CNN) -- A compromise health care proposal widely seen as having the best chance to win Democratic and Republican support would cost $829 billion over the next 10 years, nonpartisan budget analysts concluded Wednesday.

It also would reduce the federal deficit by more than $80 billion, according to a report from the Congressional Budget Office.

Three in 10 elderly patients who sought care in an emergency room after a fall were admitted to the hospital for treatment of their injuries, which was a major share of the $20 billion cost for treating falls in people over age 65 in 2006.

Since 2006, fall-related health costs are believed to have increased substantially because of a larger number of seniors suffering falls, and because of the higher costs of treating the fractures, open wounds, and head traumas they cause.

Those were two findings from a new report from the federal Agency for Health Research and Quality, which said that each year, about one-third of elderly adults experiences a fall. Falls are the most common cause of non-fatal injuries in the senior population.

Though health providers nervously prepare for an influenza pandemic that threatens their hospitals, office practices and clinics, more than half of Americans surveyed don't think the virus will have a significant impact on public health.

That's the conclusion of a Harris Interactive telephone survey commissioned between Sept. 10 and 13 by the Deloitte Center for Health Solutions. Of the 2,500 people who received phone calls, 40% agreed to respond.

Hospitals don't compete on price and rarely publish measurements of their quality, if they measure it at all.

Except in Pennsylvania. For two decades, a state agency has published "medical outcomes" -- death and complication rates -- from more than 50 types of treatments and surgery.

Social networking Web sites and modern communication media, such as text messaging, e-mail, and smartphones, are a part of our daily lives. Although such technologies have a place in society, they are taking a toll on the professional image of tomorrow's physicians.

WASHINGTON – A new report commissioned by the Robert Wood Johnson Foundation projects that if federal reform efforts are not enacted, the cost would be substantial.

According to the report, In every state the number of uninsured would increase, employer-sponsored insurance (ESI) coverage would continue to erode, spending on public programs would balloon and out-of-pocket healthcare costs for individuals and families could increase by more than 35 percent over the next decade.

BERLIN, MD – The Atlantic General Hospital and Health System has announced an agreement with the Rite Aid Corporation to open Atlantic ImmediCare clinics inside three Rite Aid stores this fall.

The clinics, which will be in Ocean Pines and Pocomoke City, Md., and Millsboro, Del., will provide extended hours for care in the evening and on weekends.

WASHINGTON – The Department of Health and Human Services has awarded $40 million to help 41 states and the District of Columbia find and enroll uninsured children who are eligible for either Medicaid or the Children’s Health Insurance Program.

“With millions of Americans either out of work or otherwise struggling to make ends meet during this recession, there is an even greater urgency to bring steady, reliable healthcare to children in these families who may have lost their coverage,” said HHS Secretary Kathleen Sebelius.

LAGRANGE, GA – The West Georgia Health System and Perot Systems have signed a deal for revenue cycle management technology and services for the health system's facilities in western Georgia and eastern Alabama.

The agreement is designed to enable the LaGrange, Ga.-based system to use technology from Plano, Texas-based Perot Systems to lower its revenue cycle administrative costs and improve its billing and reimbursement processes.

TORONTO (Reuters) - Canada outperforms the United States in health outcomes but is well behind global leaders like Japan in overall health of its population, a Canadian report released on Monday showed.

The annual report card by the Conference Board of Canada ranked Canada 10th out of 16 developed countries, with a "B" grade. The United States was the worst performer, placing 16th and earning a "D" grade.

GENEVA (Reuters) - Early use of antivirals is effective in treating H1N1 flu and health authorities must be vigilant for signs of drug resistance, the World Health Organisation said on Friday.

Silver Spring, Md. -- Vice President Joe Biden and Health and Human Services (HHS) Secretary Kathleen Sebelius today hosted a town hall meeting with seniors in Silver Spring, Md., and released a new report, Health Insurance Reform and Medicare: Making Medicare Stronger for America’s Seniors. The report, authored by HHS, outlines how health insurance reform will help seniors and answers key questions about President Obama’s health insurance reform plan.

As directed by President Obama, the Secretary of the Department of Health and Human Services (HHS) will launch a new demonstration initiative that will help states and health care systems.

"The national health reform debate is coming to a head," says Gordon Wheeler, spokesman for the American College of Emergency Physicians. "But despite the letters we've written and our own activities on the Hill, we keep hearing that if we just pass legislation to get more primary care physicians, and got everyone insured, people wouldn't need to go to the emergency room.

"Well, we know that's not true. We know that many of those 120 million patient visits to the emergency room a year will continue, some of them at the behest of their physicians. So what are we doing to invest in our emergency medicine infrastructure? Not very much."

WASHINGTON (Reuters) - Senate Finance Committee Chairman Max Baucus said on Monday he would revise his healthcare reform bill to ease concerns among fellow Democrats about the affordability of insurance requirements for low- and middle-income families.

The shift came one day before the committee begins consideration of a sweeping overhaul of the $2.5 trillion industry, President Barack Obama's top domestic priority.

Six national organizations representing thousands of healthcare professionals nationwide have joined together to create the Hospital Care Collaborative (HCC) to examine pressing needs and outcomes related to hospitalized care.

As part of the launch of HCC, the group has established 13 guiding principles for delivering team-based care in the hospital. It represents the consensus of the HCC members.

President Obama directs HHS to announce within 30 days that the Department will make available demonstration grants to States, localities, and health systems for the development, implementation, and evaluation of alternatives to our current medical liability system, consistent with the goals and core commitments outlined by the Administration.

WASHINGTON -- Senate Finance Committee Chairman Max Baucus formally unveiled a 10-year $856 billion bill that would extend health insurance to tens of millions of Americans not now covered, moving an important step forward on President Barack Obama's top domestic priority.

The sweeping measure is designed to steer a more moderate course on health policy than other major bills moving through Capitol Hill, and doesn't propose to create a new government insurance plan to compete with private insurers, as proposed in rival House legislation and favored by many liberals. Instead, the Montana Democrat is proposing to expand coverage by creating a network of nonprofit health insurance cooperatives.

As the three major nurses' organizations in the country came together earlier this month to form the largest registered nurses union and professional association in the U.S., some resistance remains from Massachusetts nurses' unions.

So far only one of the three organizations has voted unanimously to endorse and join the proposed "super union." In a meeting held on September 10, delegates from the Oakland-based California Nurses Association (CNA) became the first organization to join the super union. The Oakland-based association represents 86,000 of the potential 150,000 nurses of National Nurse United (NNU).

BOSTON (Reuters) - Most U.S. doctors favor having both public and private options in a reformed healthcare system, a survey published on Monday said.

When given a three-way choice among private plans that use tax credits or subsidies to help the poor buy private insurance; a new public health insurance plan such as Medicare; or a mix of the two; 63 percent of doctors supported a mix, 27 percent said they only wanted private options, and just 10 percent said they exclusively wanted public options.

Employment discrimination lawsuits have doubled in the last 10 years, thanks in large part to provisions of the 1991 Civil Rights Act that give juries a say in financial settlements. Among the headlines: Publix supermarkets got slapped with an $82.5 million class-action sex discrimination settlement and Coca Cola paid nearly $192.5 million in 2000 to settle a class action.

In other words, juries are ready and eager to shower aggrieved former-employees-turned-plaintiffs with millions of dollars in settlement dollars at your business's expense.

In the future, patients will communicate with their doctors via e-mail, online chat room, Web portal, mobile device, remote monitoring technology (or some other method or medium that hasn't yet been invented), thus avoiding a long wait for a short appointment that might not have been necessary anyway.

Senate Finance Chairman Max Baucus announced Monday that he may unveil his long-awaited health-care bill as soon as Tuesday -- and he predicted that Republicans will find plenty to like about it.

The Montana Democrat and his fellow "Gang of Six" Finance Committee negotiators haggled Monday over top Republican concerns, including provisions that would limit medical malpractice cases, bar benefits from reaching illegal immigrants, and block federal funds from subsidizing abortions.

In reflecting on the events of September 11th, 2001, Secretary Sebelius calls for health professionals to consider enlisting in the Medical Reserve Corps, especially in light of this year's flu season.

In July 1868, as the United States was reconstructing and reuniting after being torn apart by civil war, the nation came together to enshrine in a constitutional amendment the right of employment for every physician in the country.

Ok, that may not have been the original intent, but some California physicians are using the 14th Amendment to argue that the state's Medical Practice Act, which bans hospitals from employing doctors, is unconstitutional.

"No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States," the amendment reads, and some are arguing that targeted restrictions on how physicians can earn a living do just that.

But even more interesting, to me at least, than the legal validity of the case is the context in which it is being debated.

Those in favor of the ban on employing physicians, including the California Medical Association, have claimed the ban allows physicians to maintain their independence. They fear that an employed physician's decisions would be influenced by the hospital's profit motives, degrading the sacred physician-patient relationship.

But now it is opponents who argue that employment is nearly the only way for physicians to maintain their independence, because the financial climate has become so severe that physicians are struggling to make a living as independent practitioners.

WASHINGTON (Reuters) - Democratic leaders promised swift action on a healthcare system overhaul on Thursday after a high-stakes speech by President Barack Obama that earned good public reviews but appeared to change few minds in Congress.

U.S. House of Representatives Speaker Nancy Pelosi told reporters she was confident that Obama by year's end would sign a healthcare reform bill, his top domestic priority.

WASHINGTON — President Obama’s speech on health care failed to bridge the gulf with Republicans, but Democrats said on Thursday that the president had largely succeeded in unifying his own party by making a cogent, persuasive pitch to the American public and by casting his plan to overhaul the health care system as a political and moral imperative.

A bill that may become the strongest legislation in the nation to prevent health plans from dropping coverage to members who become ill passed the California Senate yesterday and may soon be headed for the governor's desk.

The bill, called AB 2, is expected to receive Assembly approval in the next few days.

If it is signed by Gov. Arnold Schwarzenegger, as its sponsors anticipate, the legislation would set up an independent board, managed by two state agencies, which would have to approve any health plan's cancellation of an enrollee's plan. Only when insurers prove the applicant intentionally misrepresented his or her health on the questionnaire would cancellation be approved.

If an insurer tried to cancel a policy without getting approval, the state Department of Managed Health Care and the Department of Insurance would impose administrative penalties.

After a month of angry town hall meetings and dire predictions about the state of his top domestic priority, President Obama moved forcefully Wednesday night to take the initiative on health care -- and in the process rejuvenate his presidency and unite his fractious Democratic Party.

Each of the nation's 5,700 hospitals must cut $2.6 million a year on average in costs in the next 10 years to meet the demands of President Obama's proposed health care reform, a daunting task when half of those hospitals lose money.

Criticism came from almost every corner leading up to Obama's speech before Congress on Wednesday night, yet many hospital CEOs aren't complaining, at least not publicly. They say that the hospitals they run are rife with inefficiency and that they are optimistic that the $155 billion in savings is do-able with the help of business disciplines, such as the Toyota Production System, lean manufacturing and Six Sigma.

"Efficiency has not been the hallmark of health care delivery operations," says Alan Aviles, CEO of New York City Health and Hospitals Corp. (HHC), one of the largest hospital and health care systems in the country, with $5.4 billion in revenue.

In 2009, U.S. health-care reform moved rapidly to the front burner, and it will stay there. President Barack Obama and his advisors have made it clear that reducing health-care costs is a necessary prerequisite to achieving their broader economic goals.

The levers that the new administration plans to pull will address the obvious issues: treatment variability (standardized procedures tend to be more cost-effective), value-in-use analysis (evaluating costs and benefits), chronic disease management, enhanced information technology, and utilization rates. (Utilization rates measure the amount of health care delivered and received per capita. Preventive medicine and other means of reducing long-term utilization while maintaining overall public health thus represent a major cost-saving opportunity.) The reforms are all expected to involve both public and private initiatives, reassuring voters that “if you have insurance you like, you can keep it.”

A bipartisan group of six Finance Committee senators considers a new proposal that might be the last, best hope for an overhaul agreement.

The six were to meet Tuesday on  Sen. Max Baucus' proposal to create nonprofit insurance plans to compete with those offered by profit-making companies. The proposal by the committee chairman is noteworthy for the piece that's missing: a government-run alternative favored by liberal Democrats.

CHICAGO – Janie Johnson has no health insurance, so when she cut her toe while giving herself a pedicure, she limped to the emergency room at one of Chicago's safety net hospitals and waited her turn.

"I'm 44, but I probably look about 55 right now," Johnson joked in Stroger Hospital's emergency department where more than 100 patients sat waiting. Urgent cases, from chest pains to gunshot wounds, are rushed to doctors first. Johnson was glad to have somewhere to go for health care.

"I don't know what I would do" without the hospital, she said. "My health would probably get worse."

To all the knotty issues involved in health care overhaul, add one more: The proposals in Congress may threaten the funding and future of the nation's already-struggling safety net hospitals.

It's an irony hospital leaders are expressing quietly as Congress reconvenes this week to take up health care again. Hospital leaders support expanding insurance coverage to more Americans, but they worry financing the expansion will cause some teetering urban hospitals to deteriorate and close.

WASHINGTON (Reuters) - U.S. President Barack Obama's top aides said on Sunday he still wants a government insurance option in healthcare legislation but they left room for a compromise that could disappoint his liberal backers.

Ahead of a major Obama healthcare speech on Wednesday night, the advisers sought to portray a sense of momentum behind an overhaul of the $2.5 trillion U.S. healthcare system after a tumultuous summer of debate during which Obama lost ground and Republicans rallied opposition.

Obama, speaking to a joint session of Congress, will lay out specifics of what he supports to try to regain control of the healthcare issue and gain passage of a plan this year.

Analysts say how he handles the debate this autumn is a major test of his leadership and could define his presidency.

WASHINGTON – Medicare has announced that it will pay healthcare providers the same rate to administer the H1N1 flu vaccine as the seasonal flu vaccine, according to the Centers for Medicare & Medicaid Services.

The program will pay for both H1N1 and seasonal vaccination and for administering more than one dose of vaccine, if medically necessary for the beneficiary, according to an article in the CMS publication MLN Matters.

The 12 California hospitals receiving the latest fines for putting patients in "immediate jeopardy" of harm or death include three that failed to remove sponges or towels from surgical patients, one where a psych tech repeatedly slapped an unconscious patient in the face in the belief he was "faking it," and another where staff failed to properly use restraints, resulting in a patient's critical fall.

Poor training of medication use resulted in a heparin overdose that caused a brain hemorrhage in a patient at a sixth facility while at a seventh hospital, managers failed to properly staff the intensive care unit, and a patient whose condition was quickly deteriorating was not adequately treated.

GENEVA (Reuters) - H1N1 flu has killed at least 2,837 people but is not causing more severe illness than previously and the virus has not mutated, the World Health Organization (WHO) said on Friday.

"There is no sense that the virus has mutated or changed in any sense," WHO spokesman Gregory Hartl told a news briefing.

BATON ROUGE, LA – A new study shows how Louisiana's hospitals are responsible for providing economic stability to its communities.

The study, by the Louisiana Hospital Association, indicates hospitals account for 1.9 percent of all healthcare establishments in Louisiana, yet they provide 38 percent of total healthcare employment. Hospitals also account for 43 percent of the total payroll of the healthcare sector.

When it comes to reporting a physician to the National Practitioner Data Bank (NPDB), hospitals can sometimes find themselves between a rock and a hard place. Hospitals are obligated under the Health Care Quality Improvement Act to report physicians whose privileges have been denied or revoked under certain circumstances, but in doing so, they run the risk of being sued by those same physicians.

WASHINGTON (Reuters) - President Barack Obama will seek to boost flagging support for healthcare reform next week with a rare speech to Congress after a rocky summer raised questions both about his leadership and legislative program.

Obama, who has staked significant political capital on a broad plan to overhaul the $2.5 trillion healthcare industry, will make his speech to a joint session of the U.S. Senate and House of Representatives on September 9, an administration official said.

Disruptive, offensive behavior on the part of providers is still such a significant and frequent problem in health settings, it jeopardizes patient safety, and can affect quality of care, despite Joint Commission guidance that took effect Jan. 1 to prevent such breakdowns.

Of more than 1,500 providers responding to an e-mail questionnaire, three-fourths said they had been the target of unprofessional, intimidating or inappropriate behavior within the last 24 months. Two-thirds said they considered leaving their job because of it and 41% said they actually did.

Medicare physician fee schedule payments may be "excessive" for a variety of medical services because efficiencies that occur when two or more services are furnished together are not reflected in the fee schedule, according to the Government Accountability Office (GAO) in a study examining Medicare physician payments and fees. GAO's review found that expanding Medicare's practice in this area could reduce payments by an estimated half billion dollars a year.

Medicare essentially could end up paying twice for those overlapping services, which do not involved surgery or imaging, GAO said. For instance, when two medical services are furnished together, a physician may only review a patient's medical record once, but fees paid would reflect that Medicare paid twice for that activity with both services.

Catholic Health Initiatives and Trinity Health announced today they have signed a letter of intent to combine their four Eastern Oregon-Western Idaho hospitals into a single local system. The agreement calls for transferring the three CHI facilities to Trinity Health, thus creating a new regional healthcare system to be operated by Trinity Health.

Three of the hospitals – Mercy Medical Center, Nampa, Idaho; Holy Rosary Medical Center, Ontario, Ore.; and Saint Elizabeth Health Services, Baker City, Ore. – are part of Catholic Health Initiatives (CHI) of Denver, Colo. The fourth hospital is Saint Alphonsus Regional Medical Center (SARMC) of Boise, a part of Trinity Health of Novi, Mich.

WASHINGTON – Expanding health centers to reach an additional 20 million patients as part of national health reform would save $212 billion from 2010 to 2019, including federal Medicaid savings of $59 billion, according to a new study.

The dollar value of these expected savings far exceeds the cost of the health center investment of $38.8 billion called for in the July 14 version of the House health reform bill.

Parkland Health & Hospital System in Dallas is indeed the only AAA-rated hospital in the country, according to CFO John Dragovits, but he says the hospital owes much of this designation to the underlying credit worthiness and credit standing of Dallas County, as well as to the hospitals' strong operating performance.

Dallas County has been AAA rated for 30 years. The hospital, however, had to fight for its AAA rating from both Fitch Ratings and Standard & Poor's. Rating agencies have historically discounted hospital districts by a notch or so because they have the word hospital in their name, says Dragovits.

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.

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.

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.

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.

In 2007, Cedars-Sinai Medical Center in Los Angeles rolled out a "universal floor" during an expansion project. In the time that has passed, Cedars-Sinai's innovation has lowered wait times for patients being admitted from the ED and elsewhere, reduced the number of patient safety events, and increased staff member satisfaction.

A universal floor is one on which most patient consultations can take place. Rooms are created with multiple types of patient care in mind and staff members are trained in many specialties to facilitate patients' needs on the one floor. This reduces the need for patients to travel throughout the hospital.

PRINCETON, NJ – The Robert Wood Johnson Foundation has selected 15 hospitals to participate in two new quality improvement programs as part of its Aligning Forces for Quality (AF4Q) initiative.

Foundation officials say AF4Q is designed to lift the overall quality of healthcare in targeted communities, reduce racial and ethnic disparities and provide models for real reform.

MINNEAPOLIS, MN – Leaders of three major nurses' organizations that are coming together to form the largest registered nurses union and professional association in U.S. history have said they will hold a founding convention Dec. 7-8 in Scottsdale, Ariz.

OAKLAND, CA – In a move to unite the power and influence of major U.S. nursing unions, the United American Nurses, California Nurses Association/National Nurses Organizing Committee, and the Massachusetts Nurses Association are joining together to form a new, 150,000-member association.

The new organization will be called the United American Nurses-National Nurses Organizing Committee, UAN-NNOC, and will be affiliated with the AFL-CIO.

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.

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.

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 -- President Barack Obama, seeking to rally his base, accused Republican leaders Thursday of trying to block a health-care overhaul from the start and again threw his weight behind a government-run insurance plan.

During a radio call-in show and at a town-hall meeting of supporters, Mr. Obama tacked to the left as Democratic allies inched toward trying to pass a health-care bill on their own.

Bipartisan negotiators on the Senate Finance Committee were set to resume talks Thursday night, and Mr. Obama said he still backed the effort.

A report released yesterday crunches some numbers to confirm what most of us already probably knew: The cost of our health insurance is going up much faster than our pay.

According to Families USA, a Washington nonprofit group that advocates for affordable health care, between 2000 and 2009 the cost of a family premium provided by an employer increased 95.2 percent while median income went up just 17.5 percent. To make matters more galling, workers get fewer benefits plus higher deductibles and co-pays for the extra money.

Sen. Charles E. Grassley, a key Republican negotiator in the quest for bipartisan health-care reform, said Wednesday that the outpouring of anger at town hall meetings this month has fundamentally altered the nature of the debate and convinced him that lawmakers should consider drastically scaling back the scope of the effort.

"The health system has been moving in the wrong direction," says Sean Khozin, MD, MPH. "People talk about healthcare reform, but no one is talking about what happens between a doctor and a patient. We have to pay much closer attention to the way that doctors and patients interact and transact and enhance that process because that's where care is delivered."

Khozin's futuristic Brooklyn, NY-based practice is unlike any other. It is powered by Hello Health, a secure, Web-based platform that includes a practice management system, an electronic medical records system, and a social networking tool that allows physicians to communicate with patients both online and face-to-face.

Intensive care units are an essential and costly component in most U.S. hospitals. However, little is actually known about what staffing and work-process interventions produce the best balance of quality and costs. We explore the reasons hospitals chose to either adopt or reject an innovative telemedicine approach to supporting delivery of intensive care.

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.

Survey researchers have tracked American public opinion about health reform for more than twenty years.1 As Robert Blendon and colleagues have observed, analyses of poll results have revealed two recurring tensions in Americans' views about the nation's health policy.2,3 First, although Americans report dissatisfaction with the health care system and private health insurance, they remain satisfied with their own arrangements and do not favor a single-payer plan. Second, although Americans agree that something should be done to help the uninsured, they are reluctant to pay higher taxes to do it.

Maybe not to the extent of the recent Supreme Court nominee, but President Obama's selection of David Michaels, Ph.D., MPH, to lead OSHA is a departure from previous administrations.

Michaels is a scientist, an epidemiologist in fact, and author of the recently published book, Doubt is Their Product, that criticizes the business strategy of "manufacturing uncertainty," where polluters and the manufacturers of dangerous products successfully oppose public health and environmental regulations.

WASHINGTON (Reuters) - The government-run health insurance option favored by President Barack Obama is not essential to a healthcare overhaul as long as the final measure boosts competition, a top U.S. health official said on Sunday.

Health and Human Services Secretary Kathleen Sebelius said a public insurance option was "not the essential element" of any overhaul, and non-profit cooperatives being considered by a Senate panel could also fulfill the White House goal of creating more competition on insurance.

The controversy, over proposed Medicare funding of end-of-life counseling, has come to epitomize some of people’s deepest fears about the government’s role in health care.

Yet physicians who work with patients on end-of-life planning say that while they are surprised and upset about criticism of the proposal, it has brought needed attention to what they view as a long under-funded and overlooked service.

A former insurance executive said that some opposition to President Obama’s healthcare overhaul blueprint has been generated by the private-payer industry, though he did not directly link current squabbles at town hall meetings to the insurance lobby itself.
Wendell Potter, a former vice president for Cigna, described a history of “duplicitous and well-financed PR campaigns” the insurance sector has waged whenever Congress attempts sweeping reform of the healthcare industry.

A new study by the Medical Group Management Association finds that finances, and the adoption of electronic health records continued for the second consecutive year to be the top concerns of most medical practice professionals.

State Medicaid Fraud Control Units (MFCU) recovered $1.3 billion in court-ordered restitution, fines, civil settlements, and penalties for fiscal year 2008, according to an August 7 Office of Inspector General (OIG) report.
 
MCFUs also obtained 1,314 convictions; achieved 971 civil settlements and/or judgments; and excluded 755 providers from participation in the Medicare, Medicaid, and other Federal health care programs in FY 2008, the report stated.

Polling shows that Americans - especially those who already have coverage - are skeptical of the Democratic proposals to expand coverage to millions. So Obama will use a potentially boisterous town hall-style meeting in New Hampshire to highlight how his proposals would affect workers whose employers provide their health insurance.

In the past 10 years, a fair amount of headway has been made in refining error reporting systems, especially since the Institute of Medicine report "To Err Is Human". More recently, Patient Safety Organizations have taken shape and been introduced to the healthcare industry.

One point of view missing from all of these reporting systems, however, is that of the patient and his or her family. However, a new project funded by the Agency for Healthcare Research and Quality (AHRQ) aims to utilize the patient's perspective more when analyzing adverse events.

Senators headed home for their August break Thursday amid an escalating partisan battle over health-care reform, with a small band of lawmakers hoping to keep their delicately negotiated compromise alive until Congress reconvenes in September.

Sen. Olympia J. Snowe (R-Maine), a key negotiator, said she was so alarmed about distortions involving the deal being developed by members of the Finance Committee that she urged President Obama during a visit to the White House on Thursday to rebut conservative allegations, "to lessen the concern" about the emerging legislation.

Can the federal government apply an individual mandate like the one in Massachusetts across the country?

And how would the government enforce such a rule in very large states like California, with a population of 37 million, where 34% of non-Medicare age residents lack health coverage? How much would the feds charge uninsured Americans when they get sick? And how should the government collect fines for not getting insurance?

"Everyone recognizes that we are going to do, if there's any way possible, a bipartisan bill," Senate Majority Leader Harry Reid said after Democratic senators attended a White House meeting.

The lead lobbyist for health insurance companies complained today that her industry is being "demonized" in the healthcare reform debate.

When patients understand their choices and share in the decision making process with their doctors, they tend to choose less invasive and less expensive treatments than they would have otherwise received.

So it’s not surprising that in Washington and state legislatures around the country, lawmakers are looking at expanding shared-decision making programs, both as a possible cost-cutting measure and as a way to ensure that patients get their legal right to informed consent before medical procedures.

Democrats leave town for the August recess with frayed nerves and fragile agreements on health-care reform, and a new bogeyman to fire up their constituents: the insurance industry.

With the House already gone and the Senate set to clear out by Friday, the terms of the recess battle are becoming clear. Republicans will assail the government coverage plan that Democrats and President Obama are advocating as a recklessly expensive federal takeover of health care. And Democrats will counter that GOP opposition represents a de facto endorsement of insurance industry abuses.

HHS Secretary Kathleen Sebelius today provided the down payment for a nationwide effort to reduce health care associated infections in stand-alone or same-day surgical centers.  The first effort will begin later this month in 12 states under provisions of the American Recovery and Reinvestment Act of 2009, administered by the Centers for Medicare & Medicaid Services (CMS).

“Keeping patients healthy is one of the requirements of the Recovery Act, and the first 12 states that have volunteered to focus attention on these surgical centers are taking a giant step in helping to reduce infections that affect millions of patients every year,” said Secretary Sebelius.  “CMS’s efforts with states to reduce the number of infections quickly are just one part of protecting the health of the nation’s health care system.”

WASHINGTON (Reuters) - President Barack Obama's drive for U.S. healthcare reform suffered another setback on Thursday when Senate Finance Committee leaders said the panel would not vote on a compromise plan before senators leave for a month-long August recess next week.

Committee Chairman Max Baucus said there had not been sufficient progress to complete the healthcare bill by the end of next week but talks between three Democrats and three Republicans on the panel would continue.

The heath-care bill that has been wending its way through the Senate Finance Committee is likely to contain a provision that President Obama opposed during his campaign: a tax on at least some employer-provided insurance plans.

After more than a week's delay, the House Energy and Commerce Committee said it is continuing consideration of the Tri-Committee healthcare reform bill (H.R. 3200) on Wednesday afternoon after reaching an agreement with the conservative Democrat group, the Blue Dogs, to trim $100 billion from the bill.

An agreement also was reached not to seek a full House vote on the bill prior to the beginning of the summer recess, which begins July 31.

The public health insurance plan proposed under the House healthcare reform bill (H.R. 3200) would have "a substantial price advantage" over private insurance because it would pay providers using current Medicare payment methodology, according to an analysis of the House healthcare reform bill (H.R. 3200) released by The Lewin Group this week.

Key lawmakers on Wednesday moved to cut roughly $100 billion from the cost of health-care reform proposals as they sought to break weeks of gridlock on President Obama's signature legislative initiative before Congress departs for a month-long recess.

WASHINGTON -- Liberals who see the effort to overhaul health care as a once-in-a-generation opportunity are growing anxious that a final deal -- and a Democratic president they backed -- will negotiate away their top priority: a public plan to compete with private insurers.

Some Democrats are threatening to oppose any bill that excludes this option, and sympathetic outside groups are pressuring wavering lawmakers. Health Care for America Now, a liberal group, and the American Federation of State, County and Municipal Employees spent $800,000 on television ads targeting moderate Democrats, citing their opposition to a public option.

Meanwhile, MoveOn.org announced a series of television ads Monday to run in Washington, D.C., and on national cable networks accusing the Republicans of playing political football with health care. Americans United For Change, another liberal group, announced a radio ad targeting moderate Republican Sen. Olympia Snowe of Maine, a key swing vote.

The many-headed Hydra, with breath poisonous enough to kill, is one of the more gruesome beasts in Greek mythology. In Hercules’s great clash with it, he would cut off one of its heads, only to have two more appear. No matter what he did, he couldn’t keep up.

You can think of Congress’s efforts to pay for health reform as being a little bit like a battle to slay a many-headed Hydra.

Members of Congress have come up with one idea after another to pay for covering the uninsured. But they still haven’t put together legislation that could pass. And that’s in large part because most of those ideas have a basic flaw.

WASHINGTON (Reuters) - Republican and Democratic senators negotiating financial details of healthcare reform have made great progress and are on the verge of a deal, a key Republican senator said on Wednesday.

"We have made great progress. Every day we make some progress," Senator Charles Grassley, one of the three Republicans from Senate Finance Committee involved in the talks to overhaul the healthcare system, told NPR radio.

President Obama on Wednesday will take his plea for health-care reform to audiences in North Carolina and southwest Virginia, armed with a bullet-point-style message that his aides are hoping will be persuasive.

The Congressional Budget Office said that a draft bill expected to emerge from the Senate Finance Committee would cost under $900 billion over the next decade and ensure healthcare coverage of 95% of Americans.

Committee Chairman Max Baucus (D-Mont.), speaking to reporters outside of his Capitol Hill Office, called the report “good news,” but cautioned that the package omits several key provisions. He did not go into detail, however.

“Nevertheless, the report is encouraging,” he said.

WASHINGTON — A bipartisan group of senators on Monday reported progress toward agreement on a compromise health care overhaul while the House speaker suggested that any House vote on a health plan would be delayed until more was known of the Senate approach.

“We’re on schedule either to do it now or to do it whenever,” said Speaker Nancy Pelosi, who had hoped to win approval in the full House by the end of this week.

With the Obama administration's top domestic priority struggling in Congress, supporters and opponents of the health-care proposals are focusing on the constituency that both sides agree has become pivotal to the debate: the majority of Americans who have health insurance and are generally satisfied with their care.

Although polls have consistently shown that just over half of Americans think the health-care system is in need of reform, a substantial majority say they are satisfied with their own insurance and care. Any hope of change will require their support, according to experts and advocates across the ideological spectrum.

WASHINGTON (Reuters) - Democrats in the U.S. House of Representatives pounced on a congressional budget analysis to bolster their plan for a government-run health insurance option on Monday, as party leaders said they were closer to agreement on healthcare reform.

The report by the nonpartisan Congressional Budget Office said the public option proposed by Democrats would not drive private insurers out of business and most people would still choose to get their medical coverage through employers.

NEW YORK (Reuters Health) - The U.S. is likely to face a severe shortage of heart surgeons in the next 10 years, say representatives from medical schools and thoracic surgeons' groups.

Writing in the journal Circulation, Dr. Atul Grover of the Association of American Medical Colleges in Washington, DC and colleagues point out that the number of active cardiothoracic surgeons in the U.S. "has fallen for the first time in 20 years."

More than half of today's cardiothoracic surgeons are older than 50 years, and more than 15 percent are between the ages of 65 and 74 years, the researchers note.

WASHINGTON — The major health care bills moving through Congress would require nearly all Americans to have health insurance. But as lawmakers struggle to achieve the goal of universal coverage, a critical question is whether the plans will be affordable to those who are currently uninsured.

WASHINGTON (Reuters) - Senate Democrats do not have the votes to pass healthcare reform without Republican support, a key Democrat said on Sunday, but White House spokesman Robert Gibbs said he is confident a bill will pass by year's end.

Democrat Kent Conrad, a key player in bipartisan Senate Finance Committee negotiations on healthcare, refused to predict whether the panel will be able to produce a bill before the Senate breaks for a month long recess on August 7.

WASHINGTON -- President Barack Obama's health-care plan is in jeopardy because of serious concerns that costs will spin out of control. As much as anyone, it's White House budget director Peter Orszag's job to save it.

Mr. Orszag is the administration's point man for controlling health-care spending. So when the director of the Congressional Budget Office, which Mr. Orszag used to run, testified eight days ago that none of the health plans pending on Capitol Hill would control long-term spending, Mr. Orszag knew that meant trouble.

HHS Secretary Kathleen Sebelius congratulated the National Conference of State Legislatures (NCSL) after the conference approved an amendment in favor of health insurance reform. The amendment was approved by a vote of 38-11. According to NCSL rules, amendments must receive 75 percent of the vote in order to pass.

WASHINGTON — President Obama showed great fluency in the intricate details of health policy at his news conference on Wednesday night, but experts said some of his points were debatable.

Mr. Obama said doctors, nurses, hospitals, drug companies and AARP had supported efforts to overhaul health care.

While it is true the American Medical Association has endorsed a bill drafted by House Democratic leaders, a half-dozen state medical societies have sharply criticized provisions that would establish a new government-run health insurance plan.

WASHINGTON (Reuters) - President Barack Obama said on Wednesday he realized Americans were skeptical about his healthcare overhaul, but that the country's economic recovery depended on implementing the $1 trillion plan.

Obama, insisting the "stars are aligned" for approval this year despite discord in Congress over the plan, warned inaction would undermine the economy, worsen the deficit and cripple millions of Americans financially.

WASHINGTON (Reuters) - Some of the ideas proposed for U.S. healthcare reform could cost patients thousands of dollars a year out of their own pockets, and premiums could end up being too high, according to two reports.

One analysis for the American Cancer Society's Cancer Action Network showed a plan now offered to federal employees, including members of Congress, sometimes costs patients $7,000 a year in out-of-pocket expenses -- many of which a seriously ill patient would have no way of avoiding.

President Obama's dream of dramatically remaking the nation's health-care system is still a long way from reality. But if lawmakers can reach an accord, one thing is virtually certain: For the first time ever, every American would be required to carry health insurance

The Health IT Policy Committee approved revised recommendations for defining "meaningful use" of electronic health records this past Thursday. But for many providers—especially rural community hospitals and solo or small group practices—the objectives for meaningful use are still out of reach.

The bar needs to push providers, while ensuring that a reasonable number of leading-edge organizations can achieve it by 2011, says John Haughom, MD, senior vice president of clinical quality and patient safety at PeaceHealth, a Bellevue, WA-based seven-hospital system with a 500-member medical group. Haughom is no stranger to HIT. Roughly 14 years ago, PeaceHealth implemented a community health record that shares patient information with providers throughout the region—including its competitors. The community health record has roughly 2 million patient records in its database and more than 20,000 clinical users—only a portion of whom are PeaceHealth employees

As liberal protesters marched outside,  Sen. Max Baucus sat down inside a San Francisco mansion for a dinner of chicken cordon bleu and a discussion of landmark health-care legislation under consideration by his Senate Finance Committee.

At the table on May 26 were about 20 donors willing to fork over $10,000 or more to the Democratic Senatorial Campaign Committee, including executives of major insurance companies, hospitals and other health-care firms.

WASHINGTON — As President Obama began a new push to overhaul the health system, Democratic Congressional leaders, bowing to unease among lawmakers and governors in their own party on Monday, suggested scaling back a plan to tax top earners to pay for the sweeping legislation and signaled a retreat from their ambitious timetable.

House and Senate leaders had been pressing for floor votes in each chamber before lawmakers depart for the August summer recess. But Congressional aides said it was increasingly clear that the Senate would not be ready to vote on its bill before its recess begins on Aug. 8, and that House Democrats seemed unwilling to vote to raise taxes without knowing where the Senate stood.

WASHINGTON (Reuters) - A key U.S. congressional committee on Friday approved healthcare legislation that includes a hefty tax on the rich but critics pointed to fresh warnings that President Barack Obama's health reform plan would do little to rein in skyrocketing spending.

The House Ways and Means Committee agreed to raise taxes to pay for the plan's estimated $1 trillion cost in part by higher taxes on couples making more than $350,000. Critics argue that it would harm small businesses who fall into this tax category.

WASHINGTON (Reuters) - The world's population of older people is growing at the fastest rate ever seen and the old will soon outnumber the young for the first time, U.S. researchers reported on Monday.

An aging population will push up pension and healthcare costs, forcing major increases in public spending that could slow economic growth in rich and poor countries.

WASHINGTON – Major business groups are launching a series of new advertising campaigns aimed at shaping Congress' health overhaul.

The U.S. Chamber of Commerce, which represents three million employers, plans to introduce a sharply worded multimedia advertising campaign in the next several days pushing back against the key planks of Democrats' health overhaul proposals. The group plans to run television and print advertisements in the Washington area and about a half dozen states with lawmakers who hold key votes in the debate, including Maine, Arkansas, Louisiana and Nebraska.

The ads will take aim at Democrats' proposals to create a public health insurance plan and raise taxes on the wealthy. The campaign also will emphasize the significance of existing employer-provided health insurance plans, which currently cover about 170 million Americans.

Six months into his presidency, Barack Obama may have no greater test of his ability to translate personal popularity into a successful legislative agenda than the upcoming two weeks.

With skepticism about the president's health-care reform effort mounting on Capitol Hill -- even within his own party -- the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.

Congress's chief budget analyst delivered a devastating assessment yesterday of the health-care proposals drafted by congressional Democrats, fueling an insurrection among fiscal conservatives in the House and pushing negotiators in the Senate to redouble efforts to draw up a new plan that more effectively restrains federal spending.

WASHINGTON — The House Ways and Means Committee approved legislation early Friday to overhaul the health care system and expand insurance coverage after a marathon session in which Democrats easily turned back Republican efforts to amend the bill.

In a 13-10 vote along party lines, the Senate Health, Education, Labor and Pensions Committee on Wednesday became the first committee to approve a marked up healthcare reform bill. The bill, called the "Affordable Health Choices Act," is expected to be merged with the Senate Finance Committee's bill, which is not completed.

More than 500 amendments were considered, and of those, about 160 Republican amendments were accepted, said Sen. Chris Dodd (D CT), who chaired the committee in the absence of Sen. Edward Kennedy (D MA), who is recovering from a brain tumor. "Although it wasn't a bipartisan vote, it was a bipartisan effort that produced this bill."

Few topics can get physicians worked up like generational differences in practice styles. I've heard Baby Boomer physicians complain about being forced to take call during holidays because the younger physicians in the practice refused to, and I've listened to Generation X doctors lament the lack of work-life balance and the poor communication skills in their older colleagues.

America's Best Hospitals, an annual ranking of the country's elite medical centers, is a tool for patients who need medical sophistication most facilities cannot offer. Unlike other rankings and ratings that grade hospitals on how well they execute routine procedures like outpatient hernia repair or manage common conditions like low-grade heart failure, the U.S. News approach looks at how well a hospital handles complex and demanding situations--replacing an 85-year-old man's heart valve, diagnosing and treating a spinal tumor, and dealing with inflammatory bowel disease, to name three examples.

The Congressional Budget Office on Tuesday said that the House's version of a health reform bill would cost $1.04 trillion over a 10-year period, but cautioned that its analysis is preliminary and did not take into account a plan to raise taxes or savings from Medicare and Medicaid.
 

The Senate Health, Education, Labor and Pensions Committee voted 13-10 to approve a $611 billion comprehensive healthcare reform bill that it plans to marry with the Senate Finance Committee's efforts.

WASHINGTON — Most Americans say it's important to overhaul health care this year, a USA TODAY/Gallup Poll finds, but they are less enthusiastic about some of the proposals to pay for it.

And while a majority say controlling costs should be the legislation's top goal, more than nine in 10 oppose limits on getting whatever tests or treatments they and their doctors think are necessary.

In his first full workday back at the White House after traveling last week, healthcare reform legislation was very much on the mind of President Barack Obama. Meeting later in the day with key congressional leaders, he is pushing to get legislation passed in each chamber before Congress recesses for the summer.

Regina M. Benjamin, an Alabama family physician who served for almost two decades as one of the few doctors in a shrimping village along the Gulf Coast, was nominated as U.S. surgeon general yesterday by President Obama.

Flanked by the president and Health and Human Services Secretary Kathleen Sebelius at a Rose Garden ceremony, Benjamin, 52, promised to act as "America's doctor" if appointed.

President Barack Obama nominated Regina Benjamin as U.S. surgeon general. Benjamin is a rural Alabama family physician who made headlines with her fierce determination to rebuild her nonprofit medical clinic in the wake of Hurricane Katrina.

She also is a leader in the call to improve health disparities, pushed by the need in her own fishing community of Bayou La Batre, Ala., and its diverse patient mix—where immigrants from Vietnam, Cambodia and Laos make up a growing part of the population.

WASHINGTON — In the struggle to overhaul the nation’s health care system, 16 physicians have ended up in ringside seats — as members of the House and Senate.

But they have taken different lessons from their experiences in medicine, and they do not agree on what a bill should look like.

President Obama's overhaul of the nation's health-care systems is unlikely to be completed by the White House's August deadline, lawmakers said Sunday.

Democrats and Republicans alike said the administration's sweeping health-care reform proposals are moving forward on Capitol Hill, but they cautioned against rushing into a spending plan that could cost trillions of dollars over the next decade.

WASHINGTON - The nation's hospitals will give up $155 billion in future Medicare and Medicaid payments to help defray the cost of President Barack Obama's health care plan, a concession the White House hopes will boost an overhaul effort that's hit a roadblock in Congress.

Top executives of Detroit's five major hospital systems are developing a plan to put satellites of federally qualified health centers into their emergency departments and pay the health centers a monthly fee for each patient the centers treat.

A bipartisan group of governors told President Obama yesterday that they share his urgent desire to restructure the nation's health-care system but warned that any changes should not place more burdens on strained state budgets or eliminate innovative programs they already have in place.

By David Alexander and Donna Smith

WASHINGTON (Reuters) - President Barack Obama's administration sought to regain momentum on healthcare reform on Wednesday as lawmakers, stunned by the trillion dollar price tag, delayed the legislative timetable for the program.

Health and Human Services Secretary Kathleen Sebelius, echoing Obama's own calls for speedy reforms, told an audience of Democratic activists that there was no time to waste on the administration's chief domestic policy priority.

FAIRFIELD, Conn. -- General Electric Co.'s health care division said Monday it will offer financing to doctors and hospitals that buy GE's electronic medical records equipment in an effort to cover an expected lag in the flow of federal stimulus money meant for the medical technology.

Dom Nicastro, for HealthLeaders Media, June 15, 2009

Major regulations surrounding breach notifications on PHRs by the Federal Trade Commission and unsecure PHI by the Department of Health and Human Services are due in August.

However, now is the time to start thinking about a few things when it comes to HIPAA and the new laws in the Health Information Technology for Economic and Clinical Health (HITECH) Act.

The American Medical Association wants it to be known: they support a government-sponsored health insurance plan, except when they oppose one.

In testimony to the Senate Finance Committee last month, the physician lobby went on at length detailing its discomfort with a so-called public plan, predicting it would "restrict patient choice," force private insurers out of the market and "would likely lead to an explosion of costs that would need to be absorbed by taxpayers."

When President Obama touches down today in Green Bay, Wis., he will be landing in one of the highest-value health communities in the nation, a city that by numerous measures has managed to control medical spending while steadily improving health outcomes.
"If we could make the rest of the nation practice medicine the way that Green Bay does, we would have higher quality and significantly lower costs," said Peter Orszag, the Obama administration budget chief who has emerged as a key player on health-care reform.

WASHINGTON -- A major health insurer says the government can save more than $500 billion in Medicare spending by sending patients to less expensive, more efficient doctors, reducing hospital visits by the elderly and cutting unnecessary care.

Those are among 15 suggestions made Wednesday by UnitedHealth Group Inc., a Minnesota-based health management company that is the biggest participant in the government's Medicare insurance program for the elderly. United said the proposals added up to $540 billion in savings over 10 years.

CVS's Minute Clinic, Target's Clinic, The Clinic at Walmart, Walgreens' Take Care Health Clinic—what do they have in common? They are part of a growing breed of retail clinics that provide fast, low-cost, convenient care for customers. They are also located in more affluent communities, according to a new study from the University of Pennsylvania School of Medicine.

Most retail clinics, also called convenient care clinics, tend to be located in areas of higher incomes with higher percentages of Caucasian residents, according to a new study, "The Geographic Accessibility of Retail Clinics for Underserved Populations," published in The Archives of Internal Medicine in May.

In the midst of dealing with countless challenges, both foreign and domestic, and a deep ideological divide in Congress, the Obama administration and its Democratic allies have nevertheless made important strides in their aggressive pursuit of health care reform legislation. In what President Barack Obama characterized as "a historic day, a watershed event in the long and elusive quest for health care reform," major organizations representing the nation's physicians, hospitals, health plans, and medical suppliers pledged to do their part to achieve the administration's goal of reducing by 1.5% annually the growth of health care spending over the next decade — saving an estimated $2 trillion.

OK, so there's been a lot of buzz—and a lot of articles—about hospitals that are using the micro-blogging site Twitter to describe surgeries in real time. There's also been a lot of debate over whether or not this is a good idea.

Despite many waves of debate and piecemeal reforms, the U.S. health care system remains largely the same as it was decades ago. We have seen no convincing approach to changing the unsustainable trajectory of the system, much less to offsetting the rising costs of an aging population and new medical advances.

Today there is a new openness to changing a system that all agree is broken. What we need now is a clear national strategy that sets forth a comprehensive vision for the kind of health care system we want to achieve and a path for getting there. The central focus must be on increasing value for patients — the health outcomes achieved per dollar spent.1 Good outcomes that are achieved efficiently are the goal, not the false "savings" from cost shifting and restricted services. Indeed, the only way to truly contain costs in health care is to improve outcomes: in a value-based system, achieving and maintaining good health is inherently less costly than dealing with poor health.

WASHINGTON (Reuters) - Overhauling the U.S. healthcare system to contain soaring costs and expand medical coverage to the uninsured would help boost U.S. economic output, lower budget deficits and raise workers' incomes, a White House report said on Tuesday.

A report by the White House Council of Economic Advisers said healthcare spending, which currently accounts for about 18 percent of the country's economic output, could reach 34 percent by 2040 if the current rate of cost growth continues. It said that kind of growth rate was unsustainable

After meeting at the White House three weeks ago, members of the six healthcare organizations that promised to find ways to save $2 trillion over the next decade—by decreasing by 1.5% the annual healthcare spending growth rate—yesterday sent their game plan "to bend the cost curve" in the form of a 28-page letter to the White House.

After convening seven all-day meetings and multiple conference calls, the group came up with the following projected savings:

Utilization of care ($150 to $180 billion)
Chronic care ($350 to $850 billion)
Administrative simplification and the cost of doing business ($500 to $700 billion)

WASHINGTON (Reuters) - A coalition of U.S. health industry groups on Monday outlined how they plan meet President Barack Obama's goal of cutting $2 trillion in costs industrywide over the next decade.

In a letter to Obama, the groups said some of the proposed savings can be achieved now but others depend on "good public policy" in a proposed health industry overhaul that Obama wants Congress to enact by the end of the year.

Michael Young was brought in as chief executive officer of Grady Memorial Hospital in Atlanta to work a similar turnaround that he accomplished with Erie County Medical Center in Buffalo, NY—a story I wrote back in 2006.

Cutting the outrageous deficits the troubled public hospital has been running for years was probably number one on his list of things to do. Wringing greater support from the communities that send their indigent and charity care patients to Grady was probably item number two. But changing the culture that allowed Grady to slip so far has to be third on his list.