Author Archives: henrykotula

A brewing physician-health system disconnect

Posted on by • Posted in Health System, Hospital, Hospital Industry, Leadership, Leadership Alignment, Physician, Physician Alignment, Physician Compensation, Physician Leadership, Physician Practice Management • Leave a comment

https://mailchi.mp/7d224399ddcb/the-weekly-gist-july-3-2020?e=d1e747d2d8

Addressing The Consumer-First Disconnect - B&T

We’re hearing from medical groups around the country that in the past few weeks, office visit volumes have quickly approached pre-COVID levels. Some are even busier, running at 110 percent of their February volumes, or more. At the same time, practice has become more stressful, with doctors balancing virtual care with in-person visits, new safety procedures slowing operations, and staff and patients worried about COVID exposure. Everything feels different, and irrespective of the number of patients on today’s schedule, all of the changes make a physician feel like she’s working harder than before.

A chief clinical officer from a Midwestern health system relayed the discord this has created when discussing incentives: “Our doctors were fully on board with the need to reduce salaries back in April, so we all took a 15 percent pay cut through the summer. Now that they’re busy again, they want to be bumped back to 100 percent. But the system’s financial picture hasn’t changed.”

The growing disconnect between how hard many staff are working and the economic reality of the system isn’t unique to doctors. But physicians, most of whom have their compensation tied to individual productivity, may feel it more acutely. While there are no easy solutions, it’s critical to discuss this disconnect openly, rather than letting resentment fester under the surface.

The pandemic has brought to light the brittleness of health system and physician practice finances. Prescient systems will use this moment to work with their doctors to rethink practice and align compensation with the financial success of the system, while meeting doctors’ needs for stability and security.

 

 

Meeting growing consumer demand for “care anywhere”

Posted on by • Posted in Asynchronous Care, Care Anywhere, Consumer Loyalty, Consumer Preferences, Consumer Trust, Consumerism, Emergency Care, Health System, Hospital, Hospital Industry, Maintenance Care, Office Visit, On Demand Care, Primary Care, Telemedicine, Urgent Care, Virtual Healthcare, Virtual Visit • Leave a comment

https://mailchi.mp/7d224399ddcb/the-weekly-gist-july-3-2020?e=d1e747d2d8

 

While COVID-19 provided a big push for doctors and health systems to rapidly expand telemedicine visits and other kinds of remote patient interactions, many report that they are now seeing telemedicine visits decline sharply, as in-person visits return.

While it’s natural to be glad that “things are returning to normal”, backing off virtual care is short-sighted, as recent experiences have set new expectations for patients. Survey data shows consumers like using telehealth services, both because they’re more convenient (65 percent) and help avoid COVID infection (63 percent)—and 51 percent say they would continue using them after the pandemic ends.

We’re increasingly convinced that virtual physician visits are just one part of a continuum of care that can be delivered in the convenience and safety of the patient’s home. The graphic below highlights the range of consumer-focused virtual care solutions, from asynchronous chat interactions all the way to hospital care delivered at home.

Health systems that can deliver “care anywhere”—an integrated platform of virtual services consumers can access from home (or wherever they are) for both urgent needs and overall health management, coordinated with in-person resources—have an unprecedented opportunity to build loyalty at a time when consumers are seeking a trusted source of safe, available care solutions.

 

 

America celebrates a grim milestone

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, Epidemic, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Intensive Care (ICU), Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://mailchi.mp/7d224399ddcb/the-weekly-gist-july-3-2020?e=d1e747d2d8

Epidemic vs. Pandemic, What Is the Difference Between an Epidemic ...

 

As the nation headed into the 4th of July weekend, the number of new COVID cases hit a string of daily highs, reaching a record high of more than 55,000 on Thursday. States across the South and Sunbelt, especially those that lifted stay-at-home orders early, saw the worst spikes.

Florida broke a new record with more than 10,000 cases on Thursday, and Georgia also experienced a new daily high. Hospitalizations continued to rise sharply in several states as well. Many hospitals reported a shift in COVID admissions toward younger, otherwise healthy adults, reports borne out by the lower death rate than that experienced in the initial surge of cases in the Northeast. (Advances in the management of severely ill COVID patients have also brought death rates down.)

In a Senate hearing on Tuesday, top White House health advisor Dr. Anthony Fauci said that the US was “not in total control” of the pandemic, and predicted that daily new case counts could top 100,000 if more stringent measures are not taken.

California, Florida, and other states took steps to roll back reopening efforts, and Texas Gov. Greg Abbott abruptly reversed direction and ordered a statewide mask mandate. Welcome news, but likely too late to prevent cities like Houston from exceeding available ICU capacity. Cases in the city have skyrocketed across the past month, with its positive test rate hitting 20 percent yesterday; its cancer and children’s hospitals began admitting COVID-positive adults to provide added capacity.

With celebrations scheduled across the nation this weekend, including another large event today at Mount Rushmore to be attended by President Trump, where masking and social distancing will be optional, it seems certain that we will continue to reap the whirlwind of careless behavior and hasty reopening for the rest of this month and beyond.

And looming in just six weeks—students return to schools and colleges.

US coronavirus update: 2.7M cases; 130K deaths; 33.5M tests conducted.
 

 

 

 

June’s cautious economic recovery is based in part-time work and vulnerable industries

Posted on by • Posted in 2020 Election Issues, Coronavirus, Economic Crisis, Economic Recovery, Economy Reopening, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Job, Job Growth, Job Market, Job Search, Job Security, Market Outlook, Pandemic, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.washingtonpost.com/business/2020/07/02/junes-cautious-economic-recovery-is-based-part-time-work-vulnerable-industries/?fbclid=IwAR290sM5RZgwuxNMBDi1chv_i1ulzy4zY2KF4f1cDUMCsiTTpME2wkGVM6s&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

 

The June unemployment rate of 11.1 percent, down from a peak of 14.7 percent in April, reflects a continuing, cautious economic recovery. What those numbers don’t show is an increase in employment driven disproportionately by part-time work and industries that are vulnerable to another shutdown.

The unemployment rate is a blunt tool. It takes into account anyone who works, even if they work for only one hour a week. And part-time employment has recovered much more quickly from April’s catastrophic losses than full-time employment. While full-time employment is still 12 percent lower than it was in February, part-time employment is back to pre-pandemic levels.

According to the Labor Department’s survey of American households, many of those workers would work full-time if they could and are working part-time only because of poor economic conditions. The number of people pushed into part-time work has more than doubled since February. Meanwhile, the number of people who work part-time by choice is still down by 23 percent.

 

 

The unemployment rate isn’t wrong: Part-time work is still work. However, those jobs have already proved to be vulnerable to a slowing economy. Anyone pushed into part-time work by the coronavirus’s initial shock to the economy may be even more vulnerable in the case of future shutdowns. And part-time workers may not have access to benefits such as health insurance that are available to full-time workers.

The industries that bounced back in May and June are also at the mercy of future shutdowns as coronavirus cases surge across the Sun Belt. For instance, unemployment in leisure and hospitality is still very high but dropped by 10 percentage points from April’s staggering 40 percent. Retail and wholesale unemployment dropped by a third. In contrast, finance, government and professional services have had a slow start to recovery. Unemployment in the information industry actually increased from May to June.

 

 

If the greatest gains in employment are in industries that suffered most in the early stages of the pandemic, those gains are vulnerable to future waves of shutdowns. Meanwhile, less-volatile industries may continue to be slow to bounce back. A Congressional Budget Office report predicted that the unemployment rate is expected to stay above its pre-pandemic levels through the end of 2030.

 

 

Ability to Reduce Your Chances of Getting Covid by 5x

Posted on by • Posted in 2020 Election Issues, Coronavirus, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

Image may contain: text that says 'INEQUALITY MEDIA IMAGINE IF THERE WAS A MEDICATION THAT REDUCED YOUR CHANCES OF GETTING COVID BY 5X. EVERYONE WOULD WANT THAT MEDICATION. WELL, THAT'S WEARING A MASK. @JasmynBeKnowing'

12 hospitals laying off workers in response to COVID-19

Posted on by • Posted in Cash, Cash Reserves, Coronavirus, Cost Management, Cost Reduction, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Elective Procedures, Elective Surgery, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Health Policy, Health System, Hospital, Hospital Industry, Job, Job Growth, Job Loss, Job Search, Job Security, Liquidity, Net Income, Nonoperating Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic • Leave a comment

https://www.beckershospitalreview.com/finance/12-hospitals-laying-off-workers-in-response-to-covid-19.html?utm_medium=email

Facing a financial squeeze, hospitals nationwide are cutting jobs

To address the financial fallout from the COVID-19 pandemic, hospitals across the nation are looking to cut costs by implementing furloughs, layoffs or pay cuts. 

U.S. hospitals are expected to lose $323.1 billion this year due to the pandemic, according to a recent report from the American Hospital Association. The total includes $120.5 billion in financial losses that hospitals are projected to see from July through December, as well as $202.6 billion in losses that were projected between March and June. The losses were largely due to a lower patient volume after canceling elective procedures. 

Although Congress allocated $175 billion to help hospitals offset some of the revenue losses and expense increases to prepare for the pandemic, hospitals have said it is not enough.

Nearly 270 hospitals and health systems have furloughed workers in response to the pandemic and several others have implemented layoffs. 

Below are 12 hospitals and health systems that have announced layoffs since June 1:

1. Trinity Health furloughs, lays off another 1,000 workers
Trinity Health, a 92-hospital system based in Livonia, Mich., will lay off and reduce work schedules of 1,000 employees.

2. Ohio children’s hospital cuts jobs
Dayton (Ohio) Children’s Hospital said it has cut jobs to help offset financial losses due to the COVID-19 pandemic.

3. Munson Healthcare to cut 25 leadership positions
Traverse City, Mich.-based Munson Healthcare cut 25 leadership positions to help offset financial losses amid the COVID-19 pandemic.

4. Erlanger lays off 93 nonclinical employees
Chattanooga, Tenn.-based Erlanger Health System has cut 93 nonclinical positions to help offset financial damage from the COVID-19 pandemic. The layoffs come after the health system cut 11 leadership positions June 12, including the CEO of Erlanger Western Carolina Hospital in Murphy, N.C., and made staff and pay cuts in March.

5. Michigan Medicine to lay off 738 employees by end of June
Ann Arbor-based Michigan Medicine planned to eliminate 738 positions by the end of June amid financial challenges from the COVID-19 pandemic.

6. Pennsylvania health system cuts 10% of workforce amid pandemic losses
As part of a restructuring effort to cut pandemic-related losses, State College, Pa.-based Mount Nittany Health System plans to lay off 10 percent of its workforce, or about 250 employees.

7. TriHealth eliminates 440 positions to cut costs
Cincinnati-based TriHealth cut 440 positions as part of a plan to trim at least $140 million in expenditures this year.

8. Layoffs hit U of Kansas Health System
The University of Kansas Health System St. Francis Campus in Topeka laid off employees after previously implementing furloughs.

9. Tower Health to cut 1,000 jobs
Citing a $212 million loss in revenue through May due to the COVID-19 pandemic, West Reading, Pa.-based Tower Health plans to cut 1,000 jobs.

10. Colorado hospital cuts 22 positions
Parkview Medical Center in Pueblo, Colo., eliminated 22 positions in response to the COVID-19 pandemic.

11. Arkansas Children’s cuts 42 positions
Little Rock-based Arkansas Children’s Hospital said it is eliminating 42 jobs as part of cost-savings measures in response to the COVID-19 pandemic.

12. North Carolina health system cuts 10% of workforce, closes clinics
Citing a financial hit from the COVID-19 pandemic, Lumberton, N.C.-based Southeastern Health will permanently close several clinics, cut 10 percent of its workforce and reduce executive pay.

 

 

6 latest hospital credit rating downgrades

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https://www.beckershospitalreview.com/finance/6-latest-hospital-credit-rating-downgrades-0702.html?utm_medium=email

credit ratings | Özde Kurter

The following six hospital and health system credit rating downgrades occurred since June 1. They are listed below in alphabetical order.

1. Care New England (Providence, R.I.) — from “BB” to “BB-” (Fitch Ratings); from “BB-” to “B+” (S&P Global Ratings)

2. Holy Redeemer Health System (Meadowbrook, Pa.) — from “Ba1″ to Ba2” (Moody’s Investors Service); from “BBB-” to “BB+” (Fitch Ratings)

3. Indiana (Pa.) Regional Medical Center — from “Baa2” to “Baa3” (Moody’s Investors Service)

4. Mon Health (Morgantown, W.Va.) — from “BBB+” to “BBB” (S&P Global Ratings)

5. Nuvance Health (Lagrangeville, N.Y.)  — from “A3” to “Baa2” (Moody’s Investors Service)

6. Virginia Mason Medical Center (Seattle)  — from “BBB” to “BBB-” (S&P Global Ratings)

 

 

FTC, Justice Department have new guidelines for vertical mergers

Posted on by • Posted in Antitrust, Competition, Dept of Justice (DOJ), Federal Trade Commission (FTC), Horizontal Merger, Market Consolidation, Market Power, Mergers & Acquisitions, Monopoly, Monopoly Behavior, Vertical Merger • Leave a comment

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Trump Administration Updates Vertical Merger Guidelines - Multichannel

Guidance on vertical mergers got its first major overhaul from the Federal Trade Commission and the U.S. Department of Justice in more than 35 years under new joint guidelines published June 30.

Vertical mergers are those that combine firms or assets at different stages of the same supply chain, such as healthcare company CVS Health’s acquisition of insurer Aetna. Previously proposed mergers like that of insurers Humana and Aetna would be considered horizontal.

FTC Chairman Joe Simon said in a news release that the new guidances “are an important step forward in maintaining vigorous antitrust enforcement, and reaffirm our commitment to challenge vertical mergers that are anticompetitive and would harm American consumers.”

Leaders said that the guidelines explain FTC and Justice Department investigative practices and will give the business community clarity about antitrust concerns, such as the type of evidence the FTC and Justice Department review and how they define markets.

To read the full guidelines, click here. 

 

 

 

 

 

Flu vs. Covid-19 Death Rate, by age

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, Pandemic, Personal Protective Equipment (PPE), Preexisting Conditions, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

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