Category Archives: Uncategorized

Frost and Sullivan’s 9 healthcare predictions for 2017

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Superbug infection kills patient in Reno

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A superbug infection resistant to all 27 available antibiotics killed a woman in Reno, Nevada, the Centers for Disease Control and Prevention reported Friday, in issuing a precaution to hospitals nationwide.

While this superbug case was rare, sepsis blood infections reportedly kill an estimated 258,000 Americans each year.

Medical experts have been warning for years of the dangers of overprescribing antibiotics because of the potential for antibiotic-resistant superbugs.

The female patient who died this September from the superbug infection was a Washoe County, Nevada resident in her 70s who arrived in the United States in early August 2016 after an extended visit to India, the CDC said.

On August 18, she was admitted to an acute care hospital with a primary diagnosis of an infection called systemic inflammatory response syndrome, which likely resulted from an infected right hip.

A week after she was admitted, the hospital notified the Washoe County Health District in Nevada that the patient had a bacterial infection of carbapenem-resistant Enterobacteriaceae, called CRE.

 

Pennsylvania Rural Health Model to use global capitation to pay for inpatient, outpatient care

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Building on all-payer models in Maryland and Vermont, the Centers for Medicare and Medicaid Services this week announced a new global capitation model for rural hospitals in Pennsylvania.

Participating critical access hospitals and acute care hospitals will receive all-payer global budgets for a fixed amount of money that is set in advance and funded by all participating insurers, to cover inpatient and outpatient services, CMS said.

In addition, other commercial health plan payers in the state are eligible to participate by paying participating rural hospitals through global budgets.

“Rural hospitals will use this predictable funding to deliberately redesign the care they deliver to improve quality and meet the health needs of their local communities,” CMS said.

CMS is giving Pennsylvania $25 million, which is a portion of the funding, to begin implementing the Pennsylvania Rural Health Model.

The Pennsylvania Department of Health and CMS will jointly administer the model. The state will be responsible for data analytics, quality assurance, and technical assistance.

The model seeks to increase rural Pennsylvanians’ access to care while also reducing the growth of hospital expenditures across payers, including Medicare, to increase the financial viability of the state’s rural hospitals, CMS said.

“The Pennsylvania Rural Health Model presents a historic opportunity for rural hospitals,” said Patrick Conway, MD, CMS principal deputy administrator and chief medical officer. “The model will help rural hospitals remain financially viable and continue to provide essential services to the people in their communities.”

The Pennsylvania Rural Health Model was done in agreement with the state and signed by Governor Tom Wolf and Pennsylvania Secretary of Health Karen Murphy.

University of Vermont Health Network to implement $112.4 million Epic EHR

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The University of Vermont Medical Center filed a certificate of need, or CON application, with the state of Vermont Jan. 3, seeking approval to create a unified electronic health record system across four hospitals in the University of Vermont Health Network.

The submission of the CON application signals the start of a regulatory review process for the project.

A unified EHR would significantly improve patient care by having all of a patient’s information available to a healthcare provider regardless of location whenever it is needed, health system officials noted in their CON application.

“If a patient needs to go from their primary care provider’s office to a specialist, that specialist would have instant access to the patient’s full record rather than just portions that can be shared electronically today,” John Brumsted, MD, president and CEO of UVM Health Network, in a statement.

“There are still times when the medical records are faxed or even hand-delivered by the patient at the appointment,” he added. “In urgent situations, and especially during an emergency, having immediate access to important information is critical. A unified EHR is foundational to our ability to collaborate fully to provide the highest quality care possible.”

The capital cost of the project, which is subject to CON review, is $112.4 million. It includes $3.1 million in capitalized interest. The total cost of the project over the first six years of implementation and operation is expected to be $151.6 million.

Done independently, it could cost up to $200 million for the four hospitals to upgrade their own systems, and it would lack the network connectivity, UVM officials calculated.

Gut check: Change is coming, and healthcare executives don’t necessarily think it’s a bad thing

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Self-Discovery

The future of healthcare policy is a bit murky these days. President-elect Donald Trump has pledged to repeal the Affordable Care Act, and the Republican-run U.S. Congress is already fast at work to make that happen.

What’s not known, however, is what will change for the thousands of U.S. healthcare businesses that have not only adapted to the ACA but also made millions in investments in areas such as electronic health records, value-based reimbursement and reporting to align with the policies of the outgoing administration.

Healthcare Finance spoke with several executives at healthcare businesses to get their perspectives on not only the changes they expect but also their thoughts on what the healthcare sector actually needs to do to provide the best care while still safeguarding the health of its business model.

 

Mayo summit: Healthcare payment reform requires commitment to change

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Healthcare payment reforms won’t be effective unless hospitals and health systems adopt a “policy of continuous improvement” to ensure that they meet patient needs across the spectrum of care

So said a panel of experts convened by the Mayo Clinic and Arizona State University Alliance for Healthcare.

The panel attended last week’s Health Care Payment Reform Summit, and met with the press on Saturday to discuss their findings. The biggest takeaway: There must be a sustained culture change in order for payment reforms to take hold.

“Healthcare historically has been a status quo model—improve to a certain point and stay there,” George Halvorson, chair and CEO of the Institute for Intergroup Understanding, told reporters. “The model of the future needs to be better.”

Halvorson said that the industry as a whole must embrace data and computer systems that can make care better and track where improvements are most needed. This extends to payment reform, he said, as a model needs to be established that encourages innovation and consistent improvement.

One particular area of focus is to look at ways to reduce costs and improve care for the most complex patients. Elliott S. Fisher, M.D, director of The Dartmouth Institute for Health Policy and Clinical Practice, said that the top 5% of the sickest patients incur the most costs and use the most healthcare resources. These patients often have needs outside of the hospital’s control that can contribute to their situations, like homelessness or food insecurity, he said.

The panelists agreed that an effective solution is for providers to better identify patients with complex conditions and unmet socioeconomic needs. Therefore, Fisher said, it’s important that adequate data is gathered for providers to improve care for patients with complex conditions.

Trump’s “executive orders” are a communications strategy.

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Trump’s “executive orders” are a communications strategy.

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According to Vice-President-elect Pence, “We’re working now on a series of executive orders that will enable that orderly transition to take place even as Congress appropriately debates alternatives to and replacements for ObamaCare.”

This talk about using executive orders to assure an “orderly transition” is a bit confusing. An E.O. has legal force “only if the presidential action is based on power vested in the President by the U.S. Constitution or delegated to the President by Congress.” Authority to implement the ACA, however, is vested in the Secretaries of HHS, Treasury, and Labor—not the President. In the context of the ACA, an executive order won’t be anything more than a document containing a president’s instructions to his subordinates.

That’s why, as Tim Jost details here, President Trump can’t use E.O.s to change the rules that have been adopted to implement the ACA. To do that, agency officials would have to undergo cumbersome rulemaking processes. Guidance documents are easier to withdraw and amend, but an E.O. probably can’t do the job (although strong proponents of the unilateral executive might argue otherwise). Instead, the E.O. would instruct Secretary Price or Secretary Mnuchin to withdraw or amend the guidance that their predecessors adopted.