Deadly Superbug Linked To Four Deaths In The U.S.

Deadly Superbug Linked To Four Deaths In The U.S.

Candida auris (C. auris) is a serious and sometimes fatal fungal infection that is emerging globally. (Courtesy of the Centers for Disease Control and Prevention)

A deadly new drug-resistant fungus has been linked to the deaths of four hospital patients in the U.S., according to a report released Friday from the Centers for Disease Control and Prevention.

The fungus, called Candida auris, preys on the sickest patients and can spread in hospitals. Although doctors have been concerned about the spread of antibiotic-resistant bugs for many years, this fungus is relatively new on the world scene. It was first identified in Japan in 2009 and has since spread around the globe, emerging in South America, the Middle East, Africa and Europe, according to the CDC.

The CDC first identified the fungus as a potential threat in 2013, based on a possible case in the U.S., and has been on the lookout for the fungus since June. In its new report, the CDC said the fungus has been detected in a total of 13 patients since May 2013; the agency provided details on the first seven cases, which were reported in New York, Illinois, Maryland and New Jersey.

All of the patients had serious underlying medical conditions, including cancer, and had been hospitalized an average of 18 days when they tested positive for the fungus. Two patients had been treated in the same health care facility and had nearly identical fungal strains. Doctors can’t say for sure if the patients died from the fungus or their underlying health problems.

But health officials say the nation’s hospitals need to be on alert.

“We need to act now to better understand, contain and stop the spread of this drug-resistant fungus,” said Thomas Frieden, director of the CDC. “This is an emerging threat, and we need to protect vulnerable patients and others.”

 

CHS selling 17 hospitals in 7 deals

http://www.healthcaredive.com/news/chs-selling-17-hospitals-in-7-deals/429651/

The divestitures of the 17 hospitals follow a previous announcement of the sale of a four-hospital joint venture and an April deal in which CHS spun off 38 of its hospitals into a separate entity–Quorum Health Corp.

The system has previously indicated it may sell up to 30 of its hospitals in a strategy to streamline its operation to focus on its regional hospital hubs, and that the company might even put itself on the block.

The company has been struggling to bring down its debt of $15 billion, which has also involved the sale of its majority stake in its home health division. CHS has been in trouble since acquiring Health Management Associates in 2014 that owned 23 hospitals and some clinics in Florida.

Just last week, a grim preview of its third quarter earnings resulted in CHS’ common stock dropping from $10.03 at the close of business Wednesday to $5.08 at the close of business Thursday. This week its finalized numbers indicated a third quarter net loss of $79 million compared to a net income of $52 million for the quarter last year.

Is antitrust the answer to hospital consolidation?

Is antitrust the answer to hospital consolidation?

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robust literature on the benefits of competition in the health care marketplace shows that when health care markets are competitive, prices tend to be lower, quality tends to be higher, and people have more choices for care. Competition is a remarkably powerful tool that needs to be wielded more effectively. The good news is that ensuring competition is already the law of the land. The problem is that with the pace of consolidation, monitoring potential anticompetitive effects will be increasingly difficult as the FTC is tasked with examining a rapidly increasing number of mergers. The FTC needs renewed focus from policy makers to ensure that it can do its job effectively.

Catholic Health Initiatives, Dignity Health in Merger Talks

http://www.wsj.com/articles/catholic-health-initiatives-dignity-health-in-merger-talks-1477335251

Catholic Health Initiatives operates in 18 states, but not in Arizona, California and Nevada, where Dignity Health operates its hospitals. Above, Dignity Health California Hospital Medical Center in downtown Los Angeles.

Hospital operator Catholic Health Initiatives, which has struggled after rapid expansion and a foray into health insurance, is in merger talks with Dignity Health to create one of the nation’s largest nonprofit hospital systems by revenue.

Catholic Health Initiatives and Dignity Health said in a statement they are in talks regarding “aligning their organizations.” A person familiar with the matter said the talks involve a merger.

The deal would combine 103 hospitals owned by Catholic Health Initiatives, based in Englewood, Colo., with 39 hospitals operated by San Francisco-based Dignity Health. Combined revenue for the new organization would reach $27.8 billion annually, based on the most recent financial statements.

Vermont’s all-payer ACO will begin in January

http://www.modernhealthcare.com/article/20161026/NEWS/161029930/vermonts-all-payer-aco-will-begin-in-january

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In January, Vermont will become the first state in the nation to move to a voluntary all-payer accountable care organization model, the CMS announced Wednesday.

The Vermont program is modeled after a similar one from Maryland, but the Maryland program covers only hospitals. The Vermont ACO will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services.

The CMS is giving Vermont $9.5 million in start-up funding to support the transition. The demonstration, funded through a 1115 waiver, will last five years.

“This model is historic in terms of its scope, aiming to include almost all providers and people throughout the state in an all-payer ACO model to drive improved quality, better care coordination, healthier people, and smarter spending,” the CMS’ Chief Medical Officer Patrick Conway said in a statement.

“We will become the first state in America to fundamentally transform our entire health care system so it is geared towards keeping people healthy, not making money,” said Vermont Gov. Peter Shumlin, who earlier this year traveled to Washington to negotiate a deal with HHS Secretary Sylvia Mathews Burwell.

The state aims to have 70% of its insured residents covered by an ACO by 2022. The model will be considered an advanced alternative payment model under the new Medicare reimbursement program, making participants eligible for a performance bonus.

ER visits continue, despite insurance

ER visits continue, despite insurance

Emergency rooms and hospitals are among the most expensive places to get health care. One of the big selling points for Obamacare was the idea that if people get insurance, they’ll have better preventive care and end up in the ER a lot less.

Today we have new data that buries that idea.

Though people with insurance are taking advantage of more preventive care, they’re also still going to the ER. A prior study, done by the same economists, found when you give people insurance, they use more health care services — more doctor’s visits, flu shots, prescriptions, even hospitalizations.

Dr. Renee Hsia, of the University of California San Francisco Emergency Department, said she treats many insured patients.

“We have noticed that as our patient population gets older and frailer and we have more complex diseases, there are higher-acuity things presenting to the ED,” she said.

Hsia said other reasons the insured keep showing up include patients’ doctors sending them to the ER, or people can’t get a primary care appointments quickly.

Harvard economist Kate Baicker, one of the co-leads on the paper, said people need to be clear about the impact of insurance.

“Insurance makes the emergency department affordable,” she said. “People didn’t go [when they were uninsured] because of the big bill they got when they showed up. Now that it’s more affordable, people go more.”

Based on their findings, Baicker said insurance also improves people’s financial security and reduced their rate of depression.

CHS stock plummets nearly 50% on Q3 losses

http://www.modernhealthcare.com/article/20161027/NEWS/161029917

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Investor confidence in Community Health Systems plummeted Thursday as losses in the third quarter previewed by the company after the close of markets Wednesday caused its stock to fall nearly 50%.

CHS’ stock closed the day at $5.05 per share, down $4.98 per share or 49.65%.

In a preview of third-quarter results to be announced next week, Franklin, Tenn.-based CHS Wednesday reported a loss from continuing operations before income taxes of $83 million compared with income from continuing operations of $121 million in the third quarter of 2015.

Hospital divestitures, lower-than-expected volumes and reductions to reimbursement from state supplemental programs combined to cause revenue to fall in the quarter to $4.4 billion from $4.8 billion in the year-earlier quarter, the company said.

CHS for the third straight quarter lowered its EBITDA guidance. It is now saying that earnings before income tax, depreciation and amortization in 2016 are expected to be in a range of $2.2 billion to $2.8 billion compared with last quarter’s estimate of $2.4 billion to $2.6 billion. The chain is the nation’s second-largest investor-owned hospital company with 159 hospitals.

A CHS spokeswoman did not respond to a request for comment about Thursday’s stock losses.

FDA zeroes in on hospitals that underreport medical device-related injuries, deaths

http://www.healthcarefinancenews.com/news/fda-zeroes-hospitals-underreport-medical-device-related-injuries-deaths

FDA inspected 17 hospitals after events had been reported to other entities, found no corresponding reports filed with them.

Healthcare mergers and acquisitions in 2016: Running list

http://www.healthcarefinancenews.com/slideshow/healthcare-mergers-and-acquisitions-2016-running-list?mkt_tok=eyJpIjoiWlRkaE16VTBPRGhrTmpWbSIsInQiOiIxRk44S3JKdEd3Mzl5czNscEJZNjI1N210RWE0b0RxNWd3RHhoZUg2TXJCM3U2QnZJWm1VcFhMS2daQ1pmRzEyTG5DU2E0cWFCdGtWQlJKS0N0NE51Y2FubWdZbWptcTRhVHRZaTZJNDM1VT0ifQ%3D%3D

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Expanding role of hospitalist PAs achieves similar outcomes at lower cost, study finds

http://www.healthcarefinancenews.com/news/expanding-role-hospitalist-pas-achieves-similar-outcomes-lower-cost-study-finds?mkt_tok=eyJpIjoiWlRkaE16VTBPRGhrTmpWbSIsInQiOiIxRk44S3JKdEd3Mzl5czNscEJZNjI1N210RWE0b0RxNWd3RHhoZUg2TXJCM3U2QnZJWm1VcFhMS2daQ1pmRzEyTG5DU2E0cWFCdGtWQlJKS0N0NE51Y2FubWdZbWptcTRhVHRZaTZJNDM1VT0ifQ%3D%3D

Though more medical centers are relying on hospitalists — hospital-based internal medicine specialists who coordinate the complex care of inpatients — a new study suggests that hospitals can safely lower the cost of hospitalist programs without sacrificing quality of care

The 18-month study published in the Journal of Clinical Outcomes Management compared two hospitalist groups — one with a high physician assistant-to-physician ratio (“expanded PA”) and one with a low PA-to-physician ratio (“conventional”) — and found no significant differences in the important clinical outcomes achieved by both groups.

The study saw little difference in patient mortality, hospital readmissions within 30 days, lengths of stay or specialty consultant use among patients treated by the expanded PA group and those treated by the conventional group.

From January 2012 to June 2013, the researchers implemented an expanded PA staffing model to see larger numbers of adult patients alongside physicians. The expanded PA group consisted of three physicians and three PAs, with PAs caring for 14 patients each day. At the same time, a conventional hospitalist group composed of nine physicians and two PAs had PAs caring for nine patients each day. Physicians in both groups cared for approximately 13 patients a day.