Troubled hospital giant CHS looking to sell its business

http://www.modernhealthcare.com/article/20160916/NEWS/160919916/troubled-hospital-giant-chs-looking-to-sell-its-business

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Earlier this month, Modern Healthcare reported that CHS plans to sell more than the 12 hospitals it has for sale, quoting CFO Larry Cash speaking at the Wells Fargo Securities Healthcare Conference in Boston.

Cash said they are getting interest in additional hospitals. And after examining its portfolio of 159 hospitals, it likely will see “other transactions” before the end of the year, he said.

The hospitals previously up for sale will likely be sold as part of five transactions. Not-for-profit hospital systems are among the prospective buyers, he said.

CHS is not disclosing which hospitals it is negotiating to sell. But the company said that combined, they generate annual revenue of about $1.45 billion and expect to yield net proceeds of $850 million. The proceeds will be used to reduce overall indebtedness, Cash said.

In April, CHS completed the spinoff of 38 mostly small and rural hospitals into a new public company, Quorum Health Corp. That divestiture brought about $1.2 billion in net proceeds, money that also was used to reduce debt.

Plunging earnings complicated by continued low margins at Health Management Associates hospitals that CHS purchased for $3.9 billion in 2014 has caused CHS’ stock price to plummet.

The stock traded at $60 a share a year ago.

Could It Be Sepsis? C.D.C. Wants More People to Ask

Between one million and three million Americans are given diagnoses of sepsis each year, and 15 percent to 30 percent of them will die, Dr. Frieden said. Sepsis most commonly affects people over 65, but children are also susceptible. According to one estimate, more than 42,000 children develop sepsis in the United States every year, and 4,400 die.

Sepsis develops when the body mounts an overwhelming attack against an infection that can cause inflammation in the entire body. When that happens, the body undergoes a cascade of changes, including blood clots and leaky blood vessels that impede blood flow to organs. Blood pressure drops, multiple organs can fail, the heart is affected, and death can result.

“Your body has an army to fight infections,” said Dr. Jim O’Brien, the chairman of Sepsis Alliance. “With sepsis, your body starts suffering from friendly fire.”

Sepsis appears to be rising. The rate of hospitalizations that listed sepsis as the primary illness more than doubled between 2000 and 2008, according to a 2011 C.D.C. study, which attributed the increase to factors like the aging of the population, a rise in antibiotic resistance and, to some extent, better diagnosis.

Sepsis is a contributing factor in up to half of all hospital deaths, but it’s often not listed as the cause of death because it often develops as a complication of another serious underlying disease like cancer. So although death certificates list sepsis as a cause in 146,000 to 159,000 deaths a year, a recent report estimated that it could play a role in as many as 381,000.

Yet advocacy organizations say many Americans have never heard of sepsis and don’t know the signs and symptoms.

Hospital Readmissions are Not the Enemy

http://www.healthleadersmedia.com/quality/hospital-readmissions-are-not-enemy?spMailingID=9540993&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1001565259&spReportId=MTAwMTU2NTI1OQS2

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The Centers for Medicare & Medicaid Services has all but declared war on readmissions. But one researcher suggests that the relationship between readmission rates and quality is flawed.

Four Delaware health systems form new alliance

http://www.delawareonline.com/story/news/health/2016/09/15/four-delaware-health-systems-form-new-alliance/90407280/

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The new eBrightHealth is a partnership of Christiana Care Health System, Bayhealth Medical Center, Beebe Healthcare and Nanticoke Health Services

EBrightHealth dovetails with the health care reform the state is undertaking with the Delaware Center for Health Innovation, officials say. It also builds on the relationships the systems have established over the last year as they participate in the statewide Quality Partners Accountable Care Organization.

The ACO focuses on creating more comprehensive care and cost-savings for Medicare patients. As Nevin said, it’s designed to reward hospitals for disrupting their business model by encouraging them to find ways to keep people healthier so they don’t need emergency rooms or hospital admission.

Christiana Care’s Care Link program is an example of what has come out of the ACO. Carelink identifies complex patients who are high-risk, for example those who do not have access to primary care, and connects them to physicians who will reach out and find out what their needs are.

Social workers, pharmacists, behavioral health therapists and nurses are all involved.

EBrightHealth is modeled after initiatives such as AllSpire Health Partners, which is a consortium of seven New Jersey and Pennsylvania hospital systems. That organization is three years old.

Cost Control Efforts Working ‘So Far’ in MA

http://www.healthleadersmedia.com/quality/cost-control-efforts-working-so-far-ma?spMailingID=9530189&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1001355843&spReportId=MTAwMTM1NTg0MwS2#

Health policy veteran Stuart Altman, PhD, is hopeful, but not optimistic, about healthcare delivery reforms and thinks hospitals will be forced to bring costs down because patients won't tolerate any more cost shifting.

Health policy veteran Stuart Altman, PhD, is hopeful, but not optimistic, about healthcare delivery reforms and thinks hospitals will be forced to bring costs down because patients won’t tolerate any more cost shifting.

health care expenditures 2013-2015

Each year, we put together a cost trend report that outlines what forces are at play in the state in terms of raising spending and we have hearings every October. We are trying to play an interesting role which is not be regulatory, but really to be in the face of the healthcare system in terms of saying, “Hey  be careful. Don’t go the extra mile on in spending or pricing.”

We want to do it in a way that doesn’t destroy or even hurt the health system.  In any attempt to do that, some of the forces within the health industry scream.

But, for the most part, the hospitals have been supportive of our efforts. If we were to squeeze too hard, they would react more negatively. Everyone is engaged in a very interesting balancing act. We are trying getting the system to work more efficiently… and they are trying to control costs without destroying themselves. So far it’s working.

CBO: Hospitals’ future finances depend on increasing productivity

http://www.healthcaredive.com/news/cbo-hospitals-future-finances-depend-on-increasing-productivity/426036/

  • A new analysis from the Congressional Budget Office (CBO) has recognized that changes in laws and regulations, prompted primarily by the ACA–notablyreduced Medicare payment updates and expanded insurance coverage–can be expected to significantly impact hospitals’ future finances.
  • To help provide a sense of the impacts, the CBO’s working paper predicted hospitals’ profit margins, and the share of hospitals that could lose money in 2025 under several different scenarios.
  • The researchers noted that they provided a wide range of estimates due to “substantial uncertainty” around the predictions and how hospitals will respond to the pressures of the federal healthcare law.

AHA urges CMS to withdraw Medicaid DSH proposal

http://www.beckershospitalreview.com/finance/aha-urges-cms-to-withdraw-medicaid-dsh-proposal.html

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Click to access 160914-cl-medicaid-dsh.pdf

The American Hospital Association submitted a letter Tuesday to CMS, asking the agency to withdraw a proposed rule to include third-party payments when calculating the hospital-specific limitation on Medicaid disproportionate share hospital payments.

In its proposal, CMS says the rule is simply a clarification on existing policy.

“Specifically, the rule would make clearer in the text of the regulation that uncompensated care costs include only those costs for Medicaid eligible individuals that remain after accounting for payments received by hospitals or on behalf of Medicaid eligible individuals, including Medicare and other third-party payments that compensate the hospitals for care furnished to such individuals,” the proposed rule states.

In the letter to CMS, the AHA argues the proposed rule is more than a clarification and actually establishes new policy. According to the AHA, CMS proposed the rule to avoid potentially unfavorable rulings in cases pending in federal court that address the DSH payment calculation.

20 financial benchmarks for hospital executives

http://www.beckershospitalreview.com/finance/20-financial-benchmarks-for-hospital-executives-091316.html

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Here are 20 benchmarks related to one of the most important day-to-day areas hospital executives oversee — finance.

Source: Moody’s Investors Service, “U.S. Not-for-Profit Hospital 2015 Medians” report, September 2016.

The medians are based on an analysis of audited 2015 financial statements for 340 freestanding hospitals, single-state health systems and multi-state health systems, representing 81 percent of all Moody’s rated healthcare entities. Children’s hospitals, hospitals for which five years of data are not available and certain specialty hospitals were not eligible for inclusion in the medians.

Senior finance executives name their top 10 RCM initiatives

http://www.beckershospitalreview.com/finance/senior-finance-executives-name-their-top-10-rcm-initiatives.html

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To optimize revenue cycle workflows, senior healthcare finance executives are more likely to implement updated IT and hire additional staff than contract with outside consulting services, according to a recent survey by Connance.

Connance, in conjunction with Porter Research, surveyed 93 senior finance executives in an 11-question online survey regarding their organizations’ revenue cycle improvement priorities. Respondents completed the questionnaire in July.

Below are six survey findings.