Tag Archives: Health System

Editor’s Corner: OIG audit reveals dirty secrets about Meaningful Use

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http://www.fiercehealthcare.com/it/oig-s-incentive-audit-reveals-dirty-little-secrets-about-meaningful-use?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTXpsa01XWXpOV0UxTlRkaiIsInQiOiJGY2ZNVUhtVE42ZFA1ZzJFdnd5VjlIYlh5WGtxMlVWeGZ1ZmpaQUtFdVwvZW8wbndLcmhrQ2tDQU5ReUhZcFwvcjhsRWRkVVV5aHFjWkVVWjFBXC81UGhVQzBONE15WmV6RWF2S1N6KzViT2hvVT0ifQ%3D%3D

So far this year we’ve seen a shift in attention when it comes to electronic health records: less on the EHR Incentive Program, and more on the newer, more trendy issues, such as precision medicine, the Medicare Access and CHIP Reauthorization Act and ransomware.

But that old stalwart, Meaningful Use, is still a major focus, at least for the Department of Health and Human Services Office of Inspector General. And it should be for the rest of us, as well, based on what OIG has been unearthing.

The OIG issued its latest audit report on how states are paying Medicaid Meaningful Use incentives, and it isn’t pretty. The Arizona Health Care Cost Containment System made incorrect Medicaid incentive payments to 24 out of 25 hospitals reviewed, totaling almost $15 million in overpayments.

Costly ICU Stays Don’t Improve Mortality Rates

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http://www.healthleadersmedia.com/quality/costly-icu-stays-dont-improve-mortality-rates?spMailingID=9343227&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=980918097&spReportId=OTgwOTE4MDk3S0

Hospitals that use ICUs frequently are more likely to perform invasive procedures and have higher costs

Hospitals that use ICUs frequently are more likely to perform invasive procedures and have higher costs, but without demonstrable improvement in patient survival.

Worthwhile California initiative

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Worthwhile California initiative

Worthwhile California initiative

At a time when health care spending seems only to go up, an initiative in California has slashed the prices of many common procedures.

The California Public Employees’ Retirement System (Calpers) started paying hospitals differently for 450,000 of its members beginning in 2011. It set a maximum contribution it would make toward what a hospital was paid for knee and hip replacement surgery,colonoscopies,cataract removal surgery and several other elective procedures. Under the new approach, called reference pricing, patients who wished to get a procedure at a higher-priced hospital paid the difference themselves.

Kaiser sees operating income dip 35.4% in Q2

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http://www.beckershospitalreview.com/finance/kaiser-s-operating-income-dips-35-4-in-q2.html

Kaiser Permanente said operating revenue for its nonprofit hospital and health plan units increased in the second quarter of 2016, but the Oakland, Calif.-based system reported lower operating income and net income than in the same period of the year prior.

SK&A ranks top 25 health systems by number of physicians

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http://www.beckershospitalreview.com/hospital-physician-relationships/sk-a-ranks-top-25-health-systems-by-number-of-physicians.html

Hospital-Physician Relationships

SK&A has identified the top health systems in the nation based on number of employed and affiliated physicians.

Becker’s obtained the information from SK&A via email. Here are the top 25 integrated health systems based on the number of employed and affiliated MDs and DOs, according to SK&A.

1. Kaiser Permanente (Oakland, Calif.) — 8,780 total MDs and DOs
2. Ascension Health (St. Louis) — 5,366
3. Trinity Health (Livonia, Mich.) — 4,190
4. Community Health Systems (Franklin, Tenn.) — 3,794
5. HCA (Nashville, Tenn.) — 3,670
6. Partners HealthCare System (Boston) — 3,405
7. Sutter Health (Sacramento, Calif.) — 2,976
8. Carolinas Healthcare System (Charlotte, N.C.) — 2,659
9. University of Texas Health System (Austin) — 2,615
10. Tenet Healthcare (Dallas) — 2,576
11. Cleveland Clinic Health System — 2,530
12. Mayo Clinic (Rochester, Minn.) — 2,527
13. NewYork-Presbyterian Healthcare (New York City) — 2,448
14. UPMC (Pittsburgh) — 2,413
15. Mercy Health System (Chesterfield, Mo.) — 1,971
16. Baylor Scott & White Health (Dallas) — 1,950
17. Mount Sinai Health System (New York City) — 1,915
18. Providence Health & Services (Renton, Wash.) — 1,849
19. Northwell Health (New Hyde Park, N.Y.) — 1,835
20. Catholic Health Initiatives (Englewood, Colo.) — 1,792
21. Indiana University Health (Indianapolis) — 1,716
22. Henry Ford Health System (Detroit) — 1,689
23. Banner Health (Phoenix) — 1,532
24. SSM Health Care System (St. Louis) — 1,509
25. MedStar Health (Columbia, Md.) — 1,506

Elderly Hospital Patients Arrive Sick, Often Leave Disabled

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Elderly Hospital Patients Arrive Sick, Often Leave Disabled

Ron Schwarz, 79, was hospitalized after falling in the shower. Schwarz is a patient in a special ward at the San Francisco General Hospital known as the Acute Care for the Elderly unit, or ACE. (Heidi de Marco/KHN)

Not A Priority

Hospitals can be hazardous places for elderly patients, who are at increased risk of falling, drug-induced injury and confusion.

But as the nation’s senior population grows, many facilities are ill-equipped to address their unique needs.

Kaiser Health News visited hospitals around the country, reviewed data and interviewed dozens of patients, family members and health providers to document the extent of the problem and highlight possible solutions.

How hospitals handle the old — and very old — is a pressing problem. Elderly patients are a growing clientele for hospitals, a trend that will only accelerate as baby boomers age. Patients over 65 already make up more than one-third of all discharges, according to the federal government, and nearly 13 million seniors are hospitalized each year. And they stay longer than younger patients.

Many seniors are already suspended precariously between independent living and reliance on others. They are weakened by multiple chronic diseases and medications.

Sometimes Tiny Is Just The Right Size: ‘Microhospitals’ Filling Some ER Needs

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http://khn.org/news/sometimes-tiny-is-just-the-right-size-microhospitals-filling-some-er-needs/

The two-story SCL-Health Community Hospital-Westminster opened outside Denver last fall. The microhospital offers emergency medical care, labor and delivery services, inpatient beds, two operating rooms, radiology services and an on-site laboratory. (Courtesy of Emerus and SCL Health)

http://www.healthcaredive.com/news/think-small-making-the-case-for-microhospitals/423710/

Eyeing fast-growing urban and suburban markets where demand for health care services is outstripping supply, some health care systems are opening tiny, full-service hospitals with comprehensive emergency services but often fewer than a dozen inpatient beds.

These “microhospitals” provide residents quicker access to emergency care, and they may also offer outpatient surgery, primary care and other services. They are generally affiliated with larger health care systems, which can use the smaller facility to expand in an area without incurring the cost of a full-scale hospital. So far, they are being developed primarily in a few states — Texas, Colorado, Nevada and Arizona.

“The big opportunity for these is for health systems that want to establish a strong foothold in a really attractive market,” said Fred Bentley, a vice president at the Center for Payment & Delivery Innovation at Avalere Health. “If you’re an affluent consumer and you need services, they can fill a need.”

SCL Health has two microhospitals operating in the Denver metropolitan area and another two in the works. Microhospitals “are helping us deliver hospital services closer to home, and in a way that is more appropriately sized for the population compared to larger, more complex facilities,” said spokesman Brian Newsome.

The concept is appealing, and some people suggest they should be developed in rural or medically underserved areas where the need for services is great.

 

When is it time to bring in a consultant?

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http://www.healthcaredive.com/news/when-is-it-time-to-bring-in-a-consultant/424031/

There are several good reasons to hire consultants. One is a lack of internal resources. That could be due to management vacancies, or the proposed project could be temporary in nature and hospital officials don’t want to divert existing staff or hire more full-time employees to get it done.

Still another reason is to get a gut check on decisions that are of vital importance to the organization, like planning an acquisition or a major capital expansion.

In other cases, hospitals may have expertise, but bringing in a third party — say, to assess a vendor selection process — can lend independence and objectivity to the solution, resulting in more confidence in the final decision, says Brad Armstrong, senior partner at T2C.

Hospitals turn to consultants during mergers and acquisitions, not only to advise the logistics of deal itself but also on operational changes — figuring out how to bring two entities together in a way is more efficient and functional. Consultants can also bring needed expertise to issues like staff productivity and operational efficiencies.

Consolidation in healthcare continues, but nontraditional alliances are also on the rise

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http://www.healthcaredive.com/news/consolidation-in-healthcare-continues-but-nontraditional-alliances-are-als/423716/

“The continuing uptick in mergers and acquisitions is not surprising,” says Anu Singh, managing director at Kaufman Hall. “The industry is rapidly changing and many organizations are not optimally positioned to navigate the transition to value-based care on their own. Healthcare leaders should thoroughly evaluate the partnership options to help ensure strong, competitive positioning for their organizations into the future.”

California Doctors And Hospitals Tussle Over Role Of Nurse-Midwives

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http://khn.org/news/california-doctors-and-hospitals-tussle-over-role-of-nurse-midwives/?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=32615438&_hsenc=p2ANqtz-8ImMNfbaboVFE98SiaPvCTZ4yTpxm1jcBnGL_CYvqxvYvZwPQNFNecHArS_UOxcmh7DeSB55A1rlnC8y5IjYTjPqcSTg&_hsmi=32615438

mother-baby-hospital_770

A California bill that would allow certified nurse-midwives to practice independently is pitting the state’s doctors against its hospitals, even though both sides support the main goal of the legislation.

The California Hospital Association and the California Medical Association, which represents doctors, agree that nurse-midwives have the training and qualifications to practice without physician supervision.

But they differ sharply over whether hospitals should be able to employ midwives directly — a dispute the certified nurse-midwives fear could derail the proposed law.

The bill would override an existing law that requires certified nurse-midwives to practice under the supervision of medical doctors. California is one of only six states that requires full supervision. Several other states mandate other forms of collaboration, such as in prescribing medications.

The American College of Nurse-Midwives has been chipping away for decades at state laws that require physician supervision, and it has finally passed the tipping point nationally, said Jesse Bushman, director of federal government affairs for the organization. Nurse-midwives aren’t seeking permission to go off and do whatever they want without consulting anyone, Bushman said. “They’re just asking to be able to do what they are trained to do.”

In states where nurse-midwives can practice independently, there is more access to care, he said, citing a recent report published by the George Washington University’s Jacobs Institute of Women’s Health.

There are more than 11,200 nurse-midwives around the nation, including about 1,200 in California. They provide maternity care, family planning services and other primary care for women.