Tag Archives: Health System

Nonprofit salaries for healthcare executives on the rise

Posted on by • Posted in Uncategorized • Tagged , , , • Leave a comment

http://www.healthcaredive.com/news/nonprofit-salaries-for-healthcare-executives-on-the-rise/437566/

Dive Brief:

  • Salaries for employees of nonprofit organizations, which includes some hospitals and health systems, were up about a third in 2014 from 2011 levels, The Wall Street Journal reported.
  • Nonprofit organizations have adopted salary strategies implemented in the corporate world and often offer packages totaling more than $1 million with eligibility for bonuses and deferred payments.
  • About 75% of nonprofit compensation packages delivering $1 million or more annually in 2014 went to people in healthcare positions.

Dive Insight:

The largest nonprofit compensation package discovered by The Wall Street Journal analysis went to Anthony Tersigni, president and CEO of Ascension, a hospital operator based in Missouri. He received a total of $17.6 million.

Compensation provided by hospitals correlated more with the size of an organization, location, and academic status, according to a 2013 study published in JAMA on salaries for 1,877 CEOs at 2,681 hospitals. The average CEO earned about $600,000 per year, but the average salaries for CEOs of small rural hospitals were just $118,000 while CEOs at top teaching hospitals earned an average of about $1.7 million.

The Wall Street Journal analysis reflect results from the JAMA study. While CEOs of urban teaching hospitals tend to earn more, compensation can vary widely. For instance, the chief executive of Mercy Health System, which had around $1 billion in operating revenue in 2014, earned about $8 million, Meanwhile, Catholic Health Systems collected about 15 times as much in 2015 and paid its CEO half as much.

3 Republican concepts for replacing the ACA — and what they mean

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , • Leave a comment

http://www.healthcaredive.com/news/3-republican-concepts-for-replacing-the-aca-and-what-they-mean/437475/

The bottom line

These policy ideas popular among conservatives could certainly push health insurance costs down for some — like those with few healthcare needs and reliable income — but they also would undoubtedly offer fewer benefits to those with low incomes and high healthcare costs.

“The value of the policies that insurers are offering is going to go down under all these options,” Blumberg said. “They’re going to end up attracting the higher needs population and they can’t sustain that.”

Hospitals would see significant revenue losses if millions lose coverage under repeal of the ACA and are unable to afford new coverage under the replacement plans the GOP has put forward. Some executives have warned they would have to cut vital services, such as behavioral health.

A report prepared for the American Hospital Association found that hospital revenues would decrease nearly $400 billion between 2018 and 2026 with ACA repeal. The plans put forward by Republicans would barely dent that projection, experts say.

Hospital revenues are projected to decrease by $400 billion between 2018 and 2026 under ACA repeal, according to the AHA.

The leaders of the American Hospital Association and Federation of American Hospitals have written to President Donald Trump asking him not to repeal the ACA without an adequate replacement.

“Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals’ and health systems’ ability to provide services, weaken local economies that hospitals help sustain and grow, and result in massive job losses,” they wrote. “As you know, hospitals are often the largest employer in many communities, and more than half of a hospital’s budget is devoted to supporting the salaries and benefits of caregivers who provide 24/7 coverage, which cannot be replaced.”

Republicans continue to debate whether, how and when to replace the ACA. Just as the reform law had major impacts on the industry, the process of finding alternatives will have significant consequences as well.

 

Fee-for-Value: Is Your Revenue Cycle Ready?

Posted on by • Posted in Uncategorized • Tagged , , , • Leave a comment

http://www.healthleadersmedia.com/finance/fee-value-your-revenue-cycle-ready?spMailingID=10565023&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1120501013&spReportId=MTEyMDUwMTAxMwS2

Image result for fee for value revenue cycle

Healthcare organizations are adopting innovative practices as they prepare for a new future.

 

Proposal Would Curb California Hospital Emergency Department Closures

Posted on by • Posted in Uncategorized • Tagged , , , , • Leave a comment

http://www.healthleadersmedia.com/leadership/proposal-would-curb-california-hospital-emergency-department-closures?spMailingID=10565023&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1120501013&spReportId=MTEyMDUwMTAxMwS2

Image result for emergency room closure law

Not-for-profit facilities would need the state attorney general’s sign-off in order to shutter their EDs, according to new legislation.

Uncompensated Hospital Care Costs Sink to Record Low in California

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

http://www.chcf.org/aca-411/insights/uncompensated-hospital-care-costs?utm_source=Facebook&utm_campaign=doc_patient&utm_medium=cpc

Uncompensated Care in California

As California’s uninsured rate plummeted during the first two years of the implementation of the Affordable Care Act (ACA), uncompensated care costs for California’s hospitals followed suit, declining 52% from $3.1 billion in 2013 to $1.5 billion in 2015, according to data from the California Office of Statewide Health Planning and Development (OSHPD) now available on ACA 411. This progress may be in peril, however, if efforts to repeal and replace the ACA are successful and the uninsured population increases.

The most common way to measure the cost of uncompensated care is to combine charity care and bad debt. Charity care refers to the costs for patients with a demonstrated inability to pay. Bad debt refers to the costs for patients who were considered to have the financial ability to pay — or for whom the ability to pay was never determined — but who have not done so.

While we expected to see dropping uncompensated care costs because of the increase in Californians with health insurance under the ACA, the magnitude of the decline is notable when placed into historical context. The data show that in 2015, California hospitals’ uncompensated care costs as a percentage of operating costs reached 1.7% according to the author’s analysis of OSHPD Hospital Annual Financial Data — the lowest rate in more than a decade. This mirrors national trends. For the same year, the American Hospital Association reported that US hospital uncompensated care costs (charity care and bad debt) as a percentage of total hospital expenses reached a 25-year low of 4.2% (PDF).

Estimating the cost of hospital uncompensated care is an imperfect science, and the available data have limitations. For example, the California OSHPD data above do not include uncompensated care provided by Kaiser Foundation hospitals, which provide about 10% of general acute hospital care in California.

In addition, some hospital reimbursement rates (such as Medi-Cal and Medicare) often do not cover the costs of providing care. These shortfalls are not reflected in measures of uncompensated care, as the measure is not designed to capture under-compensated care.

Still, uncompensated care, as measured by OSHPD in the chart above and in other national metrics, has been tracked for years. The steep decline between 2013 and 2015 is unparalleled and a sign of major progress.

The uncertain future of the ACA makes it difficult to predict what will happen with health care financing. However, it is clear that if changes to federal health legislation increase the uninsured population, the uncompensated care burden on hospitals will rise again as fewer people can afford care they receive at hospitals. That won’t be good for California’s people or its hospitals.

 

The Nursing Shortage? It’s Complicated

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

http://www.healthleadersmedia.com/nurse-leaders/nursing-shortage-its-complicated?spMailingID=10548476&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1120254532&spReportId=MTEyMDI1NDUzMgS2#

Image result for the nursing shortage

A workforce data analysis predicts a national nursing surplus of 340,000 registered nurses by 2025. But there is more to this story.

 

The health care system treats patients like garbage

Posted on by • Posted in Uncategorized • Tagged , , , , , , • Leave a comment

The health care system treats patients like garbage

Image result for The healthcare system treats patients like garbage

I started and stopped writing this post many times because it’s mostly whining. But, dammit, it’s a consumer’s right to whine, so here it is: in my experience (YMMV) — and that of many others I know — the health care system largely treats patients like garbage.

I was reminded of this fact during my recent experience dealing with my daughter’s broken arm. It started well enough. Our pediatrician has late hours and an X-ray machine, so we were able to skip the Friday night (and more expensive) emergency department visit for our initial diagnosis, and therefore missed all the attendant waiting and frustration.

Upon viewing the X-rays, the pediatrician conveyed that it was not a bad break and didn’t need to be addressed immediately. A brace, which she provided, was good enough for now. Fair enough. But what was our next step? “The X-rays need to be examined by a radiologist before I can tell you that,” my wife was told. OK …

I wonder how long we would have waited for that to happen. By the middle of Saturday, we became too uncomfortable to find out, so I called the pediatrician’s office. Now, and with no further consideration of the X-rays, they were wiling to give us some recommendations for orthopedic clinics. Why couldn’t those have been given to us on Friday?

Naturally, one clinic was closed on the weekend. But, the other, hospital-based one, had Sunday hours. Great! A call to that clinic got me a voice-mail. I left a message. I have never gotten a call back, but I didn’t wait for one. I called again later and got a person who told me they had 7AM walk-in hours. Just go to the main hospital entrance and ask for the walk-in orthopedic clinic, I was told.

This was bad advice. After dragging my broken-limbed daughter through every door that plausibly seemed like the main entrance, we finally found someone who said we should go through the ED entrance. That was the right answer, but not what we were told on the phone.

After waiting and registering, we finally saw the orthopedist. He was great. It was, in fact, not a bad break. Now it is safely casted. All is well. But not before we had to do a lot of legwork — and received a lot of wrong answers, promises of follow-ups that didn’t happen, etc. Meanwhile, our pediatrician has not (yet) checked in on her patient.

I get it. She’s busy with more urgent matters. It makes sense, but it sucks, and all the more knowing that we spend a fortune for such treatment. No other business would treat customers this way. In health care, inconvenience, uncertainty, lost records, lack of follow-up and coordination, the necessity of self-advocacy, and lots and lots of waiting is the norm.

Of course, there are some examples of good customer service in health care. I’ve even experienced them. But every tasty crumb I’m tossed just reminds me how awful the rest of the meal is.

https://www.wsj.com/articles/with-direct-primary-care-its-just-doctor-and-patient-1488164702

 

Hospital floors, sinks pose deadly infection risks

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.fiercehealthcare.com/healthcare/studies-hospital-floors-sinks-pose-infection-risk?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWkRjeU1tTTFPVEUyTjJaaCIsInQiOiJBNGU4aWlDQkpcL3l6eURqQUMyR2w3aVFtNStxVzBraUpQcTVOamQ4SVNEVUNDeXFQQ1RDWG5qdmptMjI4VWpiVTdHUDltN0ZTMG5ObWlHOWl0cXRmVEpjQ0h2bFU1NXJKM2YzaHBrcnc2VlVJVkoyTHJrQjBndGI5b3BGWmdJV1oifQ%3D%3D

hospital hallway

Hospital floors and sinks may pose infection risks, ones that could be overlooked when trying to control the spread of disease.

The floors in patient rooms may be contaminated by bacteria like methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile, according to a new study published in the American Journal of Infection Control. These pathogens, which can cause potentially deadly infections, can be spread when items are dropped on the floor, the researchers noted.

The research team swabbed a number of surfaces, including the floors, clothing, call-buttons and other high-touch items, in 159 rooms at five Cleveland hospitals, according to the study. The study included C. difficile-isolated rooms, and researchers found floors were often tainted by bacteria, most commonly with MRSA, C. difficile and vancomycin-resistant enterococci (VRE). The researchers also found that in 41% of these rooms, at least one high-touch object came in contact with the floor.

The study team said it hopes the results bring more attention to the infection risk posed by floors, which are not often considered in the conversation on infection control.

“Although healthcare facility floors are often heavily contaminated, limited attention has been paid to disinfection of floors because they are not frequently touched,” lead study author Abhishek Deshpande, M.D., Ph.D., an internal medicine physician for the Cleveland Clinic, said in an announcement. The results of our study suggest that floors in hospital rooms could be an underappreciated source for dissemination of pathogens and are an important area for additional research.”

Another recent study noted that hospital sinks may frequently host drug-resistant superbugs like MRSA or VRE. The research, which was published in Applied and Environmental Microbiology, set up five identical sinks in a lab that replicated sinks at the University of Virginia’s hospital in Charlottesville. The researchers then contaminated the sinks with E. coli bacteria, and though colonization began in drain pipes, it inched toward sink strainers before water spread it in the sink.

“This type of foundational research is needed to understand how these bacteria are transmitted, so that we can develop and test potential intervention strategies that can be used to prevent further spread,” Amy Mathers, M.D., an associate professor of medicine at pathology at University of Virginia, told HealthDay.

Can ACOs survive a repeal and replacement of the Affordable Care Act?

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.fiercehealthcare.com/healthcare/future-acos-can-they-survive-a-repeal-and-replace-aca?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWkRjeU1tTTFPVEUyTjJaaCIsInQiOiJBNGU4aWlDQkpcL3l6eURqQUMyR2w3aVFtNStxVzBraUpQcTVOamQ4SVNEVUNDeXFQQ1RDWG5qdmptMjI4VWpiVTdHUDltN0ZTMG5ObWlHOWl0cXRmVEpjQ0h2bFU1NXJKM2YzaHBrcnc2VlVJVkoyTHJrQjBndGI5b3BGWmdJV1oifQ%3D%3D

Doctor patient

Just as the fate of the Affordable Care Act is up in the air, so is the future of accountable care organizations, which were established under the healthcare reform law to improve care and reduce costs.

But one leading health policy expert predicted that even if Republican lawmakers come up with a plan to repeal and replace the healthcare reform law, ACOs will survive. They will just need to adapt to the new regulatory landscape.

“ACOs are here to stay,” wrote Paul Keckley, Ph.D., managing editor of The Keckley Report, in a post for Hospitals & Health Networks. “How they fit into a medical group or health system’s contracting and population health strategies will change as regulations like MACRA kick in and as employers, insurers, Medicare and Medicaid assess their value.”

More than 850 ACOs currently provide care to more than 28 million patients across the country. This year 570 ACOs will participate in Centers for Medicare & Medicaid Services models, including the Shared Savings Program  (MSSP), Next Generation ACO Model and The Comprehensive ESRD Care Model.

Two recent studies showed evidence that ACOs do lead to quality improvements and cost reductions, but those benefits grow over time. The problem is that Tom Price, the new head of the Department of Health & Human Services, doesn’t support some value-based care initiatives, such as Medicare’s mandatory bundled payment initiatives for hip and knee replacements.

But Keckley predicted physician-led ACOs that follow practices to standardize care and incentives for clinicians linked to cost savings will survive. However, in order to survive the organizations must focus on primary care driven care coordination, he said. “From these primary care centric models, virtual ACOs that incorporate rural health and teleconnectivity, and clinical models that include social determinants of health in assessing risks and care coordination tactics will evolve,” he wrote.

He also predicted that CMS will change quality measures and simplify reporting requirements under MSSP ACOs. And if Congress does move to Medicaid block grants, he expects Medicaid ACOs will be a growth opportunity.