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.

Vermont all-payer ACO model approved, will count for MACRA

http://www.healthcarefinancenews.com/news/vermont-all-payer-aco-model-approved-will-count-macra

Under model, rates paid to a given provider are set so that all third parties pay the same price for services to particular provider.

4 Tips for Keeping Politics Out of Staff Conversations

http://www.healthleadersmedia.com/hr/4-tips-keeping-politics-out-staff-conversations?spMailingID=9754012&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1021982472&spReportId=MTAyMTk4MjQ3MgS2

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Avoiding divisive topics can help maintain workplace morale during a contentious election season—and afterward.

How Night Shifts Perpetuate Health Inequality

https://www.theatlantic.com/health/archive/2016/10/night-shifts-the-worst/504800/

 

3 factors that will tank your workforce management

http://www.healthleadersmedia.com/hr/3-factors-will-tank-your-workforce-management?spMailingID=9754012&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1021982472&spReportId=MTAyMTk4MjQ3MgS2

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“No more overtime will be approved!” How many times have we heard declarations like this in an attempt to control labor costs? Considering that labor costs are a hospital’s largest expense exceeding 50% of their operating budgets, it’s no wonder that remarks like this are frequently heard. Healthcare providers have spent millions of dollars on analytics and other systems to find a way to get these costs under control. Yet, they still do not have clear insights into their labor costs and are unable to implement sustainable programs to manage and control costs. I’m going to look at three areas that limit a healthcare provider’s ability to manage their workforce in a way that optimizes labor, controls costs and drives outcomes.

Dignity Health, CHI Explore ‘Alignment’

http://www.healthleadersmedia.com/leadership/dignity-health-chi-explore-alignment?spMailingID=9754012&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1021982472&spReportId=MTAyMTk4MjQ3MgS2#

 

 

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Potential merger would create a one of the nation’s largest non-profit health systems, with more than 140 hospitals and hundreds of clinics and physicians’ offices in two dozen states.