Tag Archives: Hospital
How a bite from a stray dog shows the sick state of U.S. healthcare
Jan Kern was bitten by a stray dog while traveling abroad and ended up with a jaw-dropping illustration of why the U.S. healthcare industry is completely sick.
That’s because she underwent a series of rabies shots in three countries at four medical facilities. What that revealed, and which will surprise no one, is that Americans pay way more for the exact same treatment than people in other nations.
Moreover, her experience highlights the lack of uniformity for drug prices, including commonly used medications. One facility might charge a few bucks for the same drug that costs thousands of dollars at a U.S. hospital.
“There’s no rhyme or reason to our medical system,” said Rick Kern, 61, who contacted me about his 62-year-old wife’s global healthcare adventure after reading my recent column on drug prices.
What’s great about his story as well is that, after I shared it with about a dozen healthcare experts, the consistent reaction was one of utter disbelief. We’re accustomed to shaking our heads at U.S. healthcare costs. Things become significantly more absurd when a couple of overseas medical facilities are stirred into the mix.
“It’s obvious that our system is unlike any other health system,” said Uwe Reinhardt, a healthcare economist at Princeton University. “Other systems were set up to care for patients. Ours was set up by the providers — the hospitals and drug companies — for their own benefit.”
Surge in hospital-owned physician practices poised to increase healthcare costs
- Independent physicians and physician-owned practices could soon become a rare breed, suggests a new analysis by Avalere Health and the Physicians Advocacy Institute (PAI) released Wednesday.
- The study found the percentage of physicians employed by hospitals or health systems rose 86% from 2012 to 2015, from 95,000 to more than 140,000.
- As of mid-2015, 38% of all U.S. physicians were employed by hospitals and health systems, findings show.
- Also from 2012 through 2015, hospitals acquired 31,000 physician practices, resulting in one in four medical practices being hospital-owned.
How some providers are stoking entrepreneurial fires to ensure healthy financials
In an era of falling inpatient rates and value-based reimbursement, hospitals and health systems are seeking new ways to grow their revenue streams. For some, that has meant wearing an entrepreneurial hat and marketing home-grown solutions.
One example is the University of Pittsburgh Medical Center, which two years ago created UPMC Enterprises to develop and commercialize novel technologies.
Cleveland Clinic details hits to operating margin
http://www.healthcaredive.com/news/cleveland-clinic-details-hits-to-operating-margin/425703/
- The Cleveland Clinic’s latest financials show the hospital system ended the first half of 2016 with a significantly lower operating margin than at the same time in 2015, landing at 1.2% after the six-month period that ended June 30, 2016 vs. 5.6% in June 2015.
- Although the system’s revenue went up 17% during this period compared to last year, reaching $3.93 billion, that revenue failed to keep pace with a 23% increase in expenses.
- The system had anticipated a smaller margin this year, Cleveland Clinic chief financial officer Steve Glasstold Modern Healthcare, partly as a result of increased investments in new care-delivery models and consultants to manage those projects, as well as providing raises to medical and other employees to retain in-demand clinicians.
Is the CQO Position Needed?
In a healthcare system’s most mature state, everyone owns quality,” says Baylor Scott & White Health’s chief quality officer. So if everyone owns quality, why have a CQO?
As Healthcare Changes, So Must its CEOs, CFOs, COOs…
http://www.healthleadersmedia.com/leadership/healthcare-changes-so-must-its-ceos-cfos-coos%E2%80%A6
To keep up with big changes in how healthcare is administered, financed, and organized, top leaders are finding a need for new talents and organizational structures.
How Health Systems are Right-Sizing Their Boards
Prudent healthcare executives and boards are busily rethinking the size, composition, and focus of their governing bodies.
“An increasing number of boards are asking the question: ‘Are we structured in competency, number, and culture to lead a nine- or 10-figure business going forward?’ The time it takes to recalibrate can be fairly significant.”
“You’ve got to get beyond shared governance after a while and move toward unified governance. The right time is when you have a sense the board is struggling to keep up with the agenda and provide oversight.”
The Promise and Pitfalls of Bundled Payments
Why Bundled Payments?
Under bundled payments, a single payment is made for all of the services associated with an episode of care, such as a hip or knee replacement or cardiac surgery. Services might include all inpatient, outpatient, and rehabilitation care associated with the procedure.
There are a number of potential advantages to this payment approach. Bundled payments give providers strong incentives to keep their costs down, including by preventing avoidable complications. Bundled payments also can encourage collaboration across diverse providers and institutions, as well as the development and implementation of care pathways that follow evidence-based guidelines. In addition, bundles target the work of specialists, who have been less likely up to now than primary care physicians to participate in value-based payment arrangements.
More conceptually, health care economists are drawn to bundled payments because a bundle of care constitutes a clinically and intuitively meaningful “product” — in this case, the clinical episode. Defining clear products in health care helps create markets in which providers directly compete on quality and price. One barrier to effective health care markets has been that prices, when available, tend to relate to inputs into clinical care — such as pills, bandages, bed days, or X-rays — that are not meaningful to consumers of care and that don’t necessarily predict the total costs of care. For example, a health system that charges a lot for X-rays may still be more efficient because it uses fewer of them or saves money on other inputs. Bundles bring all these inputs together into a single price for a single basket of services.
Without Medicaid expansion, Texas hospitals left holding the bag
http://www.fiercehealthcare.com/finance/without-medicaid-expansion-texas-hospitals-left-holding-bag
Should Texas ever decide to expand Medicaid eligibility under the Affordable Care Act, its hospitals would be spared about $358 million a year in costs tied to uncompensated care, a new study has found.
The research was conducted by the Florida-based consulting firm Health Management Associates on behalf of the Texas Health and Human Services Commission, The Dallas Morning News has reported. The report was not immediately available online.
If Medicaid were expanded, about 9 percent of the approximately $4 billion a year Texas’ hospitals spend on uncompensated care could be saved, the newspaper reported. Health Management Associates (HMA) predicted about 668,000 Texans out of the 1.1 million eligible for Medicaid coverage would enroll if eligibility were expanded.
But, quoting the report, the newspaper said that Texas lawmakers are not inclined to expand Medicaid anytime soon.
HENRY KOTULA 