New York Hospitals Facing Fiscal Code Blue

http://www.bloomberg.com/politics/articles/2016-08-22/new-york-city-hospitals-seen-unwilling-to-take-stronger-medicine?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=33278487&_hsenc=p2ANqtz–Ua5Q-PC5Hs3i1ni8bTaDNOfHhzF8R8meSEL9ZdWL6LejSQMUC3wLCDN9J_cuBB9IHRmZmF7BdmyqhMlNtFPa8KBOrzA&_hsmi=33278487

New York City’s public hospitals are in critical condition with rising costs and plummeting revenue. There’s no dispute about that diagnosis. The problem is with Mayor Bill de Blasio’s proposed cure, according to health policy makers, hospital administrators and budget watchdogs.

As NYC Health + Hospitals President Ram Raju describes it, the largest U.S. municipal-healthcare provider is an ailing system of 11 hospitals that’s losing revenue because of increased competition from non-profit hospitals for Medicaid patients and drastic cuts in federal and state aid for indigents.

His prescription: shift its 40,000-plus employees into a system of neighborhood clinics and transform campuses into affordable housing and long-term care, build enrollment of its MetroPlus insurance plan and persuade federal and state governments to spend more. That aid is projected to fall by almost $1 billion -– from $2.2 billion in FY16 to $1.4 billion in 2020.

Public Health Officials Struggle To Identify Sepsis Before It Becomes Deadly

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After Rory Staunton fell at the gym and cut his arm in March of 2012, the 12-year-old became feverish and vomited during the night, complaining of a sharp pain in his leg. When his parents called his pediatrician the next day, she wasn’t worried. She said there was a stomach virus going around New York City, and his leg pain was likely due to his fall.

However, she advised his parents, Orlaith and Ciaran Staunton, to take the youngster to the emergency department because he might be dehydrated. There hospital workers did some blood work, gave him fluids and sent him home.

The next day Rory’s pain and fever were worse. His skin was mottled and the tip of his nose turned blue. The Stauntons raced back to the hospital, where he was admitted to intensive care. The diagnosis: septic shock. Rory was fighting a system-wide infection that was turning his skin black and shutting down his organs. On Sunday, four days after he dove for the ball in gym class, Rory died.

“It was frightening to think that something could kill my son so fast and it would be something that I had never heard of,” said Orlaith Staunton.

She’s not alone. Sepsis kills more than 250,000 people every year. People at highest risk are those with weakened immune systems, the very young and elderly, patients with chronic diseases such as diabetes, cancer or kidney disease and those with illnesses such as pneumonia or who use catheters that can cause infections. But it can strike anyone, even a healthy child like Rory.

Sepsis is a body’s overwhelming response to infection. It typically occurs when germs from an infection get into the bloodstream and spread throughout the body. To fight the infection, the body mounts an immune response that may trigger inflammation that damages tissues and interferes with blood flow. That can lead to a drop in blood pressure, potentially causing organ failure and death.

FL Health System on Path to Save Millions by Standardizing Surgical Practice

http://www.healthleadersmedia.com/leadership/fl-health-system-path-save-millions-standardizing-surgical-practice?spMailingID=9394331&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=981810720&spReportId=OTgxODEwNzIwS0

Ongoing discussions with large employers including Disney have led Florida Hospital to examine granular surgical data in an attempt to wring out unnecessary costs.

Hospital CEO pay rises faster than overall health care spending

https://www.bostonglobe.com/business/2016/08/16/pay-packages-rise-for-many-hospital-ceos/Sytc3sUiubyr21tPhVxp3K/story.html

BOSTON, MA - 6/24/2016: Brigham and Women's Healthcare President Elizabeth Nabel speaks at a news conference at One Brigham Circle on Friday, June 24, 2016. Hospital officials said they were reducing patient capacity and bringing in hundreds of temporary nurses in anticipation of a strike by nurses on Monday. (Timothy Tai for The Boston Globe)

Pay increases for many top Massachusetts hospital executives outpaced the growth of state health spending in 2014, according to new filings with the Internal Revenue Service.

Leading the pack was Elizabeth G. Nabel, president of Brigham and Women’s Hospital in Boston, who drew total compensation of $5.4 million that year, up 119 percent from her $2.5 million pay package in 2013. Most of the increase was attributed to a jump in deferred compensation in 2014, the year she vested in a retirement plan managed by Brigham and Women’s corporate parent, Partners HealthCare.

Cut Healthcare Spending or Face the Public Option

http://www.healthleadersmedia.com/finance/cut-healthcare-spending-or-face-public-option?spMailingID=9394331&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=981810720&spReportId=OTgxODEwNzIwS0#

“If we don’t get a handle on spending at some point, we will have a government-financed system,” predicts the head of the Pacific Business Group on Health.”

HIPAA is 20 years old. What has it meant for healthcare?

HIPAA is 20 years old. What has it meant for healthcare?

birthday cake

On Aug. 21, 1996 — 20 years ago Sunday — President Bill Clinton signed the Health Insurance Portability and Accountability Act (HIPAA) into law.

Back when bipartisanship still occasionally happened in Washington, this law, championed by then-Sens. Edward M. Kennedy (D-Massachusetts) and Nancy Kassebaum (R-Kansas) has come become to be defined by the privacy and security regulations that it enabled. Those took effect in 2002 and 2003, respectively, after the Bush administration modified rules that the Clinton administration rushed to finish before Clinton left office in January 2001.

But, as the formal name implies, HIPAA initially was known for giving people the right to “portability” of health insurance when they change jobs by limiting the ability for insurers to exclude coverage of pre-existing conditions. The complex law also led to standards for healthcare administrative transactions and a national system of provider identity codes.

HIPAA did call for a national patient identifier as well, but in 1998, Congress voted to deny the Department of Health and Human Services funding to implement a patient ID. The program still has never been funded, and the private sector has since taken it upon itself to address the issue.

So what has HIPAA accomplished in 20 years? Where has it fallen short?

Why clinical documentation is the missing link to value-based reimbursement

http://www.beckershospitalreview.com/finance/why-clinical-documentation-is-the-missing-link-to-value-based-reimbursement.html

The key to successfully making the jump from the old era of healthcare — one where fee-for-service is king — to the new era of healthcare — one where transparency, consumerism and value dominate — may actually be as simple as improving clinical documentation, according to Anthony Oliva, DO, vice president and CMO of Nuance Healthcare.

“For those who thought, ‘Maybe we can just hold out and [value-based care] will all go away,’ it’s never going to go away; it’s only going to get worse,” Dr. Oliva said at the Becker’s 2nd annual CIO/HIT + Revenue Cycle Conference in Chicago.

Healthcare is a classic example of a model explained in Ian Morrison’s book The Second Curve, according to Dr. Oliva. This two-curve model posits that any market undergoing transformation has two curves: the old and the new. Companies must ride the first curve and learn how and when to jump to the second, Mr. Morrison explains in the book.

Consumerism and RCM: 3 challenges posed by high deductibles & how to meet them

http://www.beckershospitalreview.com/finance/consumerism-and-rcm-3-challenges-posed-by-high-deductibles-how-to-meet-them.html

As high deductible health plans become more common, patients are becoming the new payers. This puts responsibility back in the hands of the provider to provide a consumer-friendly billing experience and collection strategy to maintain the speed of the revenue cycle management process.

At the Becker’s 2nd annual CIO/HIT + Revenue Cycle Conference in Chicago, the following five panelists discussed the top three challenges of consumerism and how RCM can meet those challenges: Steve Collins, vice president of business development at Zotec Partners; J. Wade Shields, owner and managing partner of Practice Partners; Susan Hawkins, executive director of revenue cycle at Hoag Memorial Hospital Presbyterian in Newport Beach, Calif.; Amanda Cancelliere, vice president of operations and business performance services at McKesson Technology Solutions; and Brooke Murphy, writer/reporter with Becker’s Healthcare.

51 hospitals, health systems with interest-free loan programs

http://www.beckershospitalreview.com/finance/50-hospitals-health-systems-with-interest-free-loan-programs.html