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 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
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.
http://khn.org/news/sometimes-tiny-is-just-the-right-size-microhospitals-filling-some-er-needs/
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.
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.
“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.”
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.
A Chicago-based healthcare system agreed to the largest HIPAA settlement fine against a single entity, HHS announced August 4. Advocate Health Care Network will pay $5.55 million to settle three separate HIPAA breaches reported in 2013. The breaches affected a total of 4 million individuals and the protected health information (PHI) included:
http://finance.yahoo.com/news/canopy-health-receives-license-names-221800300.html
Canopy Health, the Bay Area-wide health care network being developed by UCSF Health, John Muir Health and three physician groups, has received its Knox-Keene license to operate in seven Bay Area counties. It also has built out its management team, naming Meg Durbin, MD, as chief medical officer and Patrick Caster as chief financial officer.
The restricted license from the California Department of Managed Health Care enables the network to provide services in Marin, Southern Sonoma, San Francisco, Alameda, Contra Costa, and portions of San Mateo and Solano counties. Canopy Health will contract directly with health plans on behalf of all providers who are part of the network to develop an insurance product that provides access to high-quality care at an affordable price. Canopy Health currently includes more than 4,000 physicians and 12 hospitals throughout the San Francisco Bay Area.
“Our model is unique, as we are partnering with health plans to offer a competitively priced insurance product, rather than selling our own plan,” said Canopy Health Chief Executive Officer Joel Criste. “By accepting risk, we are accountable for the overall health of the patients we serve. It puts the focus where it should be – keeping patients as healthy as possible and providing the care they need in the most appropriate setting, whether that is the primary care physician’s office, an outpatient center or acute care hospital.”
HENRY KOTULA 