Tag Archives: Hospital

Court sets speedy 340B lawsuit schedule, siding with AHA

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https://www.healthcaredive.com/news/court-sets-speedy-340b-lawsuit-schedule-siding-with-aha/515988/

Dive Brief:

  • The American Hospital Association and other parties’ request for an expedited brief schedule for the group’s lawsuit over CMS cuts to the 340B program was agreed to by the U.S. Court of Appeals for the District of Columbia Circuit Tuesday, despite the government’s request for more time to respond to the lawsuit.
  • U.S. District Judge Rudolph Contreras dismissed the initial lawsuit in December, saying the groups did not have standing to sue because the cuts hadn’t yet taken effect. On January 11, AHA and the other groups appealed the decision, and then asked the court to expedite the case citing the immediate impact the cuts have on 340B hospitals’ ability to provide services to underserved communities.
  • Attorneys for the Department of Justice argued the compressed briefing schedule would not give adequate time for the government to prepare its brief and coordinate with affected agencies.

Dive Insight:

The lawsuit concerns a HHS final rule that took effect at the start of the year changing the amount 340B hospitals are paid for drugs to 22.5% less than the average sales price. Last year, hospitals paid the average price plus 6%.

“America’s hospitals and health systems are pleased that the U.S. Court of Appeals has accepted our expedited brief schedule in our appeal to reverse the significant cuts to the 340B Drug Savings Program, which for over 25 years has played a vital role in helping hospitals stretch scarce federal resources to expand and enhance patient services and access to care for vulnerable communities without any cost to the government,” Melinda Hatton, general counsel for the American Hospital Association, told Healthcare Dive.

AHA is joined in the lawsuit by America’s Essential Hospitals, the Association of American Medical Colleges, Eastern Maine Healthcare Systems (Brewer, Maine), Henry Ford Health System (Detroit) and Adventist Health System’s Park Ridge Health (Henderson, North Carolina).

The groups argue the cuts will hurt 340B hospitals’ budgeted operations, bond covenants and other items necessary to provide community care, and say the reimbursement change exceeds HHS’ authority.

“For 340B hospitals, the ability to provide care to their communities is tied to receipt of third-party reimbursements; constriction in the flow of Medicare revenues to 340B hospitals will increasingly constrict funds for medical care for all their patients, most particularly those who are poor and underserved and most reliant on these services,” the groups wrote in their request to expiate the appeal brief schedule.

AHA noted that it is actively exploring other options to address the cuts.

“We will continue to pursue our legislative and legal strategies to reverse these cuts, and expect to prevail in holding the agency accountable for overstepping its authority,” Hatton said.

The Court of Appeals set the the brief schedule to conclude by April 2, appearing to allow AHA’s request that oral arguments to occur by May, prior to the summer recess. “Otherwise the next opportunity for argument would be in September, which would likely significantly delay the resolution of this action,” the plaintiff attorneys had argued.

 

 

Major shareholder wants more frequent oversight of Tenet’s board: 5 things to know

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https://www.beckershospitalreview.com/finance/major-shareholder-wants-more-frequent-oversight-of-tenet-s-board-4-things-to-know.html

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Glenview Capital Management, which currently owns 17.8 percent of Dallas-based Tenet Healthcare, has submitted a proposal to Tenet that would amend the for-profit hospital operator’s bylaws to allow all shareholders to take action by written consent without a meeting.

Here are five things to know about Glenview’s proposal, which will be voted on at Tenet’s annual meeting.

1. In a letter to Tenet shareholders, Glenview said Tenet has been a “chronically underperforming company for decades,” and shareholders need the ability to take action by written consent.

“Just as a person in worsening health may need more frequent medical attention than a check-up once every 12-18 months, a chronically unhealthy company is likely to return to health quicker and with more certainty if its owners are allowed more frequent board oversight, and this is effectively accomplished through the ability to take action by written consent,” Glenview wrote in the letter to shareholders.

2. In addition to Tenet’s financial underperformance, Glenview said there are several other factors supporting the proposed change, including the board’s slow response to Tenet’s financial and operational challenges.

3. Although Tenet’s board approved amendments to the company’s bylaws in January that allow majority shareholders to request special meetings, Glenview argued shareholders still need action by written consent.

Glenview said the amendment to allow majority shareholders to call special meetings is “wholly impractical, clearly off-market, and sends a dangerous signal that the board may need additional feedback from shareholders to fully appreciate the cultural renaissance for which we mutually strive.”

4. Tenet said it is reviewing Glenview’s proposal. “We will make a recommendation to shareholders in due course,” Tenet said in a statement.

5. Tenet launched a $250 million cost reduction initiative last year, which involves divesting hospitals in non-core markets and cutting 2,000 jobs, or about 2 percent of the company’s workforce. The for-profit hospital operator ended the third quarter of 2017 with a net loss of $367 million on revenues of $4.59 billion. That’s compared to the same period of 2016, when the company recorded a net loss of $8 million on revenues of $4.85 billion.

Unnecessary Medical Care: More Common Than You Might Imagine

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https://www.npr.org/sections/health-shots/2018/02/01/582216198/unnecessary-medical-care-more-common-than-you-might-imagine

An analysis of insurance claims in Washington state found that in a single year more than 600,000 patients underwent testing and treatment they didn't need, at an estimated cost of $282 million.

It’s one of the intractable financial boondoggles of the U.S. health care system: Lots and lots of patients get lots and lots of tests and procedures that they don’t need.

Women still get annual cervical cancer testing even when it’s recommended every three to five years for most women. Healthy patients are subjected to slates of unnecessary lab work before elective procedures. Doctors routinely order annual electrocardiograms and other heart tests for people who don’t need them.

That all adds up to substantial expense that drives up the cost of care for all of us. Just how much, though, is seldom tallied. So, the Washington Health Alliance, a nonprofit dedicated to making care safer and more affordable, decided to find out.

CALLOUT:

Have you worked in the health insurance industry? You have expertise that could help ProPublica’s reporting. Please share your insights with Marshall Allen to help him learn about the industry.

The group scoured the insurance claims from 1.3 million patients in Washington state who received one of 47 tests or services that medical experts have flagged as overused or unnecessary.

What the group found should cause both doctors, and their patients, to rethink that next referral. In a single year:

  • More than 600,000 patients underwent a treatment they didn’t need, treatments that collectively cost an estimated $282 million.
  • More than a third of the money spent on the 47 tests or services went to unnecessary care.
  • 3 in 4 annual cervical cancer screenings were performed on women who had adequate prior screenings – at a cost of $19 million.
  • About 85 percent of the lab tests to prep healthy patients for low-risk surgery were unnecessary — squandering about $86 million.
  • Needless annual heart tests on low-risk patients consumed $40 million.

Susie Dade, deputy director of the alliance and primary author of the report released Thursday, said almost half the care examined was wasteful. Much of it comprised the sort of low-cost, ubiquitous tests and treatments that don’t garner a second look. But “little things add up,” she said. “It’s easy for a single doctor and patient to say, ‘Why not do this test? What difference does it make?'”

ProPublica has spent the past year examining how the American health care system squanders money, often in ways that are overlooked by providers and patients alike. The waste is widespread – estimated at $765 billion a year by the National Academy of Medicine, about a fourth of all the money spent each year on health care.

The waste contributes to health care costs that have outpaced inflation for decades, making patients and employers desperate for relief. This week Amazon, Berkshire Hathaway and JPMorgan Chase rattled the industry by pledging to create their own venture to lower their health care costs.

Wasted spending isn’t hard to find once researchers — and reporters — look for it. An analysis in Virginia identified $586 million in wasted spending in a single year. Minnesota looked at fewer treatments and found about $55 million in unnecessary spending.

Dr. H. Gilbert Welch, a professor at The Dartmouth Institute who writes books about overuse, said the findings come back to “Economics 101.” The medical system is still dominated by a payment system that pays providers for doing tests and procedures. “Incentives matter,” Welch said. “As long as people are paid more to do more they will tend to do too much.”

Dade said the medical community’s pledge to “do no harm” should also cover saddling patients with medical bills they can’t pay. “Doing things that are unnecessary and then sending patients big bills is financial harm,” she said.

Officials from Washington’s hospital and medical associations didn’t quibble with the alliance’s findings, calling them an important step in reducing the money wasted by the medical system. But they said patients bear some responsibility for wasteful treatment. Patients often insist that a medical provider “do something,” like write a prescription or perform a test. That mindset has contributed to problems like the overuse of antibiotics — one of the items examined in the study.

The report may help change assumptions made by providers and patients that lead to unnecessary care, said Jennifer Graves, vice president for patient safety at the Washington State Hospital Association. Often a prescription or technology isn’t going to provide a simple cure, Graves said. “Watching and waiting” might be a better approach, she said.

To identify waste, the alliance study ran commercial insurance claims through a software tool called the Milliman MedInsight Health Waste Calculator. The services were provided during a one-year period starting in mid-2015. The claims were for tests and treatments identified as frequently overused by the U.S. Preventive Services Task Force and the American Board of Internal Medicine Foundation’s Choosing Wisely campaign. The tool categorized the services one of three ways: necessary, likely wasteful or wasteful.

The report’s “call to action” said overuse must become a focus of “honest discussions” about the value of health care. It also said the system needs to transition from paying for the volume of services to paying for the value of what’s provided.

 

Broward Health offers CEO job to indicted interim leader

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http://www.sun-sentinel.com/local/broward/fl-sb-broward-health-ceo-meeting-20180130-story.html

Broward Health wraps up interviews with CEO finalists

The board of Broward Health rejected all four finalists for the chief executive officer’s job Wednesday and voted to give it to their current interim CEO, Beverly Capasso, who is under indictment.

Capasso, who earned $650,000 a year as interim CEO, faces criminal charges along with four other current or former Broward Health leaders over alleged violations of Florida’s open-meetings law in the firing of a previous interim CEO. But board members said she has done an excellent job restoring stability to the organization, with several strong hires in executive positions, and that none of the four finalists turned out to be the stellar candidate with whom they had hoped to fill the job.

At the meeting, none of them mentioned the indictments, focusing instead on Capasso’s efficiency in beefing up the system’s managerial ranks, its improved finances and the apparent end of the crises that had plagued it.

“I think she’s done an amazing job and has an amazing team,” said board member Steven Wellins.

The job of leading the five-hospital, taxpayer-supported system came open more than two years ago, when its last permanent CEO killed himself with a bullet to the chest. Since then, the system has been run by a series of interim leaders, as the board, which is appointed by Gov. Rick Scott, lurched from one hiring process to another, creating instability that affected everything from employee morale to the system’s bond rating.

The vote was 4 to 1 to give the job to Capasso, with board chairman Rocky Rodriguez dissenting from an action that he said would “corrupt the process” of hiring a new leader.

Nancy Gregoire, the newest board member, made the motion to offer Capasso the job, saying she would hold the position until the expiration of a federal oversight agreement, expected some time late in 2020. By then, she and other board members said, they hope Broward Health will have a strong enough national reputation to attract higher-quality CEO candidates.

Gregoire said in an interview that the indictment was a concern, but that the charges were only second-degree misdemeanors and that Capasso should be considered innocent until proven guilty.

“Certainly it bothers me,” she said. “However, I really believe that the four candidates we had to review were not the best thing for Broward Health right now. I’d hate to make a mistake and make matters worse.”

Several board members pointed to the mediocre scores the four finalists received from executives of Broward Health’s hospitals, who had met with the finalists. Their scores ranged from 1.7 to 2.9 on a 5-point scale.

Capasso, a registered nurse, rose through the ranks to become a hospital executive, eventually becoming chief executive of Jackson Memorial Hospital in Miami.

The job description distributed by Broward Health says the CEO position requires a master’s degrees. Capasso has one in health administration, but it’s from a defunct mail and online institution called Kennedy-Western University that federal investigators identified as a diploma mill, an institution that confers degrees for little or no academic work.

Former Broward Health board member Joseph Cobo denounced the decision to hire her. There’s talk that the whole process was a “sham,” he said, and that the plan was always to give Capasso the job.

“I have never, ever, in the 40 years I’ve been around this place, seen a staff more scared from the retaliation that has been occurring,” he said. “You need a change. Yes, there are some very good people in this organization. But a lot of people have been hurt.”

Capasso, a former Broward Health board member who lives in Parkland, was indicted along with Rodriguez, board member Christopher Ure, former board member Linda Robison and general counsel Lynn Barrett for allegedly violating the state’s open-meetings law in the secretive manner in which they handled the investigation and firing of previous interim CEO Pauline Grant. All have denied wrongdoing. The cases are pending.

The firing of Grant, one of the county’s highest-ranking black officials, gave a racial tinge to the debate over the CEO job, with many black leaders denouncing the move. But at the meeting Wednesday, five black clergymen, some of whom had criticized the board in the past, spoke in favor of giving the job to Capasso.

“From my understanding of talking with different individuals and having real heart-to-heart conversations, I think the current interim CEO and the team that she’s put together is taking the ship in the right direction,” said Pastor Allen B. Jackson, of Ark Church of Sunrise. “I think they are doing a great job bringing the ship through the storm and taking the ship where it needs to go.”

In explaining his opposition, board chairman Rodriguez said he didn’t believe in springing something at the 11th hour and that there had been an explicit and public understanding that Capasso would serve only on a temporary basis.

“We made a promise to this community that this was not going to happen,” Rodriguez said.

“But we’ve heard from the community,” Gregoire said.

“Well, they’re part of the community,” Rodriguez responded. “With all due respect, they’re a huge part of the community, but there’s other people in the community that are not here.”

Capasso was not present at the meeting, which was a special meeting called just to discuss the CEO issue. But she was in attendance at the subsequent regular meeting, where she said she would accept.

“I’m humbled and honored to accept the terms of the contract,” she told the board. “We have stabilized Broward Health. We will continue to stabilize Broward Health for our patients, our community and the 8,000 employees of Broward Health.”

 

 

The erosion of worker compensation

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https://www.axios.com/the-erosion-of-worker-compensation-1516915779-5de48fc9-bfe8-4577-88e0-4e9b46591af3.html

Corporate profits have dramatically outpaced wages and health benefits since the turn of the century, leaving workers on the hook for more of their health care costs even as their purchasing power falls, according to a review of federal data.

Key quote: “If I were a middle-class American, I’d be outraged,” said Regina Herzlinger, a professor at Harvard Business School. “I’d demand much greater transparency about how much I’m getting in health insurance and wages.”

Data: Bureau of Economic Analysis; Chart: Chris Canipe / Axios

The bottom line: American workers have not seen their wages grow in tandem with the success of their employers.

Meanwhile, health spending has been growing faster than the broader economy. Health benefits consequently are getting more expensive for employers to offer, and companies are responding by making employees shoulder more of their own health care costs — either through higher premiums or higher out-of-pocket costs, like deductibles and copays.

What it means: Health care is eating up a bigger share of paychecks that already don’t go as far as they used to.

  • “Plans are getting less generous because (employers) are paying more in absolute dollars,” said Michael Chernew, a health economist at Harvard Medical School.
  • “Your health benefit being 10% of your compensation isn’t as meaningful today as it was 15 years ago because spending on health care has grown more quickly,” added Erin Trish, a health policy professor at the University of Southern California.
  • “If a hospital visit is expensive, someone — either the employer or the worker — is going to pick up that cost,” said Matt Fiedler, a fellow at the Brookings Institution.

Yes, but: Economists say reducing the generosity of employer health plans is not necessarily a bad thing, because generous plans might encourage people to use more health care services than they need.

Plus, “the idea that an employer should be deciding what kind of health care benefits an employee gets is kind of crazy,” said Dean Baker, an economist at the Center for Economic and Policy Research. But, Baker adds, there has to be a viable health care alternative for workers.

What to watch: Whether employee compensation increases more quickly, especially as companies predict even bigger profits under the GOP tax plan.

  • There is no evidence the temporary, one-off bonuses announced by many companies, and attributed to the Republican tax cut bill, will drastically change the stagnant trajectory of worker compensation.

The details: The data are from the U.S. Bureau of Economic Analysis. The growth of three economic indicators — corporate profits, wages, and money employers spent on health insurance for their employees — were compared with overall economic growth over the past 16 years. Health coverage and wages were singled out because workers often value those compensation items most when they take a job.

The analysis showed:

  • Corporate profits were 4.7% of the U.S. economy in 2000 and climbed to 9.1% by 2016.
  • Employer health coverage mostly stayed flat, going from 3.2% of GDP in 2000 to 3.7% in 2016.
  • Salaries and wages decreased quite a bit. They represented almost 47% of the economy in 2000 and dropped to 43.4% in 2016.

10 ways compensation committees can best guide executive pay and performance

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https://www.beckershospitalreview.com/compensation-issues/10-ways-compensation-committees-can-best-guide-executive-pay-and-performance.html

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As CEO incentive pay packages bring attention to transparency issues in executive compensation, a group of directors and chief risk officers from The Directors and Chief Risk Officers Group published a set of guiding principles for compensation committees around the governance of risk related to pay and performance.

The report aims to give a company’s board of directors and board-level compensation committees guidelines for the governance of risks linked to an organization’s compensation culture.

Here are 10 guidelines for compensation committees to best guide executive pay and performance, according to the report.

1. Compensation committees must fulfill both direct and indirect pay governance responsibilities to define the best compensation culture for the company. Under direct governance responsibilities, CEOs must establish and continually review company-wide compensation philosophy. To fulfill indirect pay governance responsibilities, a company’s executives must ensure adequate resources and processes are in place for the organization’s incentive plans.

2. Committees should emphasize incentive pay for corporate performance when designing and communicating the company’s compensation philosophy. Incentive pay for an individual’s performance must be carefully applied when it is appropriate to fulfilling the individual’s role.

3. A CEO’s total compensation should be driven by how they impact the long-term interests of the company, which includes how effectively the organization takes risk.

4. A company should minimize use of external benchmarking, or the comparison of its statistical data with other organizations in the same industry, for executive pay. Instead, companies should work to incorporate internally-focused pay evaluation for executive pay.

5. Incentive-based compensation should always be considered to be “at risk,” subject to deferral periods and influenced by the company’s long-term performance.

6. Compensation committees must continually use discretion in determining an executive’s final incentive pay package. In this way, committees must make rules for determining these pay packages subject to discretionary override when the compensation culture of the organization appears to be violated.

7. When considering performance reviews and compensation design for an organization’s CEO and individuals in the succession plan, the compensation committee must provide complete transparency to the entire board. This includes the board’s approval of full details of the CEO’s performance and any final awards given to the executive.

8. Compensation committees should obtain public certification that ensures their processes of governing pay risk and compensation philosophy are “fit for purpose,” which entails executing a statement that verifies a company has performed due diligence on its pay governance processes.

9. The members of a company’s compensation committee should have diverse backgrounds and experience, expertise in risk, finance, and management and should cross-populate the company’s risk and audit committees.

10. To ensure proper compensation risk governance, companies must incorporate collaboration, feedback and review among board committee’s and the firm’s social network to maintain a properly established compensation culture.

10 thoughts from discussion on 2018 Anti-Kickback and Stark Law issues

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https://www.beckershospitalreview.com/legal-regulatory-issues/10-thoughts-from-discussion-on-2018-anti-kickback-and-stark-law-issues.html

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We had a chance to moderate and participate in a webinar with leading colleagues John Harig, Tim Fry, David Pivnick and Brett Barnett regarding key Anti-Kickback Statute and Stark Law issues facing health systems, surgery centers, dialysis providers and other healthcare providers and investors. Below are 10 key thoughts discussed during the webinar as to fraud and abuse issues in play in 2018.

1. The reading and implementation of the “Yates Memo” issued by the U.S. Department of Justice will influence how the government aims to prosecute individuals in addition to companies.

2. The reading of the U.S. Supreme Court’s Escobar decision will influence whether defendants in false claims cases will receive some relief from technical billing violations that are not fundamental or material to the government’s paying of a claim.

3. Regulators and potential buyers are focused on “creative marketing arrangements” by physician practices, often related to laboratory and/or pharmacy arrangements.

4. Government enforcement agencies and potential buyers are focused on physician compensation arrangements, particularly their compliance with the Stark Law.

5. Potential buyers face a challenge in determining how deeply to examine targets’ past practices through billing and coding audits, as well as how to handle the results of billing and coding audits in negotiation of transactions.

6. Private equity buyers face challenges in their evaluation of risk posed by regulatory issues and how to address regulatory risks in a seller’s market.

7. Sellers present the historical legal analysis of fraud and abuse issues during the due diligence process, particularly when the legal analysis is positive, but assumptions underlying the legal analysis do not align with the sellers’ actual operations.

8. The turnover in the U.S. Department of Justice may impact the timing of fraud and abuse prosecutions and settlements.

9. Recoveries by the government resulting from fraud and abuse prosecutions have increased in magnitude. Furthermore, there are more recoveries coming from cases in which the government has not joined in the case with the relator.

10. The wide array of laboratory arrangements and businesses hold implications for fraud and abuse laws.

 

13 health systems with strong finances

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https://www.beckershospitalreview.com/finance/13-health-systems-with-strong-finances-012317.html

 

Here are 13 health systems with strong operational metrics and solid financial positions, according to recent reports from Moody’s Investors Service and S&P Global Ratings.

Note: This is not an exhaustive list. Health system names were compiled from recent credit rating reports and are listed in alphabetical order.

1. Downers Grove, Ill.-based Advocate Health Care has an “Aa2” rating and stable outlook with Moody’s. The health system has a strong market position, healthy liquidity, moderate leverage and good debt metrics, according to Moody’s.

2. Morristown, N.J.-based Atlantic Health System has an “Aa3” rating and stable outlook with Moody’s and an “AA-” rating and stable outlook with S&P. The system has stable operating performance, balance sheet growth and a favorable market position, according to Moody’s.

3. Dallas-based Baylor Scott & White Health has an “Aa3” rating and stable outlook with Moody’s. The health system has strong cash flow margins and a favorable business position as the largest nonprofit health system in Texas, according to Moody’s.

4. Milwaukee-based Children’s Hospital and Health System has an “Aa3” rating and stable outlook with Moody’s. The system has a strong balance sheet and is the dominant provider of tertiary and quaternary pediatric services in southeastern Wisconsin, according to Moody’s.

5. Indianapolis-based Indiana University Health has an “Aa2” rating and stable outlook with Moody’s. The system has healthy margins and a strong market position, according to Moody’s.

6. Rochester, Minn.-based Mayo Clinic has an “Aa2” rating and stable outlook with Moody’s. Mayo has an excellent clinical reputation and diversified revenue across multiple locations, states and types of hospitals, according to Moody’s.

7. Mercy Health in St. Louis, Mo., has an “Aa3” rating and stable outlook with Moody’s and an “AA-” rating and stable outlook with S&P. The health system has solid debt service coverage and strong balance sheet metrics, according to Moody’s.

8. Chicago-based Northwestern Memorial HealthCare has an “Aa2” rating and stable outlook with Moody’s. The system has a prominent and growing market position in the Chicago region, a strong investment position, good margins and manageable leverage, according to Moody’s.

9. San Diego-based Sharp HealthCare has an “Aa3” rating and stable outlook with Moody’s. The system has strong balance sheet measures and a fundamentally stable and strong strategic position, according to Moody’s.

10. Stanford (Calif.) Health Care has an “Aa3” rating and stable outlook with Moody’s. The system has a strong market position as one of two major academic medical centers in the Bay Area, has a reputation for clinical excellence and research, and is in a service area with strong population growth and high wealth levels, according to Moody’s.

11. Iowa City-based University of Iowa Hospitals & Clinics has an “Aa2” rating and stable outlook with Moody’s. The health system has a broad market with growing patient volumes and geographic reach for its high-acuity services. Moody’s expects the health system’s expense control initiatives to continue to gain traction through fiscal year 2018.

12. Philadelphia-based University of Pennsylvania Health System has an “Aa3” rating and stable outlook with Moody’s. The health system has a strong market position, solid operating margins and limited debt burden, according to Moody’s.

13. Yale New Haven (Conn.) Health System has an “Aa3” rating and stable outlook with Moody’s. The system has a leading market position in Connecticut, solid liquidity, moderate capital needs and manageable leverage, according to Moody’s.

Geisinger, Dignity Health among first hospitals to pilot Apple’s medical records system

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https://www.beckershospitalreview.com/hospital-physician-relationships/geisinger-dignity-health-among-first-hospitals-to-pilot-apple-s-medical-records-system.html

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Danville, Pa.-based Geisinger Health System, San Francisco-based Dignity Health and Baltimore-based Johns Hopkins Medicine will be among the first 12 hospitals nationwide to pilot Apple’s medical records system, The San Diego Union-Tribune reports.

Here are six things to know about the pilot program.

1. Apple announced its intent Jan. 24 to integrate patient health records into its Health app to make it easier for consumers to review their medical data. IPhone users would need to download the 11.3 “beta” version of iOS to access the feature, according to The San Diego Union-Tribune.

2. While many hospitals and health systems already provide patient portals and other programs for patients to access their health information, Apple aims to embed patient data from multiple providers into the iPhone’s main system. This “deep integration” function could help improve smartphone users’ health by allowing patients to grant permission for other app developers to use the data to help provide the best deals on medications and connect patients taking the same medications, among other features, the report states.

3. Because the health records are stored on the patient’s device, users can send that information to any provider they choose — even those whose EHR systems are not directly compatible with the system the patient’s primary provider uses, according to Cheryl Pegus, MD, director of the division of general internal medicine and clinical innovation at the New York City-based NYU School of Medicine.

4. The challenge Apple and other tech companies with similar aspirations face, according to Dr. Pegus, is designing systems that do not inundate patients with irrelevant information.

“The key is to find a way to utilize this health data where someone puts in the right algorithms that really cause the most relevant data to bubble to the top so then you can message it how you want to. If that can happen, that’s going to be a great use,” Dr. Pegus said.

5. It is unclear if Apple’s medical records system will be able to synchronize physicians’ notes, the report states. The health records data will reside on Apple servers unless a patient’s phone automatically backs up the data to the company’s iCloud service.

6. Other hospitals involved in the pilot program include Chicago-based Rush University Medical Center; Los Angeles-based Cedars-Sinai Medical Center; and Philadelphia-based Penn Medicine.

To view the full list of participants, click here.

 

Citing cost, BCBS North Carolina CEO Patrick Conway comes out against Carolinas, UNC merger

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http://www.healthcarefinancenews.com/news/citing-cost-bcbs-north-carolina-ceo-patrick-conway-comes-out-against-carolinas-unc-merger?mkt_tok=eyJpIjoiTldGaU9Ua3lNall4WldSbCIsInQiOiJmSDNkSWVPXC9FWVlMbWY3OHFhc3RUTGVPQytZVEZSRUx6dHd2dldIamJvOUh5V2pNbFQ4dTQyY0JVQWFWVFpGZkI2VUlHV1BMVTNmTk9pSjk4T1B4ZGxRMUZRQXpNSEErSU9zdHExNVlBZkxxWDZ5YTEwdWxkXC9tTkl0dkNVZGFVIn0%3D

BSBC North Carolina office in Durham, NC Credit: Google Street View

 

The health systems touted the benefit of better leverage to negotiate deals with insurers when the proposed merger was announced in August.

BlueCross BlueShield North Carolina CEO Patrick Conway has come out against the merger between UNC Health Care and the Carolinas HealthCare System.

Should the deal go through, Conway said in a January 24 letter to the CEOs of the health systems, the cost to consumers would rise.

“Blue Cross NC has a responsibility to our customers to help slow rising healthcare costs,” Conway said in the letter. “After a thorough review of independent research which shows that when healthcare systems combine costs for consumers go up, Blue Cross NC cannot support your proposed combination.”

Conway told CEOs Bill Roper of UNC and Gene Woods of the Carolinas system that he was open to continued dialogue.

In August when the proposed merger was announced, executives of the two healthcare systems touted the benefit of the merger in giving them leverage to negotiate better deals with insurance companies and vendors.

Also questioning the deal is the UNC Board of Governors, according to The News & Observer.

UNC Board of Governors member Tom Fetzer, former chairman of the North Carolina Republican Party, reportedly sent an email to the board chairman on January 18, questioning whether the proposed partnership was being conducted legally, as the board was to be apprised of any policy changes.

The merger would result in efficiencies and $14 billion in annual revenue, according to the health systems.

Conway, MD, formerly headed the Centers for Medicare and Medicaid Services Innovation Center. He was named president and CEO of Blue Cross and Blue Shield of North Carolina on December 5.