Category Archives: government policy
WalMart Will Transform Healthcare –Not a Question of “If” or “When,” but “Where”
At a recent healthcare conference, Marcus Osborne, Walmart’s vp for health and wellness joked with his audience suggesting that he didn’t even know why he was invited: “After all, Wal-Mart’s in retail, we’re not in health care.” The crowd responded with polite, but uncomfortable chuckles. I recently read a post in The Healthcare Blog written by Dan Diamond entitled, “Wal-Mart Could Transform Care –But Does It Want To?” I have to admit that my reaction was decidedly more visceral. In fact, I found myself having fun with imagining different titles for Dan’s post: “Walmart will Transform Care –Because It Can,” [...]
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RAND Report Highlights Cost Savings Opportunity: ER Admissions Standards
With so much attention being paid to value based purchasing and the perfect, paperless order and payment process, it’s not a bad idea to remind ourselves of the role physicians play in shaping patient demand –and the impact their decisions have on any/all hospital cost savings initiatives. As the industry moves to eliminate variance in all of its forms, it is becoming clear that establishing and enforcing a more enlightened admission standard needs to become a much higher priority. Consider this: despite the fact that emergency room physicians account for only 4% of all hospital physicians, their decisions account for [...]
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What A Hospital Charges Vs. What Medicare Pays — Yet Another Case for Pricing Transparency
According to “A Study of Hospital Charge Setting Practices” by the Lewin Group, “the Medicare Payment Advisory Commission (MedPAC) has expressed concerns about the accuracy and fairness of the current Medicare hospital in- and out-patient prospective payment systems (PPSs). Payment rates for these systems are based, to varying degrees, on hospital charges. However, little is known about how hospitals set their charges.” Really? Isn’t it getting old. Why the “shell game” with hospital charges? Charging everyone the same published price –a la Walmart—is exactly what Walmart will do at thousands of outpatient clinics, so saying it can’t be done is, [...]
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Fee For Service On Life Support in Michigan –New BCBS & Trinity Contract Sets Industry Example
The new contract between Trinity Health (Trinity owns a dozen hospitals in Michigan that include Saint Mary’s Health Care in Grand Rapids and Mercy Health Partners in Muskegon, both of which now operate under the Mercy Health banner) and BCBS of Michigan puts a heavy spotlight on reform era reimbursement models. This deal highlights the latest and preferred compensation mentality –one that eliminates fee for service in favor of putting the focus on patient outcomes instead. BCBS and Trinity both refer to the agreement as a “value-based contract,” saying it should improve care quality and drive costs lower, not only [...]
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Intuit’s Inaugural Consumer Spending Index Confirms a “Nation on the Rebound”
U.S. consumers are spending again. After a prolonged lull following the 2008 recession’s historic spending lows, consumers are now spending about nine percent more than they did just four years ago. Gasoline, gift and healthcare spending have increased significantly, and the biggest spenders are men. These are among the findings of the new Intuit Consumer Spending Index, from Intuit Inc. (Nasdaq: INTU), which provides a unique view into the U.S. economy. The Intuit Consumer Spending Index findings are based on anonymized, aggregated, transactional data from Mint.com, Intuit’s leading online and mobile personal finance software. The key takeaway? Americans are rebounding. [...]
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Why ACO’s Won’t Fail — A Contrarian View?
Will ACOs succeed? Well, if you put a lot of weight behind what the industry’s “commentariat” are saying, you would be hard pressed to place a positive bet. I recently ran across a post by Les Funtleyder, the managing director of Poliwogg, where he took a contrarian view and gave reasons why ACOs will not fail. Here are some excerpts: When ACOs are touted as a saving grace for the system, you can almost hear the collective groan of the industry veterans. Ever the contrarian, however, we took the side of the debate that said ACOs will NOT fail. The [...]
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Adverse Effects of Hormonal Contraceptives Now On the Docket
I received a note over the weekend from Eric Burns, the immediate past president of Media Matters for America. Along with Karl Frisch, a former communications director, they launched a new company called Bullfight Strategies –and their business is good. The company was founded with a goal to empower clients “to win in the media arena.” It does so by focusing on the right kinds of rapid response narrative, fully conditioned to take advantage of what has become known as “the 15 minute news cycle.” Eric wanted to make sure that Healthcare Matters’ readers were aware of the latest developments [...]
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Medical Repatriation –Yet Another Unintended Consequence?
You really do need to check out this report, a collaborative project of Seton Hall University School of Law’s Center for Social Justice (CSJ) and the Health Justice Program at New York Lawyers for the Public Interest (NYLPI). It’s about a practice known as “medical repatriation.” What is it? It’s where private and public hospitals across the U.S. are unlawfully acting on their own and engaging in the deportations of ill or injured immigrant patients, usually to medical facilities abroad, completely circumventing the federal governments exclusive jurisdiction in the matter. Why do they do it? Despite the fact that the [...]
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Healthcare Reform and an Epidemic of Hospital Closings in Poor Communities –An Intended Consequence?
I ran across the following story in a Brooklyn, NY newspaper, posted by the New York Lawyers for the Public Interest. It’s an interesting read as it points out a reality in New York that is being mirrored all across the United States. In economically depressed communities in most every major city, hospitals are closing at an ever-increasing and alarming rate. In fact, and for what many regard as an unintended consequence of the Affordable Care Act, the promise of millions of newly insured entering the system is accelerating this closing trend, instead of reversing it. Jim Anderson, a correspondent [...]
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Payer Mix Realities: Is the Tail Wagging the Dog?
A recent study published in the JAMA suggests that for patients with Medicare and private insurance, hospitals benefit financially if these same patients suffer from postsurgical complications. In other words, many hospitals have the potential for adverse financial consequences if they do a better job in decreasing postsurgical complications. Yes, the potential for a negative impact on profits that is highlighted in this study clearly depends on payer mix, but it is fair to point out that these results (and the results of other similar studies) don’t nullify the idea that certain hospitals might be gaming the system. This particular [...]
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Patient Satisfaction Scores and Hospital Quality — Study Finds No Meaningful Correlation
I ran across an interesting perspective presented in an article that recently appeared in The Kaiser Health News. Essentially, the story revealed a growing sentiment in healthcare that challenges notions of patient satisfaction survey results, pointing out that patients don’t necessarily know a good thing when they see it. Put another way, the study revealed that there is no statically significant relationship between established measures/ratings for quality care rand patient satisfaction. “At present, little evidence supports the ability of patient satisfaction survey results to predict the quality of surgical care,” Heather Lyu, Dr. Martin Makary and the other researchers wrote [...]
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Can Unique Device Identification Improve the Patient Experience?
Healthcare Matters would like to welcome the following guest post from Rob Leibrandt. Rob is the Senior Market Manager at Camcode, makers of UDI Labels for Medical Equipment. Unique Device Identification (UDI) is critically important in the healthcare system. In July 2012, the U.S. Food and Drug Administration (FDA) proposed a rule (http://www.regulations.gov/#!documentDetail;D=FDA-2011-N-0090-0001) that would phase in, by device classes, requirements for medical devices to carry a unique device identifier. The benefits to implementing such a requirement include more accurate reporting and tracking of adverse events, more rapid identification of problems with specific products, better control over product recalls and improved patient [...]
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Medicaid Expansion Receives Single Digit Salute from AAPS
The public relations campaign to support Medicaid expansion frequently uses testimony by patients with serious medical conditions who have lost their private insurance. It is assumed that once they qualify for Medicaid, they will easily get their chemotherapy, hepatitis c treatment, or defibrillator battery replacement. Unfortunately, “the messages talk only about coverage, not care,” states Jane Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS). “But the real question is whether Medicaid provides access to care.” An Internet survey of AAPS members shows that about 47% of respondents think that it is more difficult for a [...]
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Marijuana Polls Are in: First Time in 43 years a Majority of American Adults Favor Legalization
The long awaited results from the Pew Research “marijuana polls” are in and the findings are crystal clear: With a change in attitude driven largely by baby boomers (there we go again) a majority of Americans now support legalizing marijuana –by a margin of 52% to 45%. It marks the first time in 43 years that a majority of Americans have backed legalization. In fact, as recently as a decade ago, only one-third of American adults backed making marijuana legal. Two major shifts in opinion are viewed as responsible: Most Americans no longer see marijuana as a “gateway” to more [...]
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AHRQ Study Reveals Low Hanging Fruit
The Agency for Healthcare Research and Quality (AHRQ) recently published a new report that identifies the most promising practices for improving patient safety in U.S. hospitals. Following up on a similar report published all the way back in 2001, this report includes analyses of a growing body of patient safety research to determine the level of evidence regarding the outcomes, as well as implementation, adoption, and the context in which safety strategies have been used. After analyzing 41 patient safety practices, a panel of experts identified 22 practical strategies. Here are the top 5: Preoperative and anesthesia checklists to help [...]
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UPMC Puts On a Clinic on How to Handle Tax Exempt Challenge
If Pittsburgh’s mayor, Luke Ravenstahl, and the other involved elected officials from Western Pennsylvania want UPMC to cough up some if its cash, they would be better served to develop a more enlightened approach. Challenging the healthcare giant’s tax-exempt status by recycling tired arguments about excessive executive compensation and UPMC’s focus on profits isn’t going to get it done. The mayor wants UPMC to pay property and payroll taxes because the city needs the cash –it’s that simple. But instead of making a deal, the city’s elected officials have taken a well-worn low road, choosing to ignore the fact that [...]
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- Healthcare in the Cloud: Forecast Still Hazy : HIMSS 2013: Top Takeaways Gathering Clouds said: [...] to David McCament’s mind, the future of healthcare cloud is not so clear. In a gue... more
- Time Definite Logistics –MNX Expands Global Network and Adds Track & Trace : Daniel said: Everything is very open with a precise description of the issues. It was definitely inform... more
- Varian Runs a “Clinic” in Effective Lobbying –Harry Reid Rides Shotgun : Thomas Finn said: Thanks for your comment Bo. I do not fully comprehend the differences between the two opti... more
- Varian Runs a “Clinic” in Effective Lobbying –Harry Reid Rides Shotgun : Barton 'Bo' Cooke said: Tom, you nailed it. This rider, put in at the last minute and was rushed into the Congres... more
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