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Transformation in McAllen

May 25, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

Six years ago, in The New Yorker, Atul Gawande, M.D., wrote a famous study of extreme  healthcare cost and waste in impoverished McAllen, Texas. He recently returned to the Rio Grande Valley community and found huge changes, which came about, we should note, to a large extent because of his writing.

On his recent return, Dr. Gwande found:

Inpatient visits down 10 percent; home healthcare spending  down 40 percent; ambulance rides down 40 percent, and cost per beneficiary down almost $3,000, resulting in nearly half a billion dollars saved in the area.

The five big lessons he saw, as described by  Kavita Patel, M.D., managing director  for clinical transformation at the Brookings Institution’s Center for Health Policy, and Frank McStay, a research assistant, Economic Studies, at the Center for Health Policy as reported in MedPage Today. (Their remarks originated as a Brookings Web site post.)

“Evidence is hard to ignore, especially if it is out in the open.”

“Physicians  do not have all the right information.”

“Local clinical leadership and clinical knowledge are important in promoting health.”

“More evidence shows payment and delivery reforms may be working.”

“The biggest opportunities for cost reductions are with complicated patients.”

 

 

Hospitals going green

May 25, 2015by Robert Whitcomb in Uncategorized tagged , , ,

 

Making hospitals “greener” is now seen as a priority and not merely trendy.

The Becker’s Hospital Review reports:

“Many hospitals have begun placing a greater emphasis on becoming ‘healthy buildings’ that incorporate sustainability into their design, construction materials, utilities and even workflow processes.”

Deb Sheehan, executive director of the health practice for CannonDesign, an design firm specializing in healthcare,  told Becker’s:

“We’ve seen a lot of larger health systems with healthy community initiatives in place really starting to say, ‘If we’re going to make good on our mission, we must be committed to investing in healthy buildings that steward the protection of the environment.'”

And: “When you look at the healthcare building typology, most acute-care facilities are 24/7 operations, so energy consumption serves to claim a robust amount of the hospital’s operating budget, just to keep the buildings running.”

John Ebers, associate director of facility engagement and the energy program at Practice Greenhealth, told the news service:

“Within a hospital, energy and utilities represent a fixed cost. Anytime hospitals can drive down a fixed cost, they can improve their margins.”

Ms. Sheehan added: “When you see different kinds of providers — including small community hospitals, large healthcare systems and academic medical providers — all talking about the same sustainable design attributes with the same stature and priority, you know this is a major expectation that isn’t just going to be à la carted. It’s not going to be seen as a variable that’s elective anymore.”

 

Providers must deal with move to chip cards

May 25, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

Healthcare providers need to prepare for credit-card issuers’ switch from magnetic-strip-based cards to microchip-based cards,  mostly as part of the drive to cut down on security lapses. Obviously this will cost the providers some money, but nothing too serious.
Karen Cox, vice president for payments and retail solutions for Moneris Solutions, a Toronto-based provider of financial-processing systems, told Modern Healthcare’s Joseph Conn.
“After October, if someone (a fraudster) with a chip card would hit a chip terminal, the merchant is protected from charge back,” by the card issuer.
However, she told Mr. Conn,  if, say,  a hospital or medical practice were still using an older magnetic strip reader, it would face  liability for charge-backs.
A big plus in the change will be that  presages very wide use of  chip technology that will make the collection and use of medical data safer and easier.
Mr. Conn also noted:”Hopes for using smart-card technology in healthcare have risen and fallen several times over the past decade. Last month, the Government Accountability Office recommended that Medicare ought to consider issuing smart cards to beneficiaries to speed patient identification and eligibility verification.”

Video: Why the CVS-Omnicare deal?

May 25, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

Video:  Bloomberg’s Cynthia Koons analyzes  CVS Health’s plan to buy Omnicare. Is it an outgrowth of the Affordable Care Act?

Boston Children’s Hospital buying N.Y. physician group

May 24, 2015by Robert Whitcomb in Uncategorized tagged ,

In a spectacular example of how health systems are expanding and seeking ways to integrate  and cross-promote physician groups and hospitals, Boston Children’s Hospital plans to buy Children’s and Women’s Physicians of Westchester (N.Y.) LLP, in what would be the hospital’s first acquisition outside Massachusetts. Terms were not disclosed.

The physician group is for-profit, the hospital a not-for-profit.

The Westchester physicians see a lot of business coming from uniting with a world-famed institution. The hospital, for its part, sees a mighty flood of well-insured referrals coming from this marriage. The Westchester group has a total of 276 physicians in New York, Connecticut and New Jersey area, many of them affluent suburban patients with generous  insurance.

The Boston Globe noted:
“The hospital already treats many patients from other states and countries, but this is its first acquisition outside Massachusetts. The deal will add thousands of patients to the Children’s network and advance the hospital’s out-of-state expansion strategy; last year Children’s earnings rose on increased business from international patients.”

3 different cancer-care models

May 22, 2015by Robert Whitcomb in Uncategorized tagged , ,

Here’s a look at three models for cancer care

At the University of Tennessee Medical Center, Hospitals & Health Networks reports, 70 percent of cancer patients “receive inpatient care that follows pathways specifically designed around cancer type by multidisciplinary teams of clinicians.”

Then there’s Baptist South Florida, which takes the Accountable Care Organization approach.

And finally, there’s the University of Texas MD Anderson Cancer Center, with has started a bundled-payment program with UnitedHealthcare.

 

Calif. capping drug prices

May 22, 2015by Robert Whitcomb in Uncategorized tagged ,

California’s health-insurance  exchange is capping what consumers must pay for expensive medications each month, in the first such limits set by a state insurance exchange in the nation. Given California’s size, we’d be surprised if many states don’t follow suit.

Under the plan,  most consumers will have their specialty-drug costs capped at $250 per month, per prescription.

 

America’s passive health consumers

May 22, 2015by Robert Whitcomb in Uncategorized tagged

 

The Kaiser Family Foundation’s April Health Tracking Poll found that fewer people than expected have  seen or used comparisons of  quality and prices in the last 12 months. Just 15 percent of respondents saw information on health and insurance plan quality and only 6 percent used it to make purchasing decisions by making comparisons among  health plans. Only 18 of respondents said they saw any information on health-plan prices, with just 9 percent using it.

Yet again, more proof of the remarkable passivity of consumers, even in sectors as expensive and important as health. But then, healthcare pricing remains all too opaque and confusing.

Physicians dissing litigious patients

May 22, 2015by Robert Whitcomb in Uncategorized

 

For readers’ entertainment — maybe — we give you three bizarre lawsuits involving physicians who acted badly if not illegally, including the case of the “hot rod” tattoo.

New Medicaid rules could boost managed LTC

May 22, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

New rules  for Medicaid managed care could fuel a major expansion of managed long-term care {LTC} for elderly and disabled beneficiaries.Modern Healthcare reports  that the  Medicaid managed-care industry hopes the new rules “will create more uniformity in state programs, while patient advocates hope the rules will strengthen beneficiary choices, transparency, and quality oversight and protections….”

“In addition to a section on managed LTC, it’s also expected to address network adequacy and access to providers, rate setting and greater standardization of quality metrics across states.”

Experts say that the rules are overdue because Medicaid managed-care enrollment has been soaring.

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