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News & Views

2019 outlook for not-for-profit hospitals not that grim

 

The financial outlook for not-for-profit hospitals has sounded  dismal for the past several years. As FierceHealthcare reports:

“They face ongoing pressures of soft revenue growth, weak inpatient volumes and single-digit reimbursement increases, pushing margins down as expenses outstrip revenue—a trend that Moody’s called an ‘unsustainable path,’ earlier this year.

New reports from the two top rating agencies—Moody’s Investors Services and Fitch Ratings—offer, for yet another year for not-for profit hospitals, a gloomy outlook for 2019. But, Fierce reports:

“[W]hile these hospitals face a tough road ahead, the news is not as bad as it might seem, said Kevin Holloran, senior director at Fitch who just gave the sector a ‘negative’ outlook.

“‘We’re putting warning flags up, but no ones calling for disaster,’ Holloran said. ”

”He acknowledged operating margins have been on the decline while hospitals deal with nontraditional competition, new technology changing the way medicine is practiced and the continued shift from inpatient to outpatient care. ‘But pretty much, however, you want to measure it, balance sheet strength is pretty much at an all-time high.”’

“He pointed specifically to hospitals’ days’ worth of cash on hand, as well as their cash-to-debt and debt-to-capitalization ratios as measures in particular that had been improving over time, leading to stable ratings for the sector.

“That’s because when times were good and the markets were rebounding several years ago, hospitals were building up their reserves and shrinking their capital expenditures.

“‘Until a significant market dislocation, we expect those balance sheets to remain kind of robust which is going to balance out the negatives from operations.”’

To read the whole article, please hit this link.


Relying on ’15-minute huddles’

Marc Harrison, M.D.,  CEO of  Salt Lake City-based Intermountain Healthcare, based in Salt Lake City,  writes in the Harvard Business Review about his system’s intense use of “15-minute huddles” to maximize care and efficiency.

“At Intermountain, the 15-minute huddle is the key. It enables knowledge from activities throughout the organization in the previous 24 hours to escalate up to executive leadership — Tier VI in our model — and be addressed.

“Using that 15 minutes effectively requires structure: Each huddle has a leader; the participants are designated, as is the recorder of the data; the huddle is scheduled; and the categories of reported information are captured on a prepared chart. We have four fundamentals of extraordinary care that are covered in our daily huddles: safety, quality, access, and stewardship of resources so they are used to provide the best possible care. Across those fundamentals, eight key topics are reported every day. They include potential serious safety events that could have harmed a patient, caregiver injuries, and reported downtimes (of equipment, elevators, systems or processes, for example).”

To read the article, please hit this link.


The transformation of Ohio’s healthcare

 

Governing Magazine looks at how a small state office in Ohio has transformed healthcare in that state. The article concludes:

“When he ran for president in 2016,  {Ohio Gov. John} Kasich took heat from his Republican primary opponents for his health-care decisions. He was assailed for expanding Medicaid, which many Republicans see as an unsustainable financial proposition that merely increases the size of government. These days, Kasich says he’s not interested in pleading his case to other Republicans about why he believes expanding and transforming health care works. He says he’s convinced history will show he made the right decision. ‘Tell me how [else] you’re going to go about meeting the needs of people. Tell me what you’re going to do to help the drug addicted and mentally ill. I haven’t heard of a better solution,’ he says. Everything else ‘is all smoke and mirrors.”’

To read the article, please hit this link.

 


Mount Sinai to provide services to Taikang Healthcare

New York City-based Mount Sinai Health System  has reached an “historic agreement” with Taikang Healthcare, in China, to provide clinical and management knowledge transfer services.

FierceHealthcare reports:

“Under the agreement, Mount Sinai will also provide education and training programs for Taikang’s Xianlin Drum Tower Hospital in Nanjing, the capital of Jiangsu Province in east-central China. Officials said Mount Sinai will also provide guidance in implementing medical care delivery standards, as well as developing clinical centers of excellence and best practices in hospital management.

“‘Our mission is to enable our international partners to raise the standards of healthcare delivery in their communities by leveraging Mount Sinai’s repository of medical knowledge, cutting-edge clinical innovations, and educational resources,”  said Arthur Klein, M.D., president of Mount Sinai Health Network.

To read more, please hit this link.

 


Using blockchain to speed credentialing

 

FierceHealthcare reports:

“Two national insurers and a Michigan health system are joining a new pilot project aimed at simplifying physician credentialing with blockchain technology.

“WellCare and Spectrum Health are among the founding participants in a pilot project launched by ProCredEx, a new company backed by Hashed Health, which specializes in blockchain and distributed ledger technologies for healthcare.

“National Government Services, an Anthem-owned federal contractor that processes Medicare claims for the Centers for Medicare & Medicaid Services (CMS), has also joined the pilot program alongside The Hardenberg Group and Accenture.”

 

To read the whole article, please hit this link.


How established physicians relate to new ones

 

An article from Medscape looks at how established physicians look at working with new ones. The article starts:

“Younger professionals entering into any workplace have doubts and concerns about how their established peers feel about them. That’s especially true for freshly minted doctors. Having just finished the debt-laden, stressful grind that is medical school, they are eager to be seen as the medical professionals they are. But what do the doctors whose staffs they are joining actually think about them?

“We asked 10 doctors across eight different specialties to share their thoughts on their younger peers. Their candid responses suggest healthy amounts of respect, but also surprising insights that point not only to generational differences but also to potential changes on the horizon for medicine. Here’s what they had to say.”

To read the piece, please hit this link.

 


The changing role of the CMO

 

An article in NEJM Catalyst examines the evolving role of the chief medical officer. Among the observations:

“The CMO has been described as the Influencer in Chief, functioning to facilitate change and build resilience. To be effective, the CMO must not only perform as a leader within the hospital C-suite, but must also mentor leadership capacity among the medical staff. CMOs are frequently involved with organizational cultural change, including the transition from volume to value. Focus on value creation may bring about increased scrutiny on CMOs to ensure return on investment.”

To read the whole article, please hit this link.

 


The distressed hospital sector

FierceHealthcare reports:

“The healthcare industry’s level of ‘distress’ is far higher than in the broader economy, according to a new report.

“The latest Polsinelli-TrBK Distress Indices for healthcare, which uses Chapter 11 bankruptcy filings for entities with $1 million or more in assets to determine ‘distress’ levels, found that 20 hospitals have filed since 2016.

“About 3 out of 4 of hospitals that filed bankruptcy were in rural areas.

“Chapter 11 filings have decreased by 53% nationwide since 2010, according to the report. But in healthcare, its distress scores increased by 305% in that same window.

“‘I think it’s going to be full speed ahead for a while,’ Jeremy Johnson, the report’s editor and a bankruptcy and restructuring attorney at Polsinelli, told FierceHealthcare. ‘The biggest issue is that no problem has been solved—the issues in healthcare we don’t think are cyclical.”’

To read the whole article, please hit this link.

 


A partnership that raises all ships

From an NEJM Catalyst article:

“What are some healthcare partnerships that went well? John Ayanian, director of the University of Michigan’s Institute for Healthcare Policy and Innovation, asks Joneigh Khaldun, director and health officer for the Detroit Health Department, to describe a public health and health system partnership that tackled a tough problem.”

To see the video and read the text on this, please hit this link.

 

 


How to lure and keep Millennials in medicine

 

 

In a Med Page Today article, Colin Zhu, D.O., discusses how to lure and keep Millennials in medicine to deal with the oncoming physician shortage.

Among his observations:

“Society associates Millennials with negative connotations like entitlement and selfishness, but I beg to differ. My generation is known for our tech savvy, flexibility, and eagerness to produce results. We crave constant feedback and seek out continuous opportunities to improve. We find culture to be a greater attraction than compensation, look for new experiences in life, and want to pursue passions outside of our chosen fields.

“As more doctors cut back their hours or plan to retire, practices and hospital administrators will need to look in new directions to increase retention among young doctors. Keeping talented people within the practice of medicine will ultimately benefit everyone. Organizations that build strong cultures by providing career opportunities and encouraging people to pursue outside passions will be more likely to attract and keep Millennial physicians. ”

Dr Zhu is the creator of TheChefDoc and author of Thrive Medicine: How to Cultivate Your Desires and Elevate Your Life.

 

To read the article, please hit this link.


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