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Robert Whitcomb

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Astute Technology boosts referral networks

February 6, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

Astute Technology boosts shared clinician-patient decision-making and physician-referral networks. And  its “online university” assists the continuing education of physicians.

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It takes a village in Manhattan

February 6, 2015by Robert Whitcomb in Uncategorized tagged

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Dr. Fred N. Pelzman, internist, writes in MedPage Today about trying to replicate some of the virtues of small-t0wn America in an urban setting to make the patient-centered medical home concept work.

”We seem to have plenty of doctors, plenty of nurse practitioners, plenty of nurses, plenty of medical technicians….  but they need more care coordinat0rs.”

”{F}or our 1,000 highest-risk, most complicated patients that need care coordination, it seems like they live in 1,000 different neighborhoods, and so the daunting process arises of building up a network of support in each of these different places.”

”{W}hat we need in each person’s neighborhood are those smaller, more individualized, high-touch resources that are much more likely to do good for the patient than whatever we do for them in the office. It could be a local community center, a place where the patient can go and spend time during the day, a place to get a healthy meal, a low-cost gym or a group that they can begin to exercise with, a pharmacist who knows them, or a support network of people who can keep an eye on them.”

”Without this, the patient-centered medical home is doomed to failure…”

 

New Partners chief takes a humble tone

February 6, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

The new head of Partners HealthCare implies that the powerful Massachusetts hospital system is reappraising its expansion plans and wants to address the impression that it’s arrogant. It would seem that its controversial plan to buy three suburban hospitals is off the table, at for now.

 

David Torchiana, M.D., a cardiothoracic surgeon, has run the 2,000-doctor physicians’ group for the past 12 years. That experience, presumably, will help better align the interests and missions of physicians and the system.

He told The Boston Globe. “We know we have to soften our external relations and get ourselves out of this place of being a miscreant in Massachusetts. It’s not a place we aspire to be.”

And, he said, Partners  will focus on controlling medical costs by higher efficiency, including better care coordination. That’s pretty much what all systems are promising to do.

Partners’  market power, high prices, but not always better patient outcomes, have been key to the intense opposition to its further expansion in metropolitan Boston, which  has involved two Hallmark Health hospitals north of the city and South Shore Hospital south of it.

Several years ago, The Globe ran a series detailing how much higher Partners’ charges were than its competitors’ for the same services, and its special deals with insurers.

 

 

GOP launches healthcare offensive

February 5, 2015by Robert Whitcomb in Uncategorized tagged , , , , , ,

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Republican lawmakers eager to repeal the Affordable Care Act are pushing tax credits and much greater freedom for states and health insurers  to make healthcare-finance policy as the GOP  starts to present its plan  to replace the ACA.

The Republican program, which President Obama is expected to veto, would end ACA coverage requirements for individuals and employers,  end expansion of Medicaid, kill  state and HealthCare.gov federal insurance marketplaces and, indeed, end virtually everything else under the ACA,  including taxes ”it imposes on medical devices and other things to finance enlarged coverage,” the Associated Press reported.

On Medicaid, the GOP plan would give states much more freedom in how to spend money in that federal-state pr0gram — even as more conservative states now seek the ACA’s added Medicaid money.

Given President Obama’s veto pen, we suspect that most of the Republican offensive is primarily rhetorical, leading up to the 2016 presidential election.  And because the  ACA has already developed powerful constituencies of beneficiaries, it’s far from clear how the GOP program will play politically in 2016, especially given that voter turnout is always higher in presidential-election years than in others.

 

How can small hospitals stay independent?

February 5, 2015by Robert Whitcomb in Uncategorized tagged , , , ,

 

 

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In this era of  hospital partnering and consolidation, is there an argument for smaller and rural hospitals to go it alone and remain independent?

Or, as this article  by Beth A. Nelson,  a consultant in the healthcare practice of the executive-search firm Witt/Kieffer,  in Hospitals & Health Networks, asks: “If not, is there a degree of creative partnering that affords local facilities independence and control, yet also access to broader services and lower costs?”

In talking with chief executives at some independent hospitals, she found various strategies for keeping as much independence as possible and the rationales for doing so.

Tim Putnam, president and CEO of Margaret Mary Health, a critical access hospital in Batesville, Ind., noted the central civic threat involved in small and rural hospitals being gobbled up by systems:

“When independent hospitals join larger systems, the mission to the local community first and foremost goes away”.

John Solheim, CEO of Cuyuna Regional Medical Center,  in Crosby, Minn.,  told her that independent hospitals tend to be nimble and can adapt easily to local needs, something that’s difficult  with a big system.

Steven Long, FACHE, president and CEO of Hancock Regional Hospital, in Greenfield, Ind., said that citizens look at the local hospital as ”their hospital and maintain a strong sense of ownership and commitment to it,” H&HN said.

Still,  the decision whether to remain independent ”usually comes down to finances,”  the article noted. {In place of “usually” we’d use the words “virtually always”.}

In any event,  the article says, ”The trick to staying local and ‘going it alone’ is often through configuring creative but limited partnerships with larger systems.”

 

 

 

 

 

 

Getting paid for women’s preventive services

February 5, 2015by Robert Whitcomb in Uncategorized tagged

 

This Medical Economics Q&A discusses how to get paid for providing women’s primary-care preventive services.

 

Staying away from Jurassic Park

February 5, 2015by Robert Whitcomb in Uncategorized tagged

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Mina Ubbing, a former hospital CEO and CFO, and currently managing partner of MDR, discusses in Hospital Impact how hospitals can avoid becoming dinosaurs.

 

“Labor is a classic area to consider. Certainly wage rates and volumes may change over time, but what about basic staffing levels per unit of service? What about overhead staffing growth? Staffing creep is not uncommon. Was there a monitoring aspect to the initial solution and does the organization still have leadership buy-in to continue the monitoring?”

 

”Efficiency can regress in other areas of the organization as well. Does your supply chain staff routinely check and verify federal or state sanction lists, recall lists and vendor master files?”

 

 

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N.C. Blues database could shake up medical industry

February 5, 2015by Robert Whitcomb in Uncategorized tagged ,

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A new online database from Blue Cross and Blue Shield of North Carolina, by making heretofore hidden price information transparent, could shake up the secretive and very expensive U.S. medical industry.

Among other things, the newly available numbers can steer patients to have surgical and other procedures done in outpatient settings that are much less expensive than those done in an inpatient settings.

It will be very interesting indeed to see how physicians and insurers reset pricing under the sunlight of medical-pricing transparency.

 

 

ABIM backs off from parts of MOC program

February 5, 2015by Robert Whitcomb in Uncategorized tagged , , ,

 

The American Board of Internal Medicine (ABIM) suspended parts of its maintenance-of-certification program and apologized ”after many internists and internal medicine subspecialists complained that it was a waste of time and money,” Modern Healthcare reported.

Indeed, some physicians have complained that the program is a money-making scheme for the organization and its  very well-compensated leadership.

The ABIM, along with the other 23 members of the American Board of Medical Specialties, ”recently changed its recertification process from one that requires an exam every 10 years to a process requiring continuous education and self-assessment,” the publican noted.

Dr. Westby Fisher, an internist and cardiologist with the NorthShore University HealthSystem,  in Evanston, Ill., denounced the ABIM in a blog post:

“The American Board of Internal Medicine deployed some chaff in an attempt to ward off a flurry of incoming Exocet missiles aimed squarely at its yearslong history of corrupt and coercive financial dealings, gross mismanagement and entirely unproven Maintenance of Certification program by saying simply, ‘We got it wrong and sincerely apologize,’ ”

Apple in the lead at hospitals

February 5, 2015by Robert Whitcomb in Uncategorized tagged , ,

Reuters reported that Apple Inc.’s healthcare technology seems to be in the lead as hospitals seek to better monitor patients remotely and to lower costs.

Reuters reported that 14 of 23  leading hospitals it contacted said they are using a pilot program of Apple’s HealthKit service — a repository for  such patient-generated health information as blood pressure, weight or heart rate – ”or are in talks to do so.”

The  aim ”to help physicians monitor patients with such chronic conditions as diabetes and hypertension” Reuters says that such Apple rivals  as Google and Samsung Electronics  ”are only just starting to reach out to hospitals and other medical partners.”

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