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Gov. Walker proposes huge long-term care changes

 

The Milwaukee Journal Sentinel reports that the proposed budget of Wisconsin Governor and possible  GOP presidential candidate Scott Walker includes a ”massive overhaul of the system that provides long-term care to more than 50,000 elderly or disabled people in Wisconsin — a dramatic change that blindsided those currently managing the care.’

“The proposal, which would affect more than $2 billion a year in spending, would replace a system built over several decades with a new model in which the state would contract with large insurance companies to manage both long-term care and medical care,” the paper reported.

“No one had any inkling this was happening,”  Michael Blumenfeld, a spokesman for the Wisconsin Family Care Association, told the paper. “We are just scratching our heads. Why would you do this?”

”The governor’s proposal, he said, is the most significant change in long-term care in the state in 20 years.”


Video: Catholic Health Initiatives CEO on integrated networks

 

Video: Catholic Health Initiatives Chief Executive Kevin Lofton explains CHI’s latest moves as it puts together integrated delivery networks and expands its insurance portfolio to gain expertise managing population health.

 

 


5 big trends, whatever happens to the ACA

 

PwC discusses five big hospital-industry trends that are  likely to continue, whatever happens to the Affordable Care Act at the Supreme Court.

“These trends are much bigger and more powerful then what’s contained in the act itself because the industry is shifting, and entrepreneurs and investors have seen opportunities in the $2.9 trillion health sector, and they have taken the ACA as a jumping-off point,” Ceci Connolly, managing director of PwC’s Health Research Institute, told  FierceHealthcare.

The five trends:

“The shift to value-based care. ”

“A renewed focus on primary care. 

“The ACA recognized the importance of physician extenders, who provide routine care while steering sicker patients to specialists. As the number of newly insured patients continues to rise, the industry will rely more on nurse practitioners and physician assistants to meet the growing demand for primary care, the report notes.”

“A new emphasis on innovation. More than 90 new companies were created since the law took effect in 2010, according to the analysis. These new entrants rushed into the market to meet the demand for lower-cost, consumer-oriented care options in the post ACA-era.”

A move from wholesale health insurance to retail insurance. Rapid enrollment in the public exchanges shows the potential for retail-style health insurance and creates renewed interest in private exchanges….”

“A new focus on the state’s role in healthcare form. States are key players in the reconfigured healthcare landscape because the ACA gave states notable discretion in how they could implement the law. ”

 


Will revocation of Calif. Blue Shield’s tax status start wave?

 

Will California’s revocation of  Blue Shield of California’s tax-exempt status lead to similar actions against some other health insurers, and some hospital systems, that call themselves “nonprofit” although they have big reserves, pay their executives multimillion-dollar salaries, charge very high prices and  create a comfortable settings for directors to profit from board memberships.

The old semi-joke  is that the only difference between “for-profit” and “nonprofit” hospitals systems is simply that the latter don’t pay taxes because of their political power. But tax-exemption criteria can vary a lot state by state. It’s dangerous to generalize.

 


Better but fewer metrics, please

 

Christine Cassel, M.D., president and chief executive of the National Quality Forum, said the healthcare-quality movement’s biggest challenge is to “reduce the noise and increase the signal strength” of measures  to assess  individual hospitals and healthcare systems. She said that healthcare has gone from having too few quality measures to having too many.

Given that, as well as the accelerating  shift to value-based payment models, “it is even more important that we get the measures right,” she said.

Dr. Cassel said that is that many metrics need more science behind them.

Her biggest goals for the NQF, as reported in FierceHealthcare:

  • “Align quality measures among all payers.
  • “Identify more actionable, meaningful measures.
  • Achieve greater consistency and rigor with consumer information.
  • “Leverage new technology and big data to identify and assess quality metrics.
  • “Make sure measure reflect actual clinical quality, not factors like socioeconomic status that are out of health systems’ control.
  • “Attribute results to specific providers.
  • “Improve consumer engagement. ”

 


Hospitals should focus on ‘labor ratio’

 

Steven Berger, the founder of data-analytics company Healthcare Insights, says that the most important benchmark related to hospital operations is the labor ratio.

Labor ratio — a hospital’s total labor costs divided by total revenue — “should be the most important metric you use in doing your budget every year,” Berger told a session at the American College of Healthcare Executives 2015 Congress.

Labor is hospitals’ largest expense, and each incremental improvement in the labor ratio goes straight to the bottom line, he notes. And many hospitals can  improve, considering the wide variation in performance on this metric.

Mr. Berger said that the median labor ratio for U.S. hospitals is 55 percent, but the highest and lowest performers  can vary by 20 percentage points.  “Best practice is about 45 percent,” he said.

He said that many rely on full-time-equivalent per occupied bed to benchmark productivity, but this metric fails to account for FTE and contract labor costs, said Mr. Berger.


Essentia goes after rural health problems

 

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The Minnesota-based Essentia Institute of Rural Health is bringing a new kind of creativity to the challenges of serving lower-income patients in the small towns of the Midwest.

The Minneapolis Star Tribune reports that Some 290 research ventures and clinical trials  are underway at Essentia ”as it tries to analyze and solve the distinct problems of medical care in the rural Midwest, where poverty is high, specialists are scarce and many people are uninsured.”


Physicians need meeting control

confroom

Often the best meeting is a cancelled one.

 

Physicians’ meetings need to be more productive  and better-timed, and doctors need to better protect their personal time to recharge.


Prizes for Mo. Medicaid recipients

 

The St. Louis Post Dispatch reports:

“The next round of contracts awarded to companies to manage healthcare for thousands of Missouri Medicaid recipients includes a new focus: patient wellness.

“Consumer wellness incentives are trending throughout the health insurance market, most notably in employer-sponsored plans. Now Missouri is getting in on the action on behalf of its roughly 400,000 managed care customers.”

”The contracts, awarded to three companies this month, include proposals designed to help patients exercise, eat healthier and make regular doctor visits. Consumers who … succeed in these programs can receive a range of incentives including gift certificates, debit cards and groceries.”


For friendlier ICU’s

 

The Wall Street Journal reports:

“Hospitals are redesigning intensive-care units to make them safer and less dehumanizing, with a new focus on engaging families and patients in decisions.

“ICU teams are testing novel approaches to solicit input from patients and their families, and to honor their preferences and goals for care. Many are using apps and devices to link up medical teams with families. Evidence has shown that patient and family participation can improve safety and outcomes, and hospitals are putting a failure to treat patients with respect and dignity on a par with other preventable medical complications.”

 


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