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Md. hospitals launch patient-engagement campaign

 

The Baltimore Sun reports on how hospitals in Maryland, as in many other places, are changing  how they deliver care, “focusing more on coordinating services and preventing complications.” And they’re launching a campaign to explain the new approach to the public.

“Called ‘A Breath of Fresh Care,’ the campaign’s goal is to get patients to engage in their care by directing them to hospital wellness and chronic-disease management initiatives, as well as information on interacting with providers or even the process of registering a complaint,” the paper reports.

So the Maryland Hospital Association has set up a Web site called breathoffreshcare.org with links to individual hospitals’ Web sites. And public-education forums will start in the fall.

“Healthcare in Maryland, is evolving by leaps and bounds; gone are the days when consumers sat on the sidelines, detached from their care,” said Carmela Coyle, association president and CEO. “Healthcare in the 21st Century is about patients; hospitals and other providers are looking to their patients and communities like never before as partners in health. Simply put, to enable Marylanders to lead long, healthy lives, we need their help.”

To read The Sun’s story, please hit this link.


4 ways to improve hospital-employee engagement and thus patient care

Jim Hemmer writes in STAT about how hospitals can improve patient care via better employee engagement.

Here are four ways:

  • “Create and share a set of core values and goals that guide the behavior of all hospital employees, from the CEO and surgeons to cafeteria and maintenance workers.
  • “Ask all employees for feedback about policies, procedures, or equipment that need to be changed to deliver the best service — and act on their advice.
  • “Develop a program to recognize and reward actions that support the core values and goals.
  • “Constantly evaluate the organization’s performance through patient surveys and other feedback mechanisms. Bringing in patient feedback is crucial — seeing the positive effects of their efforts can powerfully increase employee engagement and reinforce their caring behaviors.”

To read the STAT article, please hit this link.


Report cites poor oversight of hospital mergers

 

A report by Merger Watch finds that states tend to do a bad job of scrutinizing the potential effects of the giant hospital mergers sweeping America

ProPublica, in a joint story with Mother Jones, noted that the report  “found that only 10 states require government review before hospital facilities and services can be shut down. Only eight states and the District of Columbia mandate regulatory review when hospitals enter into more informal partnerships rather than full-scale mergers, closing a loophole that exists in other states for deals to pass with minimal state oversight.”

ProPublica/Mother Jones wrote: “Smaller, local hospitals often agree to merge with larger chains in order to survive. The goal is to cut overlapping services, negotiate better deals with insurance companies and share in the cost savings. But without state protections, local residents can see health services disappear, sometimes without a chance to weigh in.

“In a number of states, there is no oversight at all. So hospitals are just doing what makes business sense for them,” said Lois Uttley, one of the report’s co-authors and the director of MergerWatch, told ProPublica/Mother Jones. “Someone needs to be looking out for the patients and the community.”


athenahealth CEO: Hospitals need to focus on network

network

Jonathan Bush, athenahealth founder and CEO, writes here about how the future of the hospital is in the network.

He writes: “The vast majority of hospitals need to redefine themselves from organizations that deliver care to organizations that orchestrate care. Even though hospitals are one of the core lines of lifeblood in healthcare, the way in which the majority of them operate aren’t appealing to patients today, nor is it sustainable to hospitals’ future existence.”

“{O}ur {healthcare} system is so broken that it’s turned this instrument  {the hospital} of health and humanity into a walled citadel. To better serve the patients who are seemingly already going elsewhere, hospitals need to become a leading orchestrator of the very best care on behalf of patients.”

The folks at New York-based Mount Sinai seem to get it. Last year, readers of The New York Times were treated to a Mount Sinai marketing campaign headline that read, ‘If our beds are filled, it means we’ve failed.’It’s counterintuitive, but spot on. Mount Sinai has embraced the idea that ‘instead of receiving care that’s isolated and intermittent, patients [should] receive care that’s continuous and coordinated, much of it outside of the traditional hospital setting.’ It’s only with this shift away from a ‘filling beds’ mindset, combined with a refactoring to the way in which a hospital interacts with other players in the market, that hospitals will maintain a leading role across the care continuum.”

He urges:

Embracing the “requirement to leverage an infrastructure of cross-continuum connectedness and total cost and quality transparency. Software alone won’t get hospitals there; being part of a more connected national network is critical.”

Adopting “savvier consumer marketing that helps hospitals stand out amidst emerging players in healthcare — like CVS Health and Walgreens — who understand the consumer mindset and have built their brands around convenience and ease.”

Accepting that a “new era of hospital sales must emerge, working with insurers and employers to broker deals that send the right patients through your doors only for the services you do really well.”

Realizing that “successful hospitals will create a renaissance of accessibility: If you can’t provide an appointment slot served up via a mobile app for every procedure type within three days, you’re failing.”

Understanding that  “hospitals should become ecosystem partners, not brick-and-mortar investors. This means eliminating anything that can be done in a primary care practice, a retail clinic, or at home, and exporting non-invasive surgery out of the hospital to more cost-effective specialized surgical centers.”


Guidelines for blocking drug abuse and theft in hospitals

 

Here are some recommendations  from Hospitals & Health Networks to help hospitals avoid opioid  and other drug abuse and theft:

  1. “Review policies and procedures that are in place to minimize diversion. ”
  2. “Create standards for ordering and prescribing controlled substances. ”
  3. “Establish education and training across multiple disciplines to educate staff on controlled substance diversion.”
  4. “Place camera surveillance in high-risk areas.”
  5. “When something does go wrong, have procedures ready to launch to investigate potential cases of diversion and discrepancies in controlled substance inventory.”
  6. “Review staff practices that can help avoid the problem on the front end.”

athenahealth CEO on redefining hospitals’ roles in networks

network

–Graphic by Barrett Lyon

Jonathan Bush, founder and CEO of athenahealth, explains here why the future of the hospital is as part of a network.

.”…The vast majority of hospitals need to redefine themselves from organizations that deliver care to organizations that orchestrate care. Even though hospitals are one of the core lines of lifeblood in healthcare, the way in which the majority of them operate aren’t appealing to patients today, nor is it sustainable to hospitals’ future existence.”

“….{H}ospitals are the places where we see medical breakthroughs; where we find we are stronger, braver and more powerful than we think. In short, they are the places where humanity often shines at its brightest. However, our system is so broken that it’s turned this instrument of health and humanity into a walled citadel. To better serve the patients who are seemingly already going elsewhere, hospitals need to become a leading orchestrator of the very best care on behalf of patients.”

He recommends:

“First is the requirement to leverage an infrastructure of cross-continuum connectedness and total cost and quality transparency. Software alone won’t get hospitals there; being part of a more connected national network is critical.

“Second, hospitals need to embrace savvier consumer marketing that helps them stand out amidst emerging players in healthcare — like CVS Health and Walgreens — who understand the consumer mindset and have built their brands around convenience and ease.

“Third, a new era of hospital sales must emerge, working with insurers and employers to broker deals that send the right patients through your doors only for the services you do really well.

“Fourth, the successful hospitals will create a renaissance of accessibility: If you can’t provide an appointment slot served up via a mobile app for every procedure type within three days, you’re failing.

“And fifth, hospitals should become ecosystem partners, not brick-and-mortar investors. This means eliminating anything that can be done in a primary care practice, a retail clinic, or at home, and exporting non-invasive surgery out of the hospital to more cost-effective specialized surgical centers.”

 


Baltimore hospital chief touts population health

sinaihosp

Sinai Hospital in Baltimore.

In an interview with The Baltimore SunSinai Hospital President Amy Perry talks about how she ushered in a new age of population health in that city.

One example she gave was  a patient who would show up often in the emergency room with complications from diabetes. She couldn’t make regular visits to primary-care physician to manage her condition because she couldn’t get out of her apartment.  So Sinai Patient navigators  helped her  find a ground-floor apartment.

“We are working with our patients to solve basic problems,” Perry told the newspaper. “We are trying to be our patients’ advocates way beyond health care.”

“What we have found is that population health has a lot more to do with jobs, violence, prevention, education and other factors than it has to do with traditional medicine,” she said.

The paper noted that “For years, the business model for hospitals meant they made money based on how many patients they saw and how sick they were.”

“Maryland is moving away from this way of doing business faster than any other state because of a special agreement with the federal government that gives it a higher Medicaid reimbursement in exchange for better controlling cost growth. But that means hospitals are given a budget each year to serve their patient population.”

“The changes are good for the hospital industry, Ms. Perry said, but nursing homes, doctors and others outside hospitals need to be similarly regulated.”


Webinar: How to design bundled-payment systems for maximum clinical and financial success

 

In this audio/video webinar, “Physicians Design Success With Bundles,’’ George Beauregard, D.O., Chief Physician Executive of St. Luke’s Health Partners/Idaho, previously Chief Clinical Officer, Pinnacle Health, Harrisburg, Penn.; Jack Frankeny, M.D., CEO of the Orthopedic Institute of Pennsylvania, Harrisburg, and Bob Harrington, a director and senior adviser at Cambridge Management Group (cmg625.com), discuss how physicians and healthcare organizations can prosper in the bundled-payment world through collaboration-driven, physician-enabled change to meet new reimbursement challenges posed by public- and private-sector payers.

CMG has been heavily involved in assisting hospitals and physicians to redesign their bundled episodes of health services to hold and then grow market share.

This webinar demonstrates how physicians and hospitals can avoid being hurt in a race to the bottom of pricing in a newly commoditized market and how to meet the challenges posed to regional healthcare players by the entry of national brands, the shift to outpatient work and winner-take-all faceoffs.

The webinar shows how, among other things:

  • Physicians and hospitals can work together for common goals.
  • Orthopedic surgeons can play nice on a teamJ
  • Perfecting parts of bundles is not good enough.
  • Success depends on managing interactions among the parts of healthcare episodes.
  • Patient experience is at the center.
  • Effective physician leadership depends on activated colleagues.
  • To realign incentives and restore physicians’ enthusiasm.

Readers should push the arrow at the lower left to start the show, which we think you will enjoy.


Organizing data for bundled payments

This HealthAffairs piece says that the ”most effective step CMS could take toward helping hospitals prepare for bundled payments would be to make historical Medicare episode payment data for their patient populations available to each acute care hospital. The data could be organized into three levels, each progressively more detailed, to allow hospitals to select and analyze populations with high episode payments:

  1. “Total price-standardized and risk-adjusted payments for episodes, defined by clinical groupings of DRGs, compared to regional and national benchmarks.
  2. “Payments for categories of services in each of the diagnosis-related-group-defined episodes, including the index hospitalization and specific types of post-discharge services, compared to regional and national benchmarks.
  3. “Detailed claims within each service category of the episode, to facilitate the analysis of factors that contributed to higher payments and development of strategies (e.g., developing partnerships with key post-acute care providers) and interventions to improve performance.”

Facing the challenge to tax-exempt status

 

Carmela Coyle, president and CEO of the Maryland Hospital Association, says that moves by municipal, county, state and federal governments to challenge the tax-exempt status of not-for-profit hospitals are a call to arms.

She notes  in a Hospital Impact piece that the Affordable Care Act imposed additional requirements that hospitals must meet to keep their tax-exempt status:

  • Conduct a community health needs assessment at least once every three years
  • Adopt a written financial assistance and emergency medical care policy conforming to statutory criteria
  • Do not charge patients eligible for financial assistance more than “amounts generally billed” to insured patients
  • Do not begin “extraordinary collection actions” before making “reasonable efforts” to determine if a patient is eligible for financial assistance

Ms. Coyle writes: “While the individual efforts of various states and the requirements in the ACA are more than enough for hospitals to address, there’s something bigger happening. These recent movements appear to be the culmination of a significant and worrisome erosion of the trusted relationships hospitals have enjoyed for so many decades with their communities.”

“There remain many battles to be fought over the tax-exempt nature of hospitals, but fixing the root of this issue won’t take place in a courtroom or legislative hearing room. It will take place in each of the communities that hospitals are privileged to serve. In 2006, the American Hospital Association (AHA) released the 28-page Trust Counts Now report, which called for hospitals to ‘reaffirm their rightful place as valued and vital community resources that merit broad public support.”’

“With hospitals’ very nature under assault due to increased governmental budget pressures, that call is as relevant now as it was a decade ago. A Web site from AHA, Community Connections, offers resources to help with that effort, but it is at the hospital level, where nurses, doctors, trustees and others, will need to begin to rebuild and reaffirm the relationships with their communities, so that hospitals once again are perceived not as a drain on county coffers, but as the invaluable resources they are.”

 


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