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Another reminder of healthcare disparities



MedStar Georgetown University Hospital during one of Washington’s paralyzing two-inch snowfalls.

In an obvious effort to build on its affluent clientete, “MedStar Georgetown University Hospital has applied to build a new six-story, $560 million building featuring a 33-bay emergency room, a surgical pavilion with expanded operating rooms, underground parking and a rooftop helipad, ” The Washington Post reported.

“This facility {is meant] to accommodate the natural growth in terms of our market: Northwest Washington, near-in Maryland, Chevy Chase and near-in Northern Virginia,” Richard Goldberg, M.D., president of the hospital, told The Post.

The Post noted that “MedStar’s application for approval would undoubtedly improve facilities at the existing hospital, but it comes as the District continues to struggle with broader geographic and racial health disparities.

“For instance, recent research from Rand Corp. with the support of the D.C. Cancer Consortium found far fewer providers offer cancer treatment and palliative care east of the Anacostia River, and that ‘cancer incidence and mortality among black residents of the District are dramatically higher than for white residents of the District.”’

“MedStar Georgetown is near two other highly rated hospitals that are competing for market share in Northwest D.C. and the nearby suburbs; it is two miles from George Washington University Hospital and three miles from Sibley Memorial Hospital, which has been affiliated with Johns Hopkins Medicine since 2010.”

“Meanwhile residents of the rest of the District have less enviable options for emergency and specialty medical care. Howard University Hospital, in Shaw, was the recent subject of a takeover after suffering deep financial losses. The beleaguered United Medical Center remains the only full-service hospital east of the Anacostia River.”

Patricia Quinn, director of policy at the D.C. Primary Care Association, told the paper that, in The Post’s words,  “she hoped that officials from the District’s State Health Planning and Development Agency would push MedStar Health, a $4.6 billion, nonprofit health system, to do more to partner with community health organizations on cancer treatments and other services.”



Cutting waste: Advancing beyond the ACO


Modern Healthcare reported that “Chapin White, a senior policy researcher at the RAND Corp., pointed to the historic slowdown in Medicare costs as one of the most important trends in healthcare spending. But he also pointed out that the spending reductions have been achieved largely through rate cuts to providers rather than widespread adoption of risk-based payment systems. ‘ACO’s are really tinkering on the edges of the big picture of Medicare spending,’ White said.”Patient Centered Medical Homes and bundled payments are two other approaches  to avoid rewarding providers for quantity of care instead of quality.

”Kristen Miranda, vice president for strategic partnerships and innovation at Blue Shield California, said the changing payment landscape is resulting in some strange bedfellows….she cited the not-for-profit insurer’s partnership with competitor Anthem Blue Cross to launch the $80 million California Integrated Data Exchange as evidence of unique collaborations aimed at creating a more efficient healthcare system.”

Some argue that ”paying doctors more for services provided at hospitals than they get paid for the same care delivered in an office is driving up costs and driving consolidation. ‘The site-of-service differential has to go,’ said Simeon Schwartz, CEO of New York’s WESTMED Medical Group,” Modern Healthcare reported.

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