Health Care Headlines

This article explores eight of the most challenging and interesting issues that hospitals are facing as they move into 2013. Such issues include physician alignment strategy, the ability of hospitals to stay independent, the development of accountable care organizations, the evolving priorities and concerns of CEOs and several other issues.

Kaiser Foundation Hospitals and Health Plan has tapped Bernard Tyson, its current president and chief operating officer, to become chief executive officer of the health care organization.

To showcase the efforts hospitals across California are making to improve quality patient care, the California Hospital Association updated its dedicated patient safety website, www.CaringIsOurCalling.org

Reporting adverse events positively influences the perception of safety and may reduce medical errors in large, multi-site health systems, according to a new study from researchers at the Perelman School of Medicine at the University of Pennsylvania.

When Sandy roared ashore in New York City, dozens of ambulances lined up to evacuate patients from NYU Hospital.  Power at the hospital went out, and their back-up generators failed.

It was a day nearly two decades in the making, as officials flung open the doors Saturday morning to Barstow’s new state-of-the-art hospital.

Infection control efforts would be more successful if hospitals in the same region collaborated to implement similar prevention procedures, according to a study published in the journal Health Affairs, HealthDay reports (Preidt, HealthDay, 10/9).

The American Hospital Association has released a revised readmissions penalty calendar to reflect corrections announced by CMS earlier this month, according to an AHA News Now report.

Authors of a new study contend that California’s 2004 law mandating minimum nurse-to-patient ratios in hospitals has had mixed results on quality of care for patients.

According to a recent article in The Wall Street Journal, the Centers for Medicare & Medicaid Services (CMS) is expected to decide by Nov. 1 whether nurse anesthetists should get Medicare reimbursements for delivering chronic-pain treatment.

CHA members are invited to attend the Third National Accountable Care Organization (ACO) Congress, co-sponsored by the California Association of Physician Groups (CAPG) and the Integrated Healthcare Association (IHA), Oct. 30 to Nov. 1 at the Beverly Hilton Hotel in Los Angeles. 

In the week following Gov. Jerry Brown’s deadline for passing or vetoing hundreds of bills, those affected are examining successes and defeats that touch on cancer care, emergency rooms, prescribing, elder care and compensation to victims of corporate fraud.

Just days before its program to curb avoidable hospital readmissions was set to begin, the CMS acknowledged a calculation error and issued a revised list of hospitals’ penalties for 2013.

Billionaire surgeon and biotech entrepreneur Patrick Soon-Shiong is unveiling a major program Wednesday aimed at speeding the flow of patient information among doctors, says Reuters in a profile of the wealthiest man in Los Angeles.

It’s Oct. 1, the day some acute care hospitals have been eagerly awaiting…and which others have been dreading.

Some 20 percent of U.S. adults report using the emergency department at least once a year, and everyone had a theory about why they went to the ED instead of a doctor’s office or outpatient clinic, but no one had ever formally asked the patients themselves.

Patients and health care providers are calling attention to what they perceive as a hole in Medicare coverage that affects what patients pay out-of-pocket for skilled nursing care.

A hospital should not have to arrive at death’s door before the Federal Trade Commission will allow it to merge with a competitor, lawyers for the American Hospital Association have written in a friend-of-the-court brief.

Hospital organizations are responding to a stern letter sent Sept. 24 by U.S. Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius, which warns against using electronic health records to artificially inflate Medicare and Medicaid payments.

A number of regional healthcare trends in California have been identified in new market studies of Sacramento and Riverside/San Bernardino conducted by the Center for Studying Health System Change (HSC) in Washington, D.C., and funded by the California HealthCare Foundation (CHCF).

Californians must get better prepared before the next big earthquake, and practice how to protect ourselves when it happens. The purpose of the ShakeOut is to help people and organizations do both.

When it comes to safely transitioning patients from one setting to another, not all interventions are created equal, according to a study published Monday in the Annals of Internal Medicine.

Local hospitals are ramping up efforts to drive down their readmission rates as an Oct. 1 deadline looms for them to achieve results or face state-imposed penalties.

The healthcare industry’s opposition to federally required sequestration cuts will likely grow stronger this week following Friday’s report from the Office of Management and Budget that shows $11 billion in annual cuts to Medicare over the next decade.

After much anticipation: Accountable care organizations have arrived.  Or at least, researchers — armed with data that attempt to quantify ACOs’ impact — made their way to Washington, D.C., last week, drawn to a Health Affairs roundtable on payment reform.

The robot, sitting quietly in a corner, suddenly hums to life and rolls down the hospital corridor on three wheels. Perched atop the sleek machine is a monitor showing the smiling face of Dr. Paul Vespa, the physician who’s piloting the rover from miles away. He can pull up to a patient’s bedside, ask questions, observe symptoms and even use a stethoscope.

Elective deliveries prior to 39 weeks of gestation have plummeted from 10.4 percent to 3.6 percent from 2010 to 2011 at California hospitals participating in perinatal programming as part of Patient Safety First…a California Partnership for Health, led by Anthem Blue Cross, National Health Foundation (NHF) and California’s Regional Hospital Associations.

The 2013 American Hospital Association Environmental Scan provides insight and information about market forces that have a high probability of affecting the health care field. It is designed to help hospital and health system leaders better understand the health care landscape and the critical issues and emerging trends their organizations likely will face in the foreseeable future. 

The number of U.S. uninsured declined to 48.6 million last year from 50 million in 2010 and the rate of uninsured dropped to 15.7% from 16.3% during the same period.

The Iowa Healthcare Collaborative offers a free toolkit to help guide implementation of colored wristbands.

The runny nose, sneezing and aches that are classic signs of the flu may be months away, but doctors say that’s all the more reason to be vaccinated now.

California lawmakers passed legislation last week that would allow outpatient facilities to perform cardiac catheterization, according to a California Healthline report.

No matter what your role — clinician, physician, emergency preparedness coordinator or facilities management — you have a part in ensuring continuity at your hospital. 

The Iowa Healthcare Collaborative offers a free, downloadable hospital work plan designed to help healthcare organizations form and document action plans for various patient safety and quality improvement projects.

For two months Stephanie Aldana’s son complained of intense pain in his back and tremors in his legs. Doctors visits revealed nothing. She could do little but try to comfort 10-year-old Isaac as his feet swelled and his mobility deteriorated. Then Isaac lost sensation below his waist and an emergency MRI led to stark news: The fourth-grader had Ewing’s sarcoma, a rare cancer that can attack the bones.

Health plans see business potential when California expands Medicaid coverage to 1.5 million additional people in 2014 under federal health reform.

Already hurt by cutbacks in Medicare funding, hospitals in the Ventura County area would lose an additional 7.8 percent of their federal reimbursement under a new congressional proposal.

The ASC Quality Collaboration offers a free, downloadable sample hand hygiene policy and procedure.

Hospitals pressed HHS this week to address a range of Medicaid-related uncertainties created by the U.S. Supreme Court’s decision on the federal healthcare overhaul.

Recent research published in the Joint Commission Journal on Quality and Patient Safety suggests volumes are the strongest predictor of poor performance in emergency departments.

Already reeling from big cutbacks in Medicare funding, hospitals in the Los Angeles metropolitan area would lose another 2.4 percent of their federal reimbursement under a new analysis ordered by Congress.

Long before she took control of a Simi Valley Hospital competing with bigger institutions that offer more services, Kim Milstien lived in the minor leagues. Literally.

Already reeling from big cutbacks in Medicare funding, California hospitals would lose another 3-4 percent of their federal reimbursement under a new analysis ordered up by Congress.

Digital-age innovations need to be brought to bear on the healthcare industry and government has a role in effecting that change, according to a report on healthcare and information technology.

The Obama administration this week will try to encourage reluctant U.S. states to move forward with health insurance exchanges amid fears that time is running out for states to act on a reform provision meant to extend coverage to millions of low-to-moderate income uninsured Americans.

As the transformation of the nation’s health care system gains momentum, hospitals and health systems are going to find themselves being held more accountable for patient outcomes. That’s not all: Equally important is reducing the cost of care. There’s no road map for the new imperative of better patient care, improved population health and reduced costs the so-called Triple Aim, developed by the Institute for Healthcare Improvement. Each health care organization needs to create its own path, and many are well on their way. 

Experts predict that climate change, in addition to causing longer and fiercer heat waves and higher humidity, will bring an increase in viruses and bacteria that cause illness.

A nurse-led fast-track sepsis screening and diagnosis program cut mortality rates in half at nine California hospitals.

Perhaps you’ve had a mammogram recently, or taken a child for an immunization or consulted with a specialist about a weight problem. Since late 2010, those visits to health-care providers have carried an additional benefit: They’re free. Under the Patient Protection and Affordable Care Act, signed into law 28 months ago and largely upheld in June by the Supreme Court, it’s illegal for insurers to charge consumers a co-payment for a long list of health care services designed to prevent disease.

When Harbor UCLA Medical Center, a teaching hospital in Torrance, Calif., and a major safety-net facility for Los Angeles County, looked at its 30-day readmissions data, it found that readmissions for heart failure patients had increased by about 25% in just one year.

Immunizations, cancer screenings, lifestyle counseling and other wellness measures can save lives. But your doctor may not be making sure you’re up-to-date on the services you need. 

Loma Linda University Heart & Surgical Hospital has performed the Inland area’s first single-incision gallbladder removal using robotic technology.

California hospital overcrowding disproportionately affects minority patients, according to a study published today.

The U.S. Supreme Court decision to uphold most of the Affordable Care Act hasn’t changed much in California — except to put the reform effort into overdrive.

A gift of $3 million from San Manuel Band of Mission Indians to Loma Linda University Cancer Center has transformed the lives of cancer patients through improved treatment and care.

Babies born at San Gorgonio Memorial Hospital will be extra secure, thanks to a new, state-of-the-art infant monitoring system that safeguards against infant abduction.

As state mental health services have crumbled under budget cuts, tens of millions of dollars raised through a tax designed to help the mentally ill have gone to “wellness” programs like horseback riding for teens and yoga classes for city workers. And that’s by design. 

Due to the high volume of reporting issues, the Centers for Medicare & Medicaid Services has extended the Aug. 1 reporting deadline for the Hospital Outpatient Quality Reporting Program and Hospital Inpatient Quality Reporting Program. 

In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Construction of the new four-story patient tower and expanded emergency department at San Antonio Community Hospital is taking shape.

In the wake of the U.S. Supreme Court’s decision upholding the Affordable Care Act, California’s first-in-the-nation Health Benefit Exchange is redoubling its efforts to enroll as many as possible of the estimated 3 million people who will be eligible to buy insurance through the state-run purchasing pool that will open for business in 2014.

Verdugo Hills Hospital, for the last 40 years an independent hospital, has entered into merger talks with USC’s Keck Medical Center, officials said Tuesday.

The Congressional Budget Office (PDF) projected that the U.S. Supreme Court’s decision reduced the 11-year cost of the Patient Protection and Affordable Care Act by $84 billion.

In 2010, California hospitals served 16% fewer patients with mental illnesses than state hospitals did in 2005, according to a report released Thursday by the Treatment Advocacy Center, the Los Angeles Times reports.

The CMS will keep enrollment in a coming national pilot project for dual-eligible beneficiaries below 2 million people, or more than a million fewer than states have proposed.

The Joint Commission has an online guide for critical-access hospitals that use unlicensed scribes to help physicians and other licensed healthcare professionals document patient encounters in an electronic health-record system.

As the scrutiny of healthcare provider payments grows, hospital leaders say regulators are increasingly undercutting physicians’ medical judgment and resorting to overly punitive corrective actions using redundant and overlapping investigations.

A new study of statewide charges for various medical procedures suggests that consumers should compare surgical prices in much the same way that they shop for homes, cars and other large-ticket expenditures.

Nine California hospitals and health systems made Hospitals & Health Networks’ annual “Health Care’s Most Wired” list, Healthcare IT News reports. The list recognizes hospitals for successful health information technology planning and implementation.

Using an electronic health record to review portal images can lead to improvements in patient care and safety, according to a new study.

The nation’s hospitals hailed President Barack Obama’s signing of the Food and Drug Administration Safety and Innovation Act on Monday as the right step to address the nation’s drug-shortage problem.

Loma Linda University Children’s Hospital has acquired a EC-145 helicopter – an upgrade from the EC-135 used in 2011 – that is equipped with cutting-edge technology and safety features.

From The Commonwealth Fund: Encouraged by federal incentive payments promoting the use of health information technology and calls for health care providers to better coordinate care, a growing number of U.S. hospitals are adopting electronic health record (EHR) systems. 

Dignity Health has signed an agreement to buy the largest independent operator of occupational health and urgent care centers in the U.S., health system officials announced Monday.

The American Automobile Association predicts 42.3 million Americans will travel at least 50 miles from home this Fourth of July — the most Independence Day travel since 2007.  That activity also means an increased need for blood products. LifeStream is urging local residents to make a lifesaving blood donation before leaving town or upon returning home.

While California’s political leaders condemned or celebrated Thursday’s Supreme Court decision upholding the Affordable Care Act, health policy groups, doctor and hospital organizations, and state officials charged with implementing the law said they are prepared to move full speed ahead.

Dr. McDonough spoke with Medscape immediately after the Supreme Court announced its ruling on the ACA on Thursday. Although relieved by the decision to largely uphold the act, Dr. McDonough still worries about the future of this landmark law.

It was a historic moment for the nation’s healthcare system, but a routine one at Olive View-UCLA Medical Center’s emergency department. Patients packed the waiting room suffering from chest pains, skin infections, stomach cramps and headaches — the least urgent cases waiting up to 12 hours to be seen.

In lengthy letters to the CMS, the nation’s largest hospital associations again expressed concern about what they see as structural weakness in how the agency determines the effect of documentation and coding at hospitals. 

The U.S. Supreme Court ruled that the insurance provisions of the Patient Protection and Affordable Care Act are constitutional, handing President Barack Obama a major election-year victory and shunning 26 states that had sought to overturn the reform law.

Nearly 70,000 Medicare patients in California saved $41 million on their prescription drugs during the first five months of this year under the federal healthcare law, new data show.

As the Supreme Court nears a decision on health reform this week, more than 360,000 Californians are already receiving medical coverage under a state-administered precursor to the landmark legislation. 

SEIU-United Healthcare Workers West members reached a tentative
agreement with Dignity Health early this morning that maintains workers
full benefits, provides raises, and also contains unique provisions to
promote better health among Dignity employees as a way of lowering costs
and modeling healthy lifestyles to the public. The agreement averted a
strike set to begin at 11 p.m. June 26.
 

Arrowhead Regional Medical Center and the UC Riverside School of Medicine are joining in a program that will allow area high school and college students to shadow Arrowhead Regional doctors.

On the eve of a U.S. Supreme Court decision that could overturn President Obama’s signature healthcare law, federal officials announced Thursday that nearly $7 million made available by the Patient Protection and Affordable Care Act is being given to a dozen community clinics in Los Angeles County.

A new health care model being test-driven in other states could result in Los Angeles County’s 18,000 emergency medical services personnel taking on additional duties if the model is adopted here.

On June 15, a day after a Service Employees International Union (SEIU) official asked labor leaders not to oppose a change to nurse-patient ratios, California Nurses Association (CNA) Executive Director Rose Ann De Moro sent a blistering e-mail to her colleagues: “It is a war, of that I am certain, and it will not be pretty.”

If the Supreme Court strikes down healthcare reform Monday, “there is no contingency plan,” said the top U.S. Department of Health and Human Services administrator for California, as the San Bernardino County healthcare community awaits a decision on whether the law is constitutional.

It is among a healthcare leader’s greatest challenges: how to make truly sustainable, long-term cost reductions instead of annual, tactical cuts. The frustration to move from the immediate and into the long-term cost-reduction phase is perhaps best summed up by these comments from a physician organization CFO who participated in the November 2011 HealthLeaders Intelligence Report Cost Containment: Overcoming Challenges: “We can’t get beyond the idea stage. We run around like Chicken Little—the sky is falling—we must reduce costs now. 

In our annual Industry Survey, healthcare leaders place cost control and process improvement as their third-highest priority for the next three years (behind patient experience and satisfaction, and clinical quality and safety). They also cite labor, government laws and mandates, and information technology as their top healthcare cost drivers. How difficult will it be to be to achieve significant, sustainable spending cuts, and which line items present the best opportunities?

The Inland Empire Health Information Exchange (IEHIE), which recently went live in southern California, stands the debate over public vs. private HIEs on its head: Although it’s a regional HIE–one of the largest in the country, in fact–it also serves as an enterprise HIE for some of its participants. Coupled with the fact that the exchange is already financially self-sustaining, this hybrid model carries some lessons for struggling community HIEs elsewhere in the nation.

The patient who wanted a free colonoscopy offered this explanation for his urgency: the U.S. Supreme Court.

He told Dr. Jack Rotenberg, an Oxnard specialist, that he worried the high court would kill federal health-care reform and with it, free preventive tests.

There is still time to fax letters to the chairs of Senate and Assembly budget committees — Sen. Mark Leno (D-San Francisco) and Assemblymember Bob Blumenfield (D-Van Nuys) — requesting that they reject $325 million in reductions to hospitals as proposed in the Governor’s revised state budget plan.