Best Care Anywhere

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11 responses to “Best Care Anywhere”

1. 

   AlxHamiltn

   August 24, 2011

   August 24, 2011 — 9:41am ET | By Ron Shinkman

   TAGS
   charity care
   Illinois Hospital Association
   Illinois Department Of Revenue
   CEO pay

   Revocations of hospital tax exemptions justified – FierceHealthFinance – Health Finance,
   
   The Illinois Department of Revenue demonstrated bold healthcare financial leadership when it revoked property tax exemptions to three hospitals last week because their average of 1.3 percent of revenues devoted to charity care wasn’t high enough.

   In revoking the exemptions to Edward Hospital in Naperville, Decatur Memorial Hospital and Northwestern Memorial’s Prentice Women’s Hospital in Chicago, the department applied a concise litmus test: “Is it a charity or a business? Is it Motorola or is it a soup kitchen?” department spokesman Mike Klemens told the Associated Press.

   A great question–if not a seminal one, and it is one the department is applying to every hospital that has been recently expanded or acquired. I followed up with another department spokesperson, Susan Hofer, to put Klemens’s remarks in the context of healthcare.

   “They (the hospitals) provide care to everyone who needs it or for everyone who asks for it, and they make it known that they offer charity care,” Hofer said. The trio weren’t meeting that criteria, she added.

   However, the hospitals were doing an excellent job of meeting the payment demands of their top management: Decatur CEO Kenneth Smithmier was paid more than $1.2 million in 2008, the most recent year for which data was available. Edward CEO Pam David was paid $1.5 million. Northwestern Memorial CEO Dean M. Harrison was paid $3.4 million–one of five Northwestern executives who received a seven-figure paycheck in 2008.

   Just for comparison’s sake, Motorola’s CEO received $857,500 in salary in 2007, the most recent year for which that data was available.

   If anyone has data on soup kitchen CEO pay, please get in touch.

   Edward said it would appeal the ruling, while Northwestern said it disagreed with it. The Illinois Hospital Association (IHA) said it was “disappointed and deeply concerned” about the rulings.

   “Hospitals in Illinois are vital community resources that deserve tax-exempt status … providing services to thousands of people who do not have the financial means to pay for the treatment they need, and providing billions of dollars in benefits to their communities,” said IHA President MaryJane Wurth.

   Wurth neglected to mention that these hospitals are often also a resource for enriching their leadership–and Illinois is among the leaders in the Midwest in that particular achievement. One out of eight of the state’s non-profit hospital CEOs are paid more than $1 million a year. Average total annual compensation statewide tops $600,000, or about 20 percent higher than what the Internal Revenue Service says is the national average.

   Little wonder that the Prairie State–which has been struggling with huge gaps in tax revenues during the recession–is getting tough with those exemptions.

   Medical bills fuel nearly two-thirds of personal bankruptcies in the U.S. Since most filers have health insurance, it’s a trend that could be eased with paying their execs less and contributing some more toward charity care. Yet in California alone, more than a dozen non-profit hospital CEOs were recently paid more than what their hospitals spent on charity care.

   “Some not-for-profit hospitals are serving the poor; others are raking in the bucks,” said Shannon Brownlee, acting director of the New America Foundation health policy program in Washington.

   According to Claudia Wyatt-Johnson, a healthcare compensation expert in Chicago, hospital board members are often bowled over by what the CEOs are paid. “We get the 990s, go through them in detail, and they see what the comparables are. Then we scrape (the trustees) off the floor,” she said.

   Nevertheless, Wyatt-Johnson noted, the boards consent to those payouts in order to attract what they perceive is the top talent.

   The compensation firms themselves may even be abetting the pay padding.

   Pamela Knecht, president of Accord Limited, a Chicago healthcare governance consulting firm, observed that “it seems there is a possibility that when executive compensation firms are hired by boards and/or CEOs to provide multiple examples of comparable compensation, the firms may report out the higher end of the comparables.”
   Knecht qualified that she has no specific evidence that this is the case. Nevertheless, it sounds like her eyes aren’t lying.

   There’s little evidence those trends are going to change anytime soon. At the American College of Healthcare Executives annual conference last spring, a majority of hospital CEOs polled on compensation thought they were underpaid.

   That explains in part why the Illinois Department of Revenue isn’t quite finished with putting hospitals and hospital systems under its microscope. It is currently examining the tax exemptions for hospitals affiliated with 15 other systems that meet their criteria for review. Don’t be surprised if there are other revocations.
   And if some healthcare CFOs–most of whom are paid significantly less than their bosses–don’t take the risk of rocking the boat about compensation and charity care policies, expect to see other states follow Illinois’s lead. – Ron

   Read more: Revocations of hospital tax exemptions justified – FierceHealthFinance – Health Finance, Healthcare Finance http://www.fiercehealthfinance.com/story/revocations-hospital-tax-exemptions-justified/2011-08-24#ixzz1Vy4du9kT
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2. 

   AlxHamiltn

   September 1, 2011

   Recent VA News Releases

   To view and download VA news releases, please visit the following
   Internet address:

   http://www.va.gov/opa/pressrel

   Research Activities Strongly Linked to VA Physician Job Satisfaction

   WASHINGTON (Sept. 1, 2011)- Department of Veterans Affairs (VA)physicians who spend at least 20 percent of their time in research activities are more likely to have greater job satisfaction and report more favorable job characteristics, according to an article published July 27 in the August issue of Academic Medicine. The study, “Job Characteristics and Job Satisfaction among Physicians Involved with Research in the Veterans Health Administration,” also shows higher job satisfaction among physicians conducting research in VA facilities located on the same campus or within walking distance of an affiliated medical school.

   “Research and continuous learning are vital to improving the health and health care of Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “As this study shows, the outcome is not only in terms of scientific innovation and development on behalf of Veterans, but also in terms of the professional fulfillment our physicians experience.”

   Study authors David C. Mohr, Ph.D., and James F. Burgess Jr., Ph.D., of the VA Boston Health Care System, based their findings on data from the 2008 VA All Employee Survey, which included a question about research involvement. VA physicians with at least 20 percent research involvement
   provided higher ratings with regard to new skill development opportunities, work and family balance, feedback from supervisors, and job autonomy. Responses came from 7,734 full-time hysicians at 135 VA medical centers nationwide.

   VA Under Secretary for Health Dr. Robert A. Petzel added, “With physician job satisfaction vital to both workforce retention and better patient outcomes, the study holds important implications for maintaining a high performance health system.”

   Petzel, along with VA Chief Academic Affiliations Officer Dr. Malcolm Cox, VA Chief Research and Development Officer Dr. Joel Kupersmith, and VA Principal Deputy Under Secretary for Health Dr. Robert L. Jesse, co-authored a related commentary to the study, “Building Human Capital: Discovery, Learning and Professional Satisfaction,” also published in the August issue of Academic Medicine.

   To read the article and commentary, go to http://journals.lww.com/academicmedicine. To learn about VA Research visit http://www.research.va.gov.

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3. 

   AlxHamiltn

   September 9, 2011

   New health care jobs we don’t need
   Health Care Reform and the Health Care Workforce — The Massachusetts Experience

   By Douglas O. Staiger, Ph.D., David I. Auerbach, Ph.D., and Peter I. Buerhaus, Ph.D., R.N.
   The New England Journal of Medicine, September 7, 2011

   In 2006, Massachusetts enacted legislation to provide universal health insurance coverage that later served as a model for the national health care reform legislation passed in 2010.

   Since implementing these provisions, Massachusetts has achieved near-universal insurance coverage but has also seen continuing growth in health insurance premiums, a net increase in state spending on health care, and growing political pressures to control cost growth. Polls of the public and of physicians indicate that the state’s health care reforms are generally viewed favorably, though physicians are concerned about access to primary care and administrative burdens.

   The Massachusetts reform experience has been watched closely for indications of what might occur throughout the country as national health care reform is implemented under the Accountable Care Act (ACA). One aspect of the Massachusetts experience that has remained unexplored is the impact on the health care workforce, particularly the question of whether greater numbers of health care professionals or support personnel were needed to ensure the success of the reform in increasing access to care.

   Since Massachusetts enacted the Health Care Reform Plan in early 2006, total health care employment per capita in the state has grown more rapidly than that in the rest of the country.

   Most of the divergence in employment growth between Massachusetts and the rest of the country occurred in 2006 and 2007, when the Massachusetts reforms were being phased in. Had health care employment in Massachusetts grown at the same rate as in the rest of the country, approximately 18,000 fewer people would have been employed in health care by 2010.

   Most of the difference in health care employment growth occurred in administrative occupations. From 2005–2006 to 2008–2009, employment per capita in administrative occupations grew by 18.4% in Massachusetts, as compared with 8.0% in the rest of the country. These administrative occupations include management, business and financial operations, and office and administrative support (including medical records and health information technicians). In contrast, employment levels in nonadministrative positions in Massachusetts increased by 9.3% after health care reform, an increase similar to that of 8.6% in the rest of the United States.

   The Massachusetts experience provides lessons for national health care reform. First, reform may accelerate the trend toward health care’s being the dominant employment sector in the economy. More important, our analysis supports physicians’ concerns about the administrative burden of health care reforms, an issue that will have to be addressed as the ACA is implemented. Finally, rather than requiring greater numbers of physicians and nurses, reform may require larger numbers of people supporting the work of such health care professionals.

   http://healthpolicyandreform.nejm.org/?p=15255

   Comment:

   By Don McCanne, MD

   With today’s high unemployment rates, some have celebrated the fact that employment in the health care sector has continued to grow. This study confirms that health care employment in fact has grown within the state of Massachusetts, which has served as a model for our national reform through the Affordable Care Act. Should we be celebrating these newly generated jobs?

   When the Massachusetts plan was proposed the policy experts at Physicians for a National Program warned that the additional administrative excesses would add to the already very heavy administrative burden that uniquely characterizes the U.S. health care system. PNHP issued the same warning when the Affordable Care Act was under development.

   And what are these new jobs in Massachusetts? According to this report, “Most of the difference in health care employment growth occurred in administrative occupations.” More administration!

   Although there is much interest in finding new employment opportunities for residents of the United States, there is also a compelling interest in controlling runaway health care costs. With a single payer system, one of the most important efficiency targets is to reduce this profound administrative waste. Instead, our legislators brought us changes that dramatically increase this waste!

   We do need more jobs, but not more administrative jobs in a profoundly expensive health care system that is now almost sinking under the costly added burden of administrative excesses. There are far more important potential employment opportunities throughout society that would benefit all of us if Congress were to enact the type of jobs program that we need.

   Instead of adding to our profound administrative waste, let’s use our health care dollars for, of all things, health care!

   Reply
   1. 

      admin

      September 9, 2011

      Fact remains that UNTIL single payer advocates do more to change events on the ground… i.e., take actual steps to implement a nationwide, not-for-profit health service such as is made possible by passage of the Affordable Care Act, the benefits of reform, especially potential DRAMATIC cost savings will NOT inure to reward of a better, more satisfying and safer experience for patients nor to a SIGNIFICANTLY better living standard (wages plus benefits including REJUVENATING time off for caregivers.

      Who else is moving in that connection or direction more so than USASinglePayerOption.com? Who?

      For this earnest movement continue along this unproductive path (waiting on Congress to enact MORE legislation) is NOT productive and leaves us with continued cause to complain and not much else to show for it to the crippled by cost, American healthcare delivery system we are ALL stuck with for the time being.

      Reply
4. 

   AlxHamiltn

   September 15, 2011

   1. Who will be the final 30 ACO Pioneers?

   By Karen M. Cheung

   With accountable care organization (ACO) Pioneers to launch before the year’s end, Centers for Medicare & Medicaid Services (CMS) announced this week, the industry is waiting to hear who the final 30 ACO Pioneers will be. To some surprise, it wasn’t Mayo Clinic, Cleveland Clinic, Geisinger Health System, and Intermountain Healthcare, who were among the most likely candidates to join the ACO experiment. The leading health systems, along with others in the industry, complained the draft CMS rules were too burdensome and didn’t offer enough incentive to join the Shared Savings or Pioneer program.

   “When the poster boys ask that the posters be taken down, you have a problem,” said Michael Millenson, president of Health Quality Advisors LLC, in a Kaiser Health News-Politico Pro article.

   The no-thanks approach that Mayo, Cleveland, Geisinger, and Intermountain took signaled similar doubts from physician organizations, such as the American College of Physicians, the American Academy of Family Physicians, the Medical Group Management Association, the American Medical Group Association, and the American Medical Association, who generally gave a thumbs down to the ACO Medicare Shared Savings Program draft rules, the program that will proceed the Pioneer program.

   However, even with circulating skepticism around ACOs, anywhere between 30 to 50 organizations have applied to the Pioneer program, according to the Advisory Board Company, reports Kaiser-Politico. Among the applicants are Tucson Medical Center in Arizona, Monarch HealthCare in California, Norton Healthcare in Kentucky, Banner Health in multiple states, Mountain States Health Alliance (multiple states), Hackensack University Medical Center in New Jersey, and Montefiore Medical Center in New York.

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5. 

   AlxHamiltn

   September 15, 2011

   National doc database removed from public view

   By Andis Robeznieks
   Posted: September 14, 2011 – 11:00 am ET

   The national database that tracks malpractice payments and physician sanctions—but doesn’t publicly list the physicians’ names—has made its data file inaccessible to the public out of concern that the pieces of information being disclosed were being “triangulated” with other publicly accessible data sources to determine the identities of doctors listed.

   National doc database removed from public view

   “The National Practitioner Data Bank was never meant to be a public file,” said Martin Kramer, a spokesman for the U.S. Health Resources & Services Administration. “By statute, it’s not a public file.”

   The file, which lists sanctions against physicians by state medical boards, hospitals, medical societies and the Drug Enforcement Administration and has historically been updated four times a year, “is designed to provide data for statistical analysis only,” according to the NPDB section on the HRSA website. The names of physicians identified in the reports are available only to state medical boards and hospital and healthcare organizations to which doctors may apply for employment, a medical staff appointment or clinical privileges.

   However, some newspapers—most recently, the Kansas City (Mo.) Star—took information from the NPDB public use data file and compared it with names of certain local doctors listed in court filings. HRSA reacted by shutting down the previously publicly available data file on Sept. 1.

   “It’s not permanent,” Kramer said, but he added that it will down for at least six months as officials review options and procedures for making it more difficult to ascertain the identities of physicians in the reports.

   The consumer advocacy group Public Citizen has long maintained that the NPDB had its shortcomings but was still useful and provided valuable information to the public and for the organization’s research efforts. In a Sept. 13 letter to HRSA Administrator Mary Wakefield, Public Citizen maintained, “There simply is no substitute for the NPDB Public Use Data File if this vital research is to be continued.”

   “We also find it ironic that at a time in which other parts of the Department of Health and Human Services are becoming more transparent and even proposing to make detailed ratings of healthcare entities and providers available to the public, HRSA appears to be restricting access to information mandated by law to be made public,” concluded Dr. Michael Carome, deputy director of Public Citizen’s health research group, in the letter.

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6. 

   AlxHamiltn

   September 16, 2011

   CALIFORNIA HEALTHLINE
   Friday, September 16, 2011

   Report: Medi-Cal Cuts Could Harm Millions of California Residents

   Medi-Cal cuts could create risks for millions of Californians who depend on the program for treatment of chronic or terminal health conditions, according to a new report, Kaiser Health News’ “Capsules” reports. Medi-Cal is California’s Medicaid program (Barr, “Capsules,” Kaiser Health News, 9/14).

   The patient advocacy group Families USA, the American Cancer Society, the American Diabetes Association and the American Lung Association collaborated to produce the report, which is one in a series of reports examining how many people with certain chronic diseases access medical care through Medicaid.
   The report on California — released at the same time as reports on Illinois, New York and Texas — comes as the congressional debt-reduction “supercommittee” seeks ways to slash the federal deficit by $1.5 trillion (Pecquet, “Healthwatch,” The Hill, 9/14). The debt panel is expected to look closely at Medicaid because the program’s costs are growing at an unsustainable rate (“Capsules,” Kaiser Health News, 9/14).

   Key Points of California Report

   According to the report, cuts to Medi-Cal could force many California residents with serious medical conditions to forgo filling prescriptions, visiting a physician or receiving key health screenings (Families USA release, 9/14).

   The report noted that Medi-Cal covers millions of Californians who have serious health conditions, including:

   About 1.2 million stroke patients or people with heart disease;

   About 850,510 people with chronic lung diseases;

   About 562,720 people with diabetes; and

   About 140,340 people with cancer (“Capsules,” Kaiser Health News, 9/14).

   California Healthline is published daily for the California HealthCare Foundation by The Advisory Board Company.

   Comments

   Paul Billings — vice president of national policy and advocacy for the American Lung Association — said that Medicaid cuts could result in higher health care costs and more emergency department visits (Families USA release, 9/14).

   Christopher Hansen — president of the American Cancer Society Cancer Action Network — said the debt panel should make clear the importance of the health care safety net (“Capsules,” Kaiser Health News, 9/14).

   Reply
7. 

   AlxHamiltn

   September 21, 2011

   editors@fiercehealthcare.com to me September 21, 2011

   Today’s Top News

   1. Prime Healthcare blocked from acquiring hospital, closure imminent

   By Alicia Caramenico

   In a blow to hospital mergers, Prime Healthcare’s move to buy Victor Valley Community Hospital (VVCH) has been denied because the sale is “not in the public interest,” California Attorney General Kamala Harris decided yesterday.

   After review, the AG determined the sale will significantly affect the availability or accessibility of healthcare services to the High Desert community.

   This could signal the end for nonprofit VVCH, which filed for Chapter 11 bankruptcy about a year ago. Just last month, CEO Catherine Pelley announced her plans to retire on Sept. 30 and to start shutting down the hospital if Prime’s deal hadn’t finalized, reports the Victorville Daily Press.

   Prime Healthcare claims the rejection was influenced by the Service Employees International Union (SEIU), which supported Harris’s election campaign. The SEIU also publicly criticized Prime’s operations, most recently for admitting an unusually high number of emergency Medicare patients to reap the financial benefits.

   VVCH’s situation is not uncommon, as more hospitals are looking to merge or consolidate to manage rising healthcare costs and avoid closure.

   But VVCH might not have to close its doors. KPC Global Care originally won the bid for VVCH last November and got AG approval but failed to finalize the deal by the May 31 deadline. KPC is still interested in buying the hospital, notes the Daily Press.

   KPC has the funds needed to buy VVCH but hasn’t been in contact with the hospital since the deal collapsed, KPC Executive Vice President Bill Thomas told the Daily Press.

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8. 

   AlxHamiltn

   September 29, 2011

   Today’s Top News

   1. Cleveland Clinic slammed for limited charity care amid area layoffs

   By Karen M. Cheung

   Rep. Dennis Kucinich (D-Ohio) on Tuesday criticized Cleveland Clinic for not providing enough uncompensated care to the area’s low-income residents, reports The Plain Dealer. Nearby MetroHealth System, responsible for taking care in part of the area’s poor, on Monday announced it would be cutting 450 jobs, reports Fox 8 Cleveland, leaving what could be a vacuum for charity care.

   “We have to have a whole new discussion in our community about every institution sharing equally in the burden of uncompensated care,” Kucinich said at a news conference, reports The Plain Dealer. “It is time to put this on the table.”

   Kucinich said Cleveland Clinic should have provided an additional $44 million in charity care between 2006 and 2009, according to the article. However, Cleveland Clinic notes that it provides more benefits to the community aside from uncompensated care, including research and education.

   According to tax documents, Cleveland Clinic has provided $537.4 million in community benefits last year, including $149.8 million in charity care, reports The Plain Dealer.

   Meanwhile, MetroHealth last month announced it was facing operating losses of $6.3 million. To offset the budget troubles, it is implementing a hiring freeze and cutting back on consulting, in addition to cutting 450 jobs, reports Crain’s Cleveland Business.

   MetroHealth also announced today former Cuyahoga County Commissioner Tim Hagan is stepping down from his $90,000-per-year job as a part-time advisor at the health system. Hagan was responsible for expanding care and community economy, according to The Plain Dealer.

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9. 

   AlxHamiltn

   September 30, 2011

   Why the nurses’ strike isn’t just a California problem

   September 29, 2011 — 4:50pm ET | By Karen M. Cheung

   The troubles that plague California hospitals may have organizations elsewhere thanking their lucky stars that they aren’t facing strikes (or a similar patient death due to a medical error attracting the media storm). But other hospitals would be wise to remember that, like lightning, strikes can strike anywhere.

   The California nurses’ strike isn’t only limited to the West Coast, as it has repercussions for other states. Called the largest nurses’ strike in U.S. history and hitting 33 hospitals under Kaiser Permanente, Sutter Health, and Children’s Hospital Oakland, the union stand against management signals a broader problem between providers and the larger health systems.

   With the media surrounding the California health systems and union, we almost forgot how the strike started in the first place. Among the complaints of the 23,000 striking nurses were cuts to their benefits, as well as cuts to patient services, protestors said.

   Those demands spiraled into a California Nurses Association-National Nurses United strike affecting almost the entire area. Further complicating matters, reports linked the strike to a patient death at Oakland’s Alta Bates Summit Medical Center when a replacement nurse administered 66-year-old Judith Ming’s medication into the wrong catheter, the San Francisco Chronicle reported on Tuesday. The replacement nurse was one of 500 replacements that Sutter Health called in to staff its Oakland hospital and two Berkeley campuses in absence of the striking nurses.

   While the California Nurses Association said the patient death could have been avoided if Sutter had not locked out the nurses from reentering, the California Hospital Association said the union was exploiting the tragic death. The Hospital Association also rebuffed accusations that the replacement nurses were unqualified.

   As an update to the news that broke this week, the temporary nurse from Advanced Clinical Employment Staffing was credentialed to provide care, according to the Chronicle article. Ming, the patient, suffered ovarian cancer and had been hospitalized since July. While some blame the patient’s death on the temp nurses and Sutter, others point to the union as the culprit.

   “What I can tell you is this was a very tragic, very unusual mistake,” Sutter spokesperson Carolyn Kemp told the Chronicle. “There is a family, a young nurse and a hospital community all devastated by this.”
   Other news this week also showed us that other areas of the nation are not immune from such conflicts between nurses and hospital management.

   For instance, nurses at University of Michigan Health System and leadership have been battling over a new agreement for the past six months, and the nurses aren’t buying into the CEO’s message that the health system is committed to competitive wages and benefits, reports AnnArbor.com.

   Meanwhile, the Oregon Nurses Association and Saint Alphonsus Medical Center-Ontario are stalled on reaching a contract agreement, with negotiations starting back in May, reports The Argus Observer. Nurses said that the hospital must address patient care, safety, and staffing. Saint Alphonsus-Ontario responded, saying that it offers competitive compensation and benefits, according to the article.

   For better or for worse, the California strike has the attention of the country and is (or should be) a sounding alarm of other similar problems elsewhere. – Karen (@FierceHealth)

   Read more: Why the nurses’ strike isn’t just a California problem – FierceHealthcare

   http://www.fiercehealthcare.com/story/why-nurses-strike-isnt-just-california-problem/2011-09-29#ixzz1ZShE4P45

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10. 

    AlxHamiltn

    October 3, 2011

    Healthcare Business News

    Doc, hospital groups urge supercommittee on GME (Graduate Medical Education)

    By Jessica Zigmond

    Posted: October 3, 2011 – 2:30 pm ET

    Tags: American Hospital Association (AHA), American Medical Association (AMA), Education, Hospitals, Physicians

    The Joint Select Committee on Deficit Reduction should not make cuts to Medicare financing for graduate medical education, the Association of American Medical Colleges and 39 other physician and hospital groups asserted in a joint letter to the supercommittee (PDF) Monday.

    Along with the AAMC, the American Hospital Association, the American Medical Association, the American College of Physicians, the American Academy of Family Physicians and the Catholic Health Association were among the groups that signed off on the letter, which emphasized the AAMC’s projection that there will be a shortage of 91,500 physicians by 2020—and 130,600 doctors five years later.

    “The next step is to assure a sufficient number of residency training programs,” the groups noted in their letter. “Unfortunately, Medicare’s current cap on financial support for GME prevents teaching hospitals from expanding the number of training positions and often prevents new hospitals from establishing teaching programs.” They continued: “Now is the time for our nation to invest in physician training programs, not reduce them.”

    The supercommittee’s next hearing will be Tuesday, Oct. 4. The panel will examine the country’s economic outlook and question Ben Bernanke, chairman of the U.S. Federal Reserve.

    Read more: Doc, hospital groups urge supercommittee on GME – Modern Physician http://www.modernphysician.com/article/20111003/MODERNPHYSICIAN/310039990#ixzz1Zkb7heE5
    ?trk=tynt

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