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04/26/2016

Weekly E-Bulletin


Consumer Reports Investigation Identifies Hospitals with Highest, Lowest C-Section Rates

The most common surgery performed in U.S. hospitals isn’t on the heart or back or hips or knees. It’s a C-section. Roughly one of every three babies born in this country, or about 1.3 million children each year, are now delivered by cesarean section.  A new Consumer Reports investigation of more than 1,200 hospitals across the country supports that. It found that C-section rates for low-risk deliveries among U.S. hospitals vary dramatically, even in the same communities and among similar institutions, and that in most hospitals the rates are above national targets.  Click herefor the report, including their list of hospitals with the highest and lowest rates.

For-Profit Hospitals See Rare Inpatient Growth:  Fitch

For-profit hospitals reported their first uptick in organic growth in inpatient admissions last year for the first time since 2008, Fitch Ratings said in a statement announcing the publication of the report, “U.S. Hospitals’ Credit Diagnosis: Noteworthy Items in Patient Volume Trends.”  However, the increase was just 0.75 percent. And Fitch does not believe it will last. “The improving economy and ACA have provided a lift that cannot overtake longer-term headwinds to growth, like pressure by payers to reduce short stays and readmissions,” said Fitch.  Click herefor more on the Fitch announcement.

Hospices, SNFs, and IRFs To Get Pay Hikes from CMS

CMS last week released proposed Medicare fiscal 2017 payment rules for hospice, nursing homes, and inpatient rehab facilities. CMS wants a 2 percent increase in hospice payments for 2017, and two new hospice quality measures – to assess staff visits during the last week of life and to look at whether patients received treatment consistent with federal guidelines. CMS wants a 2.1 percent increase for SNFs. And in order to comply with the IMPACT Act, CMS proposed one new assessment-based quality measure and three claims-based measures to be included in the nursing homes’ quality reporting program. The agency proposed that inpatient rehabilitation facilities receive a 1.6 percent increase in payments. For the CMS fact sheets for hospice, click here, for SNFs, click here, and for IRFs, click here.

Half of All Male Physicians Have at least $1Million Net Worth

About 49 percent of male physicians reported a net worth of $1 million or more, compared to just one-third of female physicians, according to a new Medscape analysis. The report finds that net worth is also reflective of age – about 36 percent of physicians age 55 and older had a net worth greater than $2 million and only 4 percent of physicians age 28 and younger had a net worth greater than $1 million. The report also found that that while male physicians may choose more lucrative specialties than their female counterparts, both genders make similar decisions with their personal finances. Click herefor the full analysis.

Financial Picture for Primary Care Physician Practices Improving:  Survey

The financial picture appears to be a bit rosier for primary care physicians, according to a new survey by Medical Economics. Of the 2,065 physicians who responded to the survey for 2014, 22 percent said the financial state of their practice was better than it was a year ago; that’s compared to only 15 percent who said in 2013 they saw growth in finances over the year before. However, 46 percent said their financial state was about the same and 30 percent said it was worse than a year ago. Responses to the previous year’s survey had those numbers at 45 percent and 39 percent, respectively. Click herefor the survey.

New Reports Say India’s Medical Schools Are Sub-Par

How bad are most of India’s medical schools? Very, according to new reports. Fake degrees, bribes for admission, and barely a peer-reviewed research paper to be seen — India’s medical schools have a long way to go. There are more medical colleges and teaching hospitals in India than anywhere else — 579 to be exact.  But a couple of recent studies and reports have cast serious doubts on the quality and ethics of the country’s vast medical schooling system. Click here for the report.

UnitedHealth Cutting Health Exchange Participation

United Health, the nation’s largest health insurer, will sell plans in only “a handful” of state exchanges in 2017, its CEO said on a call with investors last week. UnitedHealth Group CEO Stephen Hemsley reiterated concerns about the financial viability of the law’s health insurance marketplaces. The company stated it expects to lose $650 million on its exchange business this year. An analysis released by the Kaiser Family Foundation found that consumers in more than half of the 1,855 counties where UnitedHealth now competes would have just one or two health plans to choose from if the company withdraws and no new competitors emerge. Click here for more from the Washington Post. For the KFF study, click here.

Patients Access Care at Similar Rates Whether on Exchanges or Employer Coverage

Patients covered by ACA exchange plans are just as likely to have had a routine physical checkup in the last year as people with employer-based coverage, according to new data from the Urban Institute’s Health Reform Monitoring Survey. Just over two thirds of both groups reported having a physical in the last 12 months, while for Medicaid beneficiaries the level was just over 70 percent. However, a significantly higher level of exchange consumers (14.2 percent) reported dissatisfaction with their choice of providers compared to those with employer-based coverage (5.5 percent). Click here for the report from the Urban Institute.

HRSA Reopens Comment Period on 340B Mega Guidance

The Health Resources and Services Administration (HRSA) has reopened the comment period on the proposed 340B Mega Guidance. HRSA stated the proposed Mega Guidance comment period is being reopened due to the fact that the agency received a number of comments supporting and opposing the pricing proposal. Click here for more from HRSA.

Healthcare Number 1 for Cyberattacks

Healthcare hit the No 1. spot for cyberattacks last year, though no industry was immune from such incidents, according to an IBM cybersecurity report. The report says healthcare rising to the top of the list did not come as a surprise, considering that at the end of 2015, IBM declared it the year of the healthcare security breach.  Five of the eight largest healthcare security breaches so far this decade–those in which more than 1 million records were compromised–took place during the first six months of 2015, according to the report. More than 100 million healthcare records were compromised last year. Click here to download the report.

Seniors Taking More and More Meds

Tracking prescription drug use from 1999 to 2012 through a large national survey, Harvard researchers reported that 39 percent of those over age 65 now use five or more medications — a 70 percent increase in polypharmacy over 12 years. Lots of factors probably contributed, including the introduction of Medicare Part D drug coverage in 2006 and treatment guidelines that call for greater use of statins.  And its just not prescription drugs.  In a JAMA study, more than a third were taking at least five prescription medications, and almost two-thirds were using dietary supplements, including herbs and vitamins. Nearly 40 percent took over-the-counter drugs. Click here for the NYTimes story.

Personal Debt Falling Because of Medicaid Expansion

Medicaid expansion significantly cut the number of unpaid non-medical bills and the amount of debt individuals were sending to collection agencies, according to a report released last week. The study suggests that debt collection balances were cut by between $600 and $1,000 for individuals who gained Medicaid coverage because of the ACA. Click here for the report.

Cost of Chronic Disease Detailed in Each State

The Partnership to Fight Chronic Disease released a new data set on the cost of chronic disease, broken down by every state and the District of Columbia. The Partnership states the research shows how healthy behaviors and better treatments could potentially save 16 million lives across the net 15 years. Click here for more from the Partnership.

CMS Releases Medicare Advantage Data Focused on Racial and Ethnic Groups

For the first time, the CMS Office of Minority Health last week released data detailing the quality of care received by people with Medicare Advantage by racial or ethnic group.  “While these data do not tell us why differences exist, they show where we have problems and can help spur efforts to understand what can be done to reduce or eliminate these differences,” said Director Cara James. The data are based on an analysis of two sources of information.  The first is part of the Healthcare Effectiveness Data and Information Set (HEDIS). The second part is the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey, which is conducted annually by CMS. Click here for the report.

President Signs Older Americans Act Reauthorization

President Obama has signed bipartisan legislation renewing the Older Americans Act for three years. Passage comes almost 10 years since the Act was last reauthorized, a delay which has been a source of great dismay to advocates. Currently, one in five older adults – 11 million people – receives services from an Older Americans Act program. The bill provided an increase of 6% in funding and tweaked the state funding formula by allowing increases for states with growth in their 60+ population. Click here for the text of legislation, and here for information from the White House.

HHS OIG Finds Coding Initiative Led to Improper Payments

HHS’ Office of the Inspector General (OIG) found that states’ inconsistent implementation of an Affordable Care Act national coding initiative led to improper Medicaid payments as high as $17.5 billion in 2014 alone. The ACA required all states to implement the Medicaid National Correct Coding Initiative (NCCI) which are set up to prod providers to code correctly by automatically denying fee-for-service Medicaid payments for services that do not meet basic medical or billing standards, according to the OIG. Of the 49 states that implemented the NCCI edits into their claims processing systems, 47 did not use all of the NCCI edits correctly. The resulting improper payments to healthcare providers totaled around $17.5 billion in fiscal 2014. Click here for the OIG report.

Suicide Rate Surges to 30 Year High

A concerning new CDC report finds that suicide rates among nearly every age group has climbed over the last 15 years, with the most noticeable uptick in the past decade. The nation’s suicide rate has increased 24 percent since 1999 – up about 1 percent every year between 1999 and 2006, then 2 percent per year through 2014. The increase was seen among all age groups with the exception of men and women 75 and older, who had a lower suicide rate in 2014 than in 1999. To read the report, click here. Click here for the NYTimes story.

Hospital to Pay Big for Allowing TV Crews to Record

Federal authorities have reached a $2.2 million settlement with New York-Presbyterian Hospital over filming by a TV crew that disclosed two patients’ health information without their authorization, according to news reports. HHS stated the Manhattan hospital let the ABC crew for “NY Med” film a patient who was dying and another in distress. For more on the settlement from HHS, click here. For more on the story from the New York Times, click here.

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