WEEKLY E-BULLETIN


Truven Names Top 15 Health Systems

Truven Health Analytics last week released its 2014 top 15 health systems list. Click here to review. Truven released its 100 best hospitals list in March – click here to see that list.

Senator’s New Report Says Hundreds of Thousands Die In Hospitals From “Errors and Preventable Harm”

Between 210,000 and 440,000 Americans die annually from errors and preventable harm at hospitals, according to research cited in a report released late Friday by U.S. Senator Barbara Boxer (D-CA). The report calls such errors “a quiet and largely unseen tragedy” and calls on the federal government to incorporate a standard way of reporting medical errors in the next round of regulations for electronic medical records and on Congress to review whistleblower protections for health care workers. Click here for the senator’s report.

Moody’s Reviews Not-For-Profit Hospitals Financial Position

Expense growth continued to outpace revenue growth in the not-for-profit hospital sector in fiscal year 2013, leading to lower operating and cash flow margins for the second year in a row, according a report released last by Moody’s Investors Service. Also contributing to the decline is an increase in high-deductible health plans, which leave patients with larger bills and hospitals with more bad debt; and a shift from inpatient admissions to lower reimbursed outpatient visits and observation stays, the report states. Click here for details.

Report List Top Conditions Associated With Most Hospital Readmissions

Hospitals working to reduce 30-day readmissions can gain insights from a new federal report that lists the top conditions associated with approximately 3.3 million readmissions in 2011. The report also analyzes how conditions vary depending on insurance coverage. Readmissions in 2011 contributed $41.3 billion in total hospital costs. The study covered Medicare beneficiaries aged 65 and older, and individuals aged 18-64 who were privately insured, covered by Medicaid or uninsured. Click here for the report.

Researchers: ACOs May Need Better Incentives

Harvard researchers found that one-third of those on Medicare assigned to accountable care organizations in 2010 and 2011 weren’t assigned to the same ACOs in both years, in a study published last week in JAMA Internal Medicine. The patients assigned to different ACOs tended to be in high-cost categories, such as those with end-stage renal disease, disabilities and Medicaid coverage. Researchers also found that 66.7 percent of visits with specialists were provided outside the assigned ACO. The findings suggest that ACOs might need better incentives and more ways to improve care efficiency. Click here for more.

Top CMS Officials Outline Agency’s Strategies

In a JAMA article last week, the top CMS administrators outlined their goals in testing a variety of payment reform initiatives, including ACOs and reform efforts with the states. If you want to get a good idea of where CMS is headed, this is a must read, click here.

Report: Rural, Urban Hospitals Face Very Different Challenges

It’s no surprise that the challenges facing rural and urban hospitals are markedly different. A new report from the CDC demonstrates just how different. For example:

  • A higher percentage of inpatients in rural hospitals were aged 65 and over (51%) compared with inpatients in urban hospitals (37%).
  • The average number of diagnoses for rural and urban inpatients was similar, as was the average length of stay.
  • Sixty-four percent of rural hospital inpatients, compared with 38% of urban hospital inpatients, had no procedures performed while in the hospital.

Click here for the full report.

Study: Rural, Urban Hospitals Have Comparable Outcomes

Rural hospitals are equal to their urban counterparts in care quality, patient safety and outcomes, and their emergency departments are more efficient and less expensive, according to a study out last week by iVantage Health Analytics. Click here for the report.

Ambulance Services Targeted for Fraud

HHS has identified ambulance service as one of the biggest areas of overuse and abuse in Medicare — companies billing millions for trips by patients who can walk, sit, stand or even drive their own cars, according to new reports. “It’s a cash cow,” said Assistant U.S. Attorney Beth Leahy, who has prosecuted six ambulance fraud cases. “It’s basically like a taxi service except an extremely expensive one that the taxpayers are financing.” Click here for the story.

Medicare Paid Chiropractors About $500 Million in 2012

Almost half a billion Medicare dollars went to chiropractors in 2012, according to a Forbes review of the $77 billion in provider payments released by CMS earlier this month. In the column, the author argues that Medicare shouldn’t cover chiropractic services. Click here.

Physician House Calls Coming Back for Some Services

Physician house calls are making a come back, particularly as part of hospitals’ palliative care programs, according to a report last week in the NY Times. Patients would rather be at home and care teams can lower costs and improve the quality of care. Click here for the report.

UnitedHealth, Aetna Give Views on Insurance Exchanges

The nation’s two largest insurers, UnitedHealth and Aetna, are giving their perspective on how the new insurance exchanges are working for them. So far, it appears generally positive. Click here for Aetna’s CEO summary. Click here for UnitedHealth’s take.

Big Medicaid MCO Touts Rapid Growth

Centene Corporation – one of the nation’s largest Medicaid managed care companies - last week touted double-digit revenue growth, and said that about 39,700 people have enrolled in and paid premiums for qualified health plans (QHPs) the company is offering through the exchanges in nine states. However, the insurer still expects to have about 70,000 paid enrollees by the second business quarter. Click here for their financial summary.

CO-OPs Sign Up More Than 400,000 People

More than 400,000 people have enrolled in the nonprofit health insurance cooperatives called CO-OPs, created by the Affordable Care Act to sell qualified health plans through state health insurance marketplaces, the National Alliance of State Health CO-OPs announced last week. There are currently CO-OPs in 23 states, and three additional states expect to offer them next year, the alliance said. Click here for their report.

CBO Lowers Estimate of Medicaid Costs to States

The Congressional Budget Office has reduced by one-third its estimate of how much more states will spend on Medicaid in the coming decade because of the Affordable Care Act. In early February, the budget office estimated that state spending on Medicaid and a related program for children would be $70 billion higher from 2015 to 2024 because of the law’s coverage provisions. In a new report, the budget office puts the cost at $46 billion. Click here for the CBO report.

10 Major Medicaid Trends Outlined

Major changes are underway for Medicaid as states work to reduce their financial exposure and increase quality outcomes. A new report from LifeHealth Pro outlines the 10 most significant trends in Medicaid reform. Click here and here.

Administration Targets Fixed Benefit Plans

The Obama administration is quietly trying to stamp out some of the skimpiest health plans, a decision that industry officials say could trigger yet another wave of cancellation notices, according to at least one major health plan. The administration is targeting a type of coverage called fixed benefit or indemnity insurance, which give patients a fixed sum of money whenever they visit the doctor or land in a hospital. Click here for the story. Click here for the letter to HHS from Assurant Health.

Some Democratic Candidates Cozying Up to Obamacare

Something must be going right for Obamacare if Democratic candidates are becoming more vocally supportive just six months until the election. Candidates for governor and senator in numerous states are airing commercials that put a positive spin on the health care law. Click here for the NY Times story.

CMS Publishing Inpatient Psych Quality Scores

CMS last week announced for the first time that quality measures from inpatient psychiatric facilities will be publicly reported on its Hospital Compare website. Hospital Compare now has data from 1,753 inpatient psychiatric facilities on patient care for the period of October 1, 2012 through March 31, 2013. Click here for further details.

CMS Takes Position on Medicare Advantage and Sequestration Cuts

CMS seems to be supporting hospitals’ position in a long-standing dispute over whether Medicare Advantage plans may pass along sequestration pay cuts to providers, according to a CMS letter last week to the American Hospital Association. CMS Administrator Marilyn Tavenner said the agency cannot get involved in contract disputes between plans and providers, but she clarified a key policy position. Click here for the letter.

National Health Expenditures Up 6.7%

A report by the Altarum Institute’s Center for Sustainable Health Spending last week revealed spending on health care reached a seasonally adjusted $3.05 trillion in February, and expenditures increased by 6.7% over the previous year. Physician and clinical services accounted for 20% of total health spending, while hospital expenses accounted for 32% and prescription drugs for 10%. Click here for details.

Health Care Mergers and Acquisitions Hit New High

Health care mergers and acquisitions are hitting a new high, according to business analysts, most of it in the pharmaceutical industry. Click here for a good CNN summary.

FDA Issues Warning on Autism Products and Therapies

FDA issued a warning last week that several companies are making false or misleading claims about products or therapies that claim to treat or cure autism. The so-called treatments, such as “chelation” therapy or mineral treatments, carry significant risks, FDA says. Click here for the FDA announcement.

Scientists Creating Largest Patient Medical Record Data Base

Government-funded scientists have begun collecting and connecting together terabytes of patient medical records in what may be one of the most radical projects in health care ever attempted, according to press reports last week. The data — from major hospital centers across the country — include some of the most intimate details of a life including vital signs, diagnoses and conditions, results of blood tests, X-rays, MRI scans, surgeries, insurance claims and in some cases, links to genetic samples. Click here for the story.

FDA Proposes Regs on E-Cigarettes

After years of planning to control electronic cigarette use, the FDA last week proposed its first regulations on such devices, while also including other tobacco products such as some types of cigars, pipe tobaccos and hookahs. The proposed measures would prohibit the sale of e-cigarettes among individuals younger than age 18 as well as require manufacturers to gain FDA approval for their products. The proposal doesn’t contain any marketing restrictions. Click here for more from the FDA.

7.5% of Children Given Behavioral Health Drugs

An estimated 7.5% of 6- to 17-year-olds, or about 3.2 million children, were given prescription drugs for treatment of behavioral or emotional problems in 2011, according to a CDC report released last week. Children covered by Medicaid or the Children’s Health Insurance Program were more likely to be prescribed such medications than those with private insurance or no insurance. Officials also found that boys had higher prescription rates than girls. Click here for the details from CDC.