WEEKLY E-BULLETIN


Truven’s Top 100 Hospitals List Announced

Truven Health Analytics last week released its annual 100 Top Hospitals list. Truven says the study evaluates hospitals on measures of overall organizational performance, including patient care, operational efficiency, and financial stability. Click here for the list. Click here for the complete report.

  • Healthgrades released their top 100 hospitals the previous week. Click here for that list.
  • Click here to see the 12 hospitals that made both lists.

 

Study: Are Best Hospitals’ Lists Confusing Consumers?

The general news media picked up on these announcements last week looking at a new study in Health Affairs that complicate the “best hospitals” lists. Are they worthwhile? Why are there so few hospitals on both lists? Do they confuse consumers? Click here for the Washington Post report. Click here for the NY Times.

 

MedPAC Passes on 340B, Focuses on Short-Stay Policies

In the ongoing debate over whether to reign in the 340B drug discount program, MedPAC is concerned that any recommendations it makes could undermine the program. The Medicare Payment Advisory Commission met last week to review the program and determine whether there should be changes. Following a brief staff presentation, commissioners spent most of the time discussing whether MedPAC can even address the issue, since it doesn’t have jurisdiction over 340B. Click here for an excellent 2-page summary of the MedPAC meeting, including hospital short-stay policy issues.

 

AMA: Huge Physician Shortage by 2025

The nation will face a shortage of between 46,000-90,000 physicians by 2025, according to a report released last week by the Association of American Medical Colleges. The study, which is the first comprehensive national analysis that takes into account both demographics and recent changes to care delivery and payment methods, projects shortages in both primary and specialty care, with specialty shortages particularly acute. Click here for the study.

 

ICD-10 On Track But Docs Want Back Up Plan

ICD-10 is still on track for its October 1 implementation, but physician groups are urging CMS to enhance its transition plans as contingency plans may not be enough to address serious disruptions that might happen on or after the implementation date. According to a letter sent to CMS acting Administrator Andrew Slavitt last week by 100 groups, a lower acceptance rate for Medicare claims could have a great effect on the system and on physician payment. Click here for more.

  • ICD-10 tech solutions are expected to be the top tech purchase of providers in 2015, according to a new report. Click here for a very good analysis of where providers will be spending their IT budgets.

 

Health Care Transformation Examined

The American health care system is working its way through its greatest transformation in a generation. The Economist takes a closer look at the rapidly changing health care environment as consumers are looking for more care but wanting to pay less. The review also discusses how hospitals are adapting – or not. Click here.

  • For a very good summary of the most prevalent current and future health care payment models, click here.

 

CMS: Process Measures Improving More Than Outcome Measures

U.S. healthcare facilities are improving more rapidly on process measures than they are on clinical outcome measures, according to a new CMS report. Overall, the nation saw improvement on most of the publicly reported measures evaluated between 2006 and 2013. The report found that of 119 publicly reported measure rates across seven quality-reporting programs, 95% showed improvement between 2006 and 2012. Click here for the report.

 

FDA OKs First Biosimilar Drug

The FDA last week approved the first biosimilar drug for use in the United States, paving the way for less expensive alternatives to an entire class of complex and costly drugs. The drug, called Zarxio, produced by Sandoz, is used to help prevent infections in cancer patients receiving chemotherapy. It is a close copy of an existing medication called Neupogen, made by Amgen. Click here for the FDA announcement. Click here for the NY Times story.

 

Cancer Rx Prices Increasing Steadily

A new paper published by the National Bureau of Economic Research finds that, of 58 cancer drugs that were approved by the FDA between 1995 and 2013, the launch prices increased by 10% a year, or an average of about $8,500, when adjusted for inflation and a formula for determining survival benefits. Click here for the report.

 

Supreme Court Hears Arguments Challenging Obamacare Subsidies

It was a big week for Obamacare before the U.S. Supreme Court. In King vs. Burwell, justices heard arguments on both sides about whether the federal government is allowed to provide subsidies to beneficiaries enrolled in federally-controlled health exchanges. A final court decision isn’t expected until June, but the stakes are high – politically and personally for those receiving benefits. Click here for a very good explanation of the case from the Associated Press. Click here for a report about many states being nervous about a ruling against Obamacare. Click here for the story on why the GOP is bracing for a win.

  • Click here for a report on how a number of hospital CEOs are reacting to the Supreme Court case.

 

Report Details Impact of Medicaid Claims Growth, 2-Midnight Rule on Providers

Between 2013 and 2014, Medicaid and Medicaid managed care organizations claims increased by nearly 6 percentage points, but there was very little change in states that didn’t expand Medicaid, according to a new analysis. Also, the “two midnights” rule, though much maligned by hospitals, is causing a shift from short-term inpatient stays to outpatient observation. Given the rise of high-deductible plans, the study recommends that hospitals need to focus more on their bill collection efforts. Click here.

 

GOP Senators Raise Serious Concerns with HITECH Spending

Five senior GOP Senators last week raised serious questions about the implementation of the HITECH Act, which is providing $35 billion to health care providers to implement new EHR and related technologies. “Countless electronic health record vendors, hospital leaders, physicians, researchers, and thought leaders have told us time and again that interoperability is necessary to achieve the promise of a more efficient health system for patients, providers, and taxpayers. There is inconclusive evidence that the program has achieved its goals of increasing efficiency, reducing costs, and improving the quality of care.” Click here to read their blog in Health Affairs.

 

Study: Remote Care Favorably Impacts Outcomes

Patient engagement through a remote behavioral health intervention following a cardio vascular event has the ability to reduce hospital admissions and length of hospital stays, according to a study published last week in the American Journal of Managed Care. Researchers from telemedicine provider AbilTo, Boston-based Brigham and Women’s Hospital and Aetna conducted the study. Click here for the study.

 

CDC: Digital Tools Help Improve Diabetics

The CDC last week acknowledged for the first time that digital tools can help patients change their lifestyles to prevent type 2 diabetes. The public health agency identified tech companies that met its standards: Omada Health, which coaches online groups on healthy behaviors, weight-loss software company DPS Health, and Noom, whose apps offer exercise and diet advice, along with phone-based services. Click here for more from the CDC. Click here for the news report.

 

Texas Health Resources Pushes Back on Nurse’s Ebola Claims

After nurse Nina Pham filed a lawsuit a week ago alleging that her employer had neglected to provide proper Ebola training and equipment and had violated her privacy, Texas Health Resources is pushing back. Chief Executive Barclay Berdan says that Texas Health Presbyterian Hospital in Dallas followed government privacy rules about what information could be shared publicly about Pham’s condition and Pham OK’d its release. Click here for the story.

 

Feds Made $60 Billion in Improper Medicare Payments in 2014: GAO

The federal government lost ground last year in reducing improper payments from programs such as Medicare, Medicaid and tax credits for the working poor, experiencing a nearly 18 percent increase in the costs. A report last week from the Government Accountability Office said the U.S. government gave an estimated $124.7 billion to ineligible recipients in 2014, representing the first jump in four years. Medicare reported the highest number of improper payments last year, with the program accounting for nearly $60 billion in incorrect disbursements. Click here for the GAO report.

 

New Condition Code 53 Raises Serious Problems for Providers

The late January 2015 release of instructions by CMS about the new condition code, CC-53, was severely lacking in scope, breadth, and directly applicable information, according to an industry report last week. This new condition code carves out an entirely new dimension for device credit reporting, adding to the already burgeoning bucket of implantable replacement devices with 50 percent-or-greater credits an entirely new chunk of services that must be reported: this includes initially placed devices that are provided to a facility either free of charge or with 100 percent credit. Click here for the report.

 

Think Tank Releasing Proposals to Cut Waste, Improve Patient Outcomes

Over the next year, Third Way will release policies that aim to reduce waste without cutting benefits or damaging care and to improve the patient experience. The think tank started with two last week, recommending discussion guides (click here) to help consumers make informed health care choices and proposing better diabetes screening to delay or prevent the disease’s onset (click here).

 

States Seeking to Tax Non-for-Profits

A variety of states are eyeing non-profits, including hospitals, for a source of new tax revenue – according to a report last week from the Pew Trust. Efforts in Maine, Pennsylvania, Ohio, Vermont, New York and others to tax not-for-profits are raising new concerns in the charitable community. Click here for the report.

 

Heroin Fatalities Increasing: CDC

Overdose fatalities involving heroin increased from 1 death for every 100,000 people in 2010 to 2.7 per 100,000 in 2013, CDC researchers reported last week. The heroin-related death rate was highest among blacks aged 45 to 64 in 2000, but whites ages 18 to 44 accounted for the most deaths from the drug in 2013. Click here for the CDC report.

 

Obesity Is Hurting U.S. Economy: Report

Unpublished research reviewed by Bloomberg News last week shows medical expenses linked to being extremely overweight have skyrocketed. Experts say the damage is augmented by reduced productivity, wider gender and income inequality and even higher transportation costs. Click here for the story.

 

FDA Says Testosterone Use Increases Health Risks

The FDA last week said that manufacturers of testosterone drugs used by millions of Americans will be required to change labels for the drugs to warn that they could increase the risk of heart attacks and strokes and should not be prescribed to treat symptoms in men brought on by age, such as declining sexual drive. Click here for the FDA announcement. Click here for news reports.