WEEKLY E-BULLETIN


Truven Awards 2015 Top Health Systems

Three large, 3 medium and 3 small health systems were awarded Truven’s top health systems for 2015 last week. Truven analyzed data from more than 340 health systems and 2,841 member hospitals to single out 15 hospital systems that achieved superior clinical outcomes based on a composite score of nine measures of quality, patient perception of care, cost per episode of illness, and efficiency. Click here to see the list. Click here for the backgrounder.

  • For those of you who missed it last week, Medicare has awarded its first star ratings to hospitals based on patient satisfaction. Only 7 percent of hospitals received 5 stars. Click here to see the list of ALL hospital scores, by state by hospital.

Physician Compensation Detailed in New Survey

How much do physicians earn for patient care? Surprisingly, North Dakota and Alaska have the highest average compensation for physicians. Not surprisingly, pediatrics is at the bottom of the list at an average $189,000 a year; orthopedics tops the list at $421,000. 72% of women physicians are employed. Medscape is out with its latest survey of nearly 20,000 physicians. Click here for this interesting report.

 

Medicare To Increase Inpatient Psych Payments

Inpatient psych facilities will receive a small payment increase from Medicare in FY16, according to an announcement late Friday. The proposed rule released late Friday also updates the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program, which requires participating facilities to report on quality measures or incur a reduction in their annual payment update. CMS is proposing to update the estimated payments to IPFs 1.6 percent (or $80 million). Click here for details.

 

Inpatient Rehab Medicare Rates To Increase

CMS last week issued a proposed rule outlining proposed FY16 Medicare payment policies and rates for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and the IRF Quality Reporting Program (IRF QRP). CMS is proposing to update the IRF PPS payments to reflect an estimated 1.9 percent increase. Click here for all the details.

 

Pioneer ACOs Saved Money; ACOs Expanding Reach Nationwide:

A new study in the NEJM concludes that the government’s first ACOs, called Pioneers, actually saved the government money in their first year. Click here for the complete report. Another report last week found that almost 70% of Americans reside in an area with accountable care organization services. The number of ACOs in the U.S. reached 585 in January. The percentage of Medicare beneficiaries served by ACOs has increased from 10% last year to 11% this year. Click here for the Oliver Wyman report.

 

HHS Pressuring GOP States To Expand Medicaid

Is your state led by a Republican governor who is resisting expanding Medicaid? The Obama Administration is ratcheting up the pressure on these states with a new strategy they hope will result in more Medicaid expansions. Click here for the Bloomberg report. Not every group thinks Medicaid expansion is a good idea. One conservative think tank is out with a new report saying enrollment is exceeding projections and will cause serious budgetary problems. Click here.

 

ACA Side-Effect: More Hospital Mergers

One of the effects of the Affordable Care Act, according to some analysts, is the consolidation of hospitals into large mega-systems. There were 95 hospital mergers and acquisitions last year. Not everyone thinks its a positive trend. Click here for a report in the Wall Street Journal from a surgeon at Johns Hopkins. After more than 2 years in the negative, the Affordable Care Act is now trending more positively in public attitudes. Click here to see the trend.

 

Medicare Advantage Whistleblower Suits Increasing

Federal court records show at least a half dozen whistleblower lawsuits alleging billing abuses in Medicare Advantage plans have been filed under the False Claims Act since 2010, including two that just recently surfaced. The suits have named insurers from Columbia, S.C., to Salt Lake City to Seattle, and plans that have together enrolled millions of seniors. Click here for the report.

 

21st Century Cures Draft Bill Updated, Criticized

The House Energy and Commerce Committee is developing a new draft of legislation entitled “21st Century Cures” that focuses mostly on making changes that will advance pharma and medical devices (click here for details). A new draft is expected to be released this week. It is transformative, but is growing increasingly controversial as various interest groups seek substantive changes. One of those groups, Public Citizen, was out last week with 5 recommendations they believe should be incorporated into this initiative – including the publishing of clinical data. Click here.

 

PQRS Participation Increasing Significantly

Participation in the Physician Quality Reporting System (PQRS) program increased by 47 percent from 2012 to 2013, according to a new CMS report. In 2013, 641,654 eligible professionals participated either as individuals or as part of PQRS group practices. The 2013 PQRS incentive payments totaled $214,551,741. 469,755 eligible professionals were subject to a 2015 PQRS negative payment adjustment. Based on 2013 PQRS reporting, 469,755 eligible professionals are subject to a reduction of 1.5 percent of their 2015 Part B Medicare Physician Fee Schedule allowed charges. Click here for the complete report.

 

PCMHs Should Have Strong IT Component: Study

Patient-centered medical homes should develop relationships not just with patients but also with health care professionals in the community, including in schools, workplaces, long-term care facilities and public health organizations, according to a HealthITAnalytics.com report out last week. Physicians can use health IT, including electronic health records, to develop community and patient ties, and engage in disease management initiatives, the report says. Click here.

 

CDC: More Naloxone Use Would Reduce Overdose Deaths

Allowing more basic emergency medical service staff to administer naloxone could reduce drug overdose deaths that involve opioids, according to a new CDC study. In 2013, more than 16,000 deaths in the United States involved prescription opioids, and more than 8,000 others were related to heroin. Naloxone is a prescription drug that can reverse the effects of prescription opioid and heroin overdose, and can be life-saving if administered in time. Click here for the CDC report.

 

Breast Cancer Cases on the Rise; New Genetic Test Very Inexpensive

By 2030, the number of breast cancer cases in the United States will be 50% higher than the number in 2011, according to new research out last week from the National Cancer Institute. In the new study, researchers used cancer surveillance data, census data and mathematical models to arrive at projections. Click here for more. A Silicon Valley start-up with some big-name backers is threatening to upend genetic screening for breast and ovarian cancer by offering a test on a sample of saliva that is so inexpensive that most women could get it. Click here for the report.

 

Government Again Recommends Against Routine Mammograms Under 50

The U.S. Preventive Services Task Force is sticking with a 2009 recommendation that women under 50 should wait to start getting mammograms. Last week, it issued updated guidance on the issue for the first time in six years, also reiterating that women over 50 should be screened every two years. Click here.

 

$120 Million Awarded for Comparative Clinical Effectiveness Studies

The Patient Centered Outcomes Research Institute last week approved $120 million for 34 comparative effectiveness studies, including $58.5 million for five studies comparing practical clinical treatments. One of the clinical studies will compare new proton beam therapy versus conventional proton radiation therapy for breast cancer. The Institute awarded $61.6 million for fund 29 other studies investigating different options for improving outcomes for conditions such as opioid addiction, arthritis, stroke, Parkinson disease, leukemia, chronic kidney disease, and child abuse. Click here and scroll down to see the list of recipients — also by state.

 

Most Hospitals Have Adopted EHRs with Clinical Notes

Seventy-six percent of non-federal acute care hospitals in 2014 adopted at least a basic electronic health record system with clinician notes—a 27 percent increase from 2013—according to new government data. Additionally, over a third of hospitals were using more advanced EHR functionality. Click here for the government’s 10-page data brief, which includes a state-by-state look.

 

Nurse vs. Hospital Ebola Court Battle Underway

The Dallas Morning News reports on the starting court battle between Nina Pham, a nurse that contracted Ebola last fall after treating Thomas Eric Duncan in Texas, and Texas Health Resources, which owns the hospital where Pham was working. Click here.

 

Widely-Used Cancer Drug Recalled

Generic drug maker Mylan is recalling a range of cancer drugs distributed last year by one of its subsidiaries in India because particulate matter has been found in some of the products. The nationwide recall includes several formulations of injectable gemcitabine, a chemotherapy agent used to treat ovarian, breast, non-small-cell lung and pancreatic cancers. Click here for more from the FDA.

 

Study: Technology Could Benefit Poor Children’s Health

A new white paper from the Children’s Health Fund looks at the growing health gap for children who live in poverty and what difference health technology might make in improving their access to timely quality care. The paper, released last week, makes five specific recommendations. Among them: New technologies must be designed for or adapted to the needs of children, and CMS should create a special fund to incentivize the development of technologies to improve health care access and quality for medically underserved kids. Click here for the report.

 

Study First to Link Sugary Drinks and Cardiovascular Disease

Two weeks of drinking high fructose corn syrup-sweetened beverages increases the risk factors for cardiovascular disease, a new study by University of California Davis researchers has found. The researchers are touting the study as the first to “demonstrate a direct, dose-dependent relationship between the amount of added sugar consumed in sweetened beverages and increases in specific risk factors for cardiovascular disease. Click here for details.

 

Parents Push FDA on e-Cigarette Regs

Last week marked one year since the FDA released its proposal to regulate e-cigarettes, cigars, hookah and other currently unregulated tobacco products, and public health groups say it’s about time the FDA finalize the rules. The American Lung Association sent President Barack Obama a letter last week signed by 3,462 parents urging him to tell the FDA to get a move on. Click here for the letter.

 

HHS OIG Urges Governing Boards to Focus on Compliance Risks

“A health care governing Board should make efforts to increase its knowledge of relevant and emerging regulatory risks, the role and functioning of the organization’s compliance program in the face of those risks, and the flow and elevation of reporting of potential issues and problems to senior management.” That’s one of many recommendations made last week by the HHS inspector general and several other organizations to health care governing boards. Click here for their report.

 

Politics: Obama as Comedian-in-Chief

Ok. It’s not really health care related, but Obama played comedian-in-chief Saturday night at the White House Correspondent’s Dinner. To see the President deliver his top 10 jokes – click here.