WEEKLY E-BULLETIN


Moody’s: Not-for-Profit Hospital Financial Picture Is Strong

Margins among non-profit hospitals have rebounded completely from the Great Recession and have hit highs not seen in several years, according to Moody’s, which analyzed the numbers for 190 hospitals and healthcare systems.  Not-for-profit hospital revenue grew a preliminary median of 7.4 percent in 2015, up from 4.7 percent in 2014. The three-year compounded annual growth rate is 5.6 percent. That actually outstrips the 5.5 percent compounded growth rate in expenses–the first time that has occurred in five years. Click here for the Moody’s report.

Vermont Has Most “A” Grade Hospitals; Three Have No “A” Grade Hospitals: Healthgrades

798 hospitals received an “A” grade, while only 15 scored an “F” in the Leapfrog Group’s spring safety score update released last week.  Hospitals could save at least 33,000 lives each year if they followed the patient safety policies and procedures of the highest-scoring hospitals in the hospital safety score update, a new study finds. In all, an estimated 206,021 people die avoidable deaths in U.S. hospitals each year, the analysis showed. Click here to find specific hospital scores.  Click here for the state rankings.  Click here for the 10-page study.

Truven Names Top 15 Health Systems; California Has Most

Truven named its top 15 health systems last week.  Among the key findings: winning health systems achieved higher survival rates and fewer errors at a lower overall treatment cost than non-winning health systems. Specifically, overall mortality rates were 14.7% lower for winning health systems versus non-winning peer group hospitals; complication rates were 15.1% lower; and ED wait times were 12.3 % lower.  Click here for the list.  (Truven’s top 100 hospitals for 2016 were announced a couple of months ago and can be found here.)

CDC: Mixed Results in Hospital Infection Rates

New CDC figures highlighted in the latest issue of JAMA show mixed results in hospital infection rate trends. In 2014, there was almost a 50 percent drop in central line-associated bloodstream infections since 2008. There was also a slight decrease – about 8 percent – in hospital-acquired Clostridium difficile infections reported since 2011. Meanwhile, C difficile infections increased by 4 percent from 2013 to 2014. Click here for the JAMA report.

CMS Proposes New Physician Payment System: MACRA

CMS has released long-awaited proposed regulations that detail the new Medicare physician payment formula.  The 1,000 page proposal is based on the legislation Congress passed last year that repealed the previous payment formula known as the SGR.  The new system, referred to as MACRA, creates two distinct tracks for physicians and other eligible clinicians.  One track, on which most physicians will start in 2019, is a Merit-Based Incentive Payment System (MIPS) and carries penalties and bonuses based on performance.  The other track, referred to as the Qualified APM program, allows physicians to avoid MIPS if a certain percentage of their Medicare patients are enrolled in payment models that carry both up and down sided risk.  Click here for a CMS summary.  Click here for a good 14-page fact sheet.

Patient Danger Zone:  Hospital Discharge

Medication mistakes are one of the most common complications for discharged patients. The federal government views them as “a major patient safety and public health issue,” and a Kaiser Health News analysis of government records shows such errors are frequently missed by home health agencies.  Between January 2010 and July 2015, the analysis found, inspectors identified 3,016 home health agencies — nearly a quarter of all those examined by Medicare — that had inadequately reviewed or tracked medications for new patients. In some cases, nurses failed to realize that patients were taking potentially dangerous combinations of drugs, risking abnormal heart rhythms, bleeding, kidney damage and seizures.  Click here for the government’s action plan against adverse drug events.  Click here for the KHN story.

Effort Grows To Remove State-Specific Licensure for Nurses

Hospitals and some nursing groups are lobbying state legislators across the nation to do away with requirements that nurses be licensed in each state where they work, arguing that the rules inhibit the use of new health-care methods such as telemedicine. The push to get states to join nursing licensing compacts reflects growing adoption of remote health services such as patient care and monitoring online and by the phone. Telemedicine, as it is known, is expected to soar in the U.S. to $1.9 billion in 2018 from $240 million in revenue in 2013, according to research firm IHS Technology.  Click here for the WSJ story.

New Report Critical of 340B Hospitals

Many hospitals participating in the 340B discount drug program are not giving their patients enough information about charity care, according to a new report.  The report, published by the Berkeley Research Group, concluded that less than 62 percent of 340B hospitals informed patients of their eligibility for charity care programs before initiating collections. Only 37 percent limited charges for eligible patients to Medicare or commercial insurance rates. The study noted that many hospitals participating in the 340B program have yet to comply with charity care-related reforms connected with the Affordable Care Act.  Click here for the report.

Teen Pregnancy Rates at All-Time-Low

New data from the CDC has found that the teenage birth rate plunged 60 percent between 1991 and 2014 in the United States. Births among Hispanic and black teens alone have fallen by nearly half since 2006. However, despite recent improvements, the U.S. teenage birth rate is still much higher at 24 births per 1,000, than other peer nations such as Canada 10 births per 1,000, France 9 births, Germany 7 births per 1,000, and United Kingdom 15 births per 1,000. For the CDC report, click here. For the World Bank data, click here.

More Public Data Released on Nursing Homes

CMS added six new quality measures to the Nursing Home Compare website, including three that are not self-reported by nursing homes. This is the first time CMS is including quality measures not based solely off the providers’ self-reported data. The agency added measures on: percentage of short-stay residents who were successfully discharged to the community; percentage of short-stay residents who have had an outpatient emergency department visit; percentage of short-stay residents who were re-hospitalized after a nursing home admission; percentage of short-stay residents who made improvements in function; percentage of long-stay residents whose ability to move independently worsened; and percentage of long-stay residents who received an anti-anxiety or hypnotic medication. Click here for the CMS fact sheet.

Alaska, Wisconsin, North Dakota Have Highest Health Costs – Florida, Arizona Lowest

Residents in many states face health care costs that are thousands of dollars more than in other areas, even in cities just miles away, according to an analysis released last week. Alaska had the highest average health care prices, with residents paying twice the costs of the national average, with Wisconsin, North Dakota, New Hampshire and Minnesota making up the rest of the top five with the highest health care costs. Only 15 states had health care costs below the national average. Florida, Arizona, Tennessee, Maryland and Nevada had the lowest in the country. To read the study, click here.

Medigap Policies Saw Strong Growth Last Year

In 2015, Medicare Supplement carriers saw a big increase in membership growth. Enrollment in Medicare Supplement plans (also known as Med Supp or Medigap) exceeded 11.9 million, up 6.5% over 2014 figures. UnitedHealth retained a strong lead in this segment as its membership surpassed 4 million. Breakdowns of in-force policies show that carriers issued more than 5.020 million new policies from 2013 through 2015. Carriers reported an aggregate of 6.901 million in-force older policies that had been issued prior to the year 2013. Click here for details.

Link between E-Cigarette Ads and Teen Usage

There is a link between e-cigarette advertisements and their use by middle and high school students, according to the CDC. This study is the first to directly link exposure to e-cigarette advertising and current e-cigarette use. It concludes that efforts to reduce youth exposure to such advertising are critical. CDC researchers analyzed data from the 2014 National Youth Tobacco Survey, found that the greater the exposure to e-cigarette advertisements among middle and high school students, the greater the odds of their e-cigarette use. Click here for more from the CDC.

House Committees Approve a Dozen Opioid Related Bills; Use of Synthetic Drugs Grow

In an effort to assemble a legislative package to combat opioid abuse, the House Judiciary and Energy and Commerce Committees approved over a dozen related bills last week. The bills were approved unanimously. The bills will form a package, which House leaders consider an improvement to the Senate approved plan (S.524) that passed 94-1 in mid-March. These bills will likely be voted on when the House returns from its recess next week. Click here for summaries of the first package of 8 bills passed. Click here for the next 3 that passed. Click here for the two bills that passed the Judiciary Committee.

  • States are scrambling to fight new and dangerous synthetic drugs that are growing in popularity. Among the most popular synthetic drugs in the U.S. are synthetic cathinones, known commonly as bath salts, and synthetic cannabinoids, essentially smokable imitation marijuana products, which are sold in stores using kid-friendly branding like Scooby Snax. Click here for more.

Cancer, Heroin Abuse and Contaminated Water Are Top U.S. Health Concerns

Safe drinking water is now one of the top public health concerns of Americans, according to new polling data from the Kaiser Family Foundation. In the wake of the recent Flint, MI water crisis, just over one-third of respondents cited contaminated drinking water as an “extremely serious” health problem. Contaminated water concerns are now in a virtual tie with heroin abuse, and trail only the fear of cancer. Click here for the data from Kaiser.

CMS: Medicaid Can Cover Eligible Persons on Probation, Parole or In-Home Confinement

Individuals on probation, parole or in-home confinement who are Medicaid-eligible can get coverage under the program, CMS said in guidance issued last week.  Individuals in these circumstances are not considered inmates of a public institution so states can receive federal Medicaid funds for coverage provided to them. Existing Medicaid law prohibits the federal government from paying for medical services provided to inmates except when that person is being treated in an inpatient facility, such as a hospital.  Obama administration officials estimated that today’s guidance will improve coverage for as many as 96,000 people in Medicaid expansion states.  Click here for the CMS guidance.

Government Initiative Designed To Steer Americans into Health Care Jobs

The Obama administration announced a new proposal, Health Careers Pathways, to help steer Americans to work in the health care sector across the next decade. The effort builds on a Department of Labor effort to help community college graduates match with employers’ needs. The endeavor will be jointly led by the Advisory Board Company, which is putting together employers like the University of Pittsburgh Medical Center and the New York City Health and Hospitals Corp., with the Hope Street Group, which is organizing training and hiring efforts in Denver, Minneapolis and five other communities. Click here for the White House blog describing the initiative.

WHO Reports Progress in Killing Malaria Worldwide

21 countries are in a position to eliminate malaria within five years, according to the World Health Organization. This analysis comes one year after the World Health Assembly approved a global strategy for eradicating malaria. The goal is to eradicate the virus in at least 35 countries by 2030. Click here for the report from the WHO.

Millennials Are Now the Largest Generation

According to the new Census population assessments the U.S. population is broken down in the following generation estimates: Millennials (born 1981-1997): 75.4 million; Generation X (born 1965-1980): 66 million; Baby Boomers (born 1946-1964): 74.9 million; Silent Generation (born 1928-1945): 28 million.  The Pew Research Center analyzed what has caused this surge here.