During the presidential campaign, Americans will be bombarded with proposals to improve the U.S. health care system in ways big and small that would either build on or radically revamp the Affordable Care Act. All will claim to reduce costs and improve quality. In order to accomplish this, proposals will largely focus on what is termed "wasteful spending" in health care, spending not associated with improved quality that, by some estimates, accounts for over one-fourth of total health care spending. But, as Michael Porter and Robert Kaplan of Harvard Business School have argued, we need to examine costs at a more granular level at which clinical outcomes are matched with the business and administrative processes.
The board that certifies orthopedic specialists will use ProPublica's Surgeon Scorecard to help assess the competency of its surgeons, the organization's top administrator said today. The American Board of Orthopaedic Surgery will incorporate Scorecard's ratings into its recertification process, in which surgeons are formally re-evaluated every 10 years, Executive Director Dr. Shephard Hurwitz said. Surgeons may also be put on a watch list based on their Scorecard rating, he said. Action won't be taken based on a surgeon's performance in ProPublica's analysis alone, Hurwitz said.
If you pay attention to health care trends, Mitch Edgeworth's biggest priority for Vanderbilt University Hospital and clinics might not surprise you: He wants to improve access. Well, that's one of two priorities for Edgeworth, who moved into the CEO role at the hospital July 1. Internally, he's focused on empowering Vanderbilt's faculty and staff to do the same. But externally, Edgeworth is all about access, as is the system as a whole. Edgeworth takes over the system's adult services at a transformative time for Vanderbilt. Vanderbilt University Medical Center and Vanderbilt University are undergoing an unprecedented split, designed to make both function more efficiently.
As a child, Bishop Douglas Miles heard the warnings about vans trolling East Baltimore streets, snatching up young African-Americans for medical experiments at nearby Johns Hopkins Hospital. Whether there was any truth behind those stories—Hopkins has always denied them—hardly mattered. The mythology lived on and, combined with the hospital’s very real development decisions, contributed to a persistent view of Hopkins as an imperious, menacing presence amid the largely poor and African-American neighborhoods surrounding it. But now, Miles says, that perception could be changing. Johns Hopkins University and the Hopkins hospital and health system have launched an ambitious initiative to fill many more jobs with residents from distressed Baltimore neighborhoods and boost the use of minority contractors and vendors from those areas.
The cost of health care in the U.S. has been ballooning: A recent report found that the U.S. collectively spends about $9,000 per person on health care each year, which adds up to 17 percent of the country's GDP. But what happens when patients can't afford to pay their bills? At nonprofit hospitals, an unpaid bill either becomes bad debt for the patient or is written off as "charity care." Nationally, this adds up to $57 billion in uncompensated care. But a group of researchers argue that the way charity care is given out could be made more efficient.
The cost of health care in the U.S. has been ballooning: A recent report found that the U.S. collectively spends about $9,000 per person on health care each year, which adds up to 17 percent of the country's GDP. But what happens when patients can't afford to pay their bills? At nonprofit hospitals, an unpaid bill either becomes bad debt for the patient or is written off as "charity care." Nationally, this adds up to $57 billion in uncompensated care. But a group of researchers argue that the way charity care is given out could be made more efficient.
In 2005, University of Rochester researchers published a study on medical ambiguity. Led by psychologist David Seaburn, the investigators hired actors to pose as patients and visit local physicians. During some visits, the "patients" described the classic symptoms of gastroesophageal reflux. During other visits, ambiguous symptoms were described: some emotional stress, dizziness, fatigue, and mysterious chest pains. Each visit was secretly audiotaped, and then the researchers transcribed and coded the physician-patient interactions. Their results were troubling. Twenty-two percent of the time, the physicians simply ignored the ambiguity. For instance, after a patient described "vague symptoms of general chest pain," the doctor would respond with a statement of "fact": "Your pain is caused by gastroesophageal reflux." The doctors simply were not inclined to discuss the ambiguous symptoms.