HealthLeadersMedia.com - Quality Pillar News & Analysis

UnitedHealth will tie doctors' payments to quality of care

Fri, 10 Feb 2012 12:07:00 GMT

UnitedHealth Group Inc., the largest U.S. health insurer by sales, will pay doctors based on the quality of their care in a cost-cutting effort that also benefits the company's consulting business. UnitedHealth expects to save twice as much as it would spend on incentive payments for doctors because patients will be healthier, according to company documents

The future of mHealth: Healthcare apps to lower insurance costs

Fri, 10 Feb 2012 11:41:00 GMT

Several large U.S. health insurance companies, including Aetna, WellPoint and UnitedHealth Group, currently offer mobile apps that help members find network providers and perform other simple functions. On the surface, these apps strengthen connections with members and providers. However, the mobile health revolution holds deeper implications for the insurance industry, which plans to enhance future mobile offerings to more directly impact patient health, according to the American Medical Association.

CMS Reveals Central Line Infection Rates, Finally

Thu, 09 Feb 2012 19:51:00 GMT

For the first time, the Centers for Medicare & Medicaid Services has added to its Hospital Compare website the rates of central line-associated bloodstream infections, or CLABSIs, for specific hospital intensive care units.

FL hospitals brace for Medicaid-related cutbacks

Thu, 09 Feb 2012 12:02:00 GMT

Gov. Rick Scott's controversial plan to overhaul the way Florida hospitals are compensated to treat the state's poorest and sickest residents—which could have cost the facilities some $1.7 billion next year—has failed to win backing from state lawmakers. But hospitals can still expect significant state cuts for their Medicaid care in the new budget year, with the House backing a plan to slash rates by 7 percent and the Senate unveiling a measure on Wednesday that could result in a 10 percent reduction.

Some physicians not always honest with patients

Thu, 09 Feb 2012 12:00:00 GMT

Despite wide institutional acceptance of a medical professionalism charter that endorses openness and honesty in physicians' interactions with patients, not all doctors comply, according to a survey whose results are published in the February 2012 issue of Health Affairs, released Wednesday. Although about two-thirds of doctors responding to the survey did agree that they should disclose serious medical errors to patients, about one-third did not completely agree that they should.

NH hospital officials blast for-profit cancer center bill

Thu, 09 Feb 2012 11:54:00 GMT

Representatives of New Hampshire's major hospitals fought a proposal that could pave the way for a for-profit cancer facility to come to the state at a hearing Tuesday that was notable for the absence of the company that was the impetus for the legislation: Cancer Treatment Centers of America (CTCA). The bill would create a special "destination cancer hospital" classification, which would be exempt from the state's Certification of Need review process for new hospitals, as well as the Medicaid Enhancement Tax on the grounds that it wouldn't accept Medicaid patients.

LSU criticized for hospital cuts

Thu, 09 Feb 2012 11:50:00 GMT

Louisiana's health chief Bruce Greenstein on Tuesday blasted LSU for "irresponsible" cuts to its hospital operations and lack of planning to offset their impact. Greenstein also said LSU overspending—not Gov. Bobby Jindal's midyear budget cuts—is responsible for the reductions. "They got their budget and a whole lot more money," Greenstein said. "They were spending at a rate that would have put them above it." LSU's top officials refused Tuesday to respond to Greenstein's accusations.

Expect more insurance drama in Pittsburgh

Thu, 09 Feb 2012 11:44:00 GMT

If you think Pittsburgh's health insurance landscape has changed dramatically in the last year, you ain't seen nothing yet, according to six of the region's top insurance executives. Expect more friction between physicians and health plans as insurers try to wring what they call unnecessary procedures, scans and surgeries out of the system.

Emergency Surgery Needs Distinct Code Registry, Researchers Say

Wed, 08 Feb 2012 12:31:00 GMT

Oversight of emergency surgery might work better if it operated a lot more like how the national and regional trauma systems function, with their own separate patient registries, surgical researchers suggest.

Doctor discipline: MN fails to offer full disclosure

Wed, 08 Feb 2012 12:04:00 GMT

Malpractice findings are increasingly easy to find on websites maintained by medical boards in 19 states, but not in Minnesota, where regulators have resisted efforts to make more information available to people who want to check into the backgrounds of their doctors. The Minnesota Board of Medical Practice also doesn't disclose whether doctors have been disciplined by regulators in other states or lost their privileges to work in hospitals and other facilities for surgical mistakes and other problems—information provided in 13 other states.

Rethinking hospital readmissions

Wed, 08 Feb 2012 12:02:00 GMT

Hospitals have always said there's nothing they can do to change how people behave once they leave the hopsital. But starting this October that excuse won't wash any more. As part of the new health care law, hospitals will face hefty fines for allowing too many readmissions. At University of Pennsylvania Hospital, Dr. Shreya Kangovi launched a program that focuses on the five poorest zip codes in Philadelphia—responsible for 85 percent of readmissions in the city.

WA state has new plan for ER limits; doctors critical

Wed, 08 Feb 2012 11:53:00 GMT

Lawmakers last year called for reducing poor patients' use of emergency rooms to save Medicaid $72 million, but state officials' first try at a three-visit limit on "nonemergency" visits to the ER was criticized by doctors and hospitals and struck down by a judge over procedural flaws. The state now has a new plan with a stricter limit: Medicaid will cover zero ER visits if treatment in an emergency room is "not medically necessary" for a health condition.

Engineering a High-Performance Emergency Department

Tue, 07 Feb 2012 12:47:00 GMT

A revamped staffing model for nurses and a boost to physician compensation and accountability are among the operational and clinical improvements documented in our case study of Cambridge Health Alliance's internal transformation.

HCA profit tops expectations; shares rise

Tue, 07 Feb 2012 12:16:00 GMT

HCA Holdings Inc, the largest U.S. hospital operator, on Monday reported better-than-expected fourth-quarter earnings as it admitted more patients to its facilities and recorded a one-time gain from an investment, sending its shares up 6 percent. A focus on controlling operating expenses and a reduction in bad debts helped offset lower surgical volumes, the company said. Cardiovascular surgery volumes were down for the third consecutive quarter, though the rate of decline slowed, company officials said on a conference call. Managed-care admissions, which slumped during the economic downturn as workers lost jobs and insurance, rose slightly for the second quarter in a row.

Medicaid changes challenge TX hospitals to do things differently

Tue, 07 Feb 2012 12:09:00 GMT

The goal is lofty: improve and expand health care for millions of Texans. But with billions of dollars at stake and the new project under way before the rules are even written, decisions made over the next few months are causing anxiety in many Harris County hospitals. The new rules—part of a complicated, first-of-its-kind project approved by the federal government—will determine who gets paid for providing charity care, and how much. Hospitals that historically received the most government reimbursement for charity care are not guaranteed to prosper under the new rules.

Why do cardiologists often pass up safe, low-tech treatments for chest pain?

Tue, 07 Feb 2012 12:00:00 GMT

Can American doctors say "No" to an aggressive and high-tech treatment they're used to providing even when it turns out a less heroic and cheaper one works just as well? It's an important question. The affordability of American medical care in the future will depend, in part, on the ability of physicians to simplify and economize, which are two things they've never been good at. With national health expenditures amounting to $2.6 trillion a year—45 percent of it paid by government—prosperity and political stability may also be at stake.

Health secretary to Mayor Landrieu: LSU at fault for hospital cuts

Tue, 07 Feb 2012 11:56:00 GMT

State Health and Hospitals Secretary Bruce Greenstein responded Monday to New Orleans Mayor Mitch Landrieu's call for state leaders to rescind major cuts to mental health services for the poor and uninsured. The Louisiana State University System approved the changes Friday. In his letter and in public statements since LSU's decision, Greenstein puts responsibility for the bed closures and layoffs squarely on LSU. The university points to Jindal administration budget maneuvers earlier this year that, according to LSU, limited its access to federal money intended to cover "uncompensated care," the cost of treating patients who are under-insured or have no insurance.

NY eyes tough reporting system for dispensing of prescription drugs

Mon, 06 Feb 2012 12:18:00 GMT

Maybe it's the mounting death toll or the sobering addiction statistics. Or that it's an election year for all state lawmakers. No matter the reason, efforts are taking hold for New York to join other states that require doctors and pharmacists to participate in a real-time reporting system before dispensing prescriptions for painkillers, sleeping pills and other controlled drugs. Stalled for several years, the push is on at the state Capitol to end a system that now permits growing numbers of people addicted to powerful narcotics to physician- and pharmacy-shop for their drug supplies.

Jackson Health System to announce 'significant' layoffs

Mon, 06 Feb 2012 12:08:00 GMT

Miami's Jackson Health System plans to "right-size" its organization with "significant" layoffs, Chief Executive Carlos Migoya said Friday. Though he refused to give specifics, he said managers are examining each department to see where reductions make sense without hurting the quality of patient care. Jackson is working quickly to decide where to cut. "We want to know in the next 10 days to two weeks," he said.

TX prisons consider switch to local hospitals for convict care

Mon, 06 Feb 2012 12:05:00 GMT

State prison officials are poised for the first time in 18 years to contract directly with someone other than a state university to provide medical care for Texas convicts. Officials confirmed to the American-Statesman on Friday that an agreement has been reached for Huntsville Memorial Hospital to provide nine emergency-care beds on the second floor of its hospital, and that negotiations are under way for the hospital to operate an emergency room and specialty care clinic inside the Estelle Unit east of town.