Two servers were hit but the issue was resolved and no ransom was paid to the attackers.
Keck Medical Center of USC said it suffered a ransomware attack on servers at two hospitals but was able to remedy the problem and retrieve data without paying a ransom.
The incident began August 1 when employees at Keck Hospital of USC and Norris Comprehensive Cancer Care Center detected ransomware on two servers, Keck Hospitals CEO Rod Hanners said in a statement posted on the USC Keck website.
The malware attack encrypted files on both servers, which made the servers inaccessible to employees, but there is no evidence that any medical files were breached, according to the statement.
"Our investigation has not revealed any evidence that data was retrieved or accessed as a result of this ransomware," said Hanners.
USC notified patients because certain sensitive information was in the folders encrypted by the malware.
The servers affected by the ransomware did not store Keck's electronic medical records system, but some data on the servers included departmental files that contained internal operational documents.
Data potentially affected by the incident included names and demographic information, dates of birth, identifiable health information—including treatment and diagnosis for some patients—and, in certain cases, Social Security numbers.
USC contacted the FBI, began an internal forensic investigation, and hired Ernst & Young, LLP to review the steps it took to investigate the matter. The attack "was quickly contained and isolated to prevent the
spreading of malware to other servers, USC officials said.
"The medical center was able to fully restore the data from the encrypted folders to the servers. No ransom was paid."
Coordinated care goes beyond simply making sure patients have a follow-up appointment after hospital discharge.
Coordinating patients' diabetes and cardiovascular treatment with mental health care can both reduce depression and improve patients' glucose and blood pressure numbers, according to a nationwide program.
Eighteen care systems and 172 clinics enrolled 3,609 patients with depression and comorbid diabetes or cardiovascular disease across the United States in a nationwide initiative called COMPASS (Care of Mental, Physical and Substance-use Syndromes).
Patients who were enrolled in the initiative talked at least once a month with a care manager, who worked with their primary care physician, about their depression and their medication for diabetes, hypertension or both.
Forty percent of patients with uncontrolled disease at enrollment achieved depression remission or response; 23% achieved glucose control; and 58% achieved blood pressure control during a mean follow-up of 11 months, according study results published in the journal General Hospital Psychiatry. Surveys also showed that patients and clinicians were satisfied with COMPASS care.
Care managers at each clinic conducted patient outreach and regularly reviewed patient cases with a psychiatrist and primary care physician. If patients were new or not improving, the outreach to patients and the reviews were done weekly.
Care managers had either behavioral health or medical training, but also had expressed an interest in treating the patient as a whole person, rather than treating one condition at a time.
The Center for Medicare and Medication Innovation funded the $18-million, three-year initiative.
"This was a successful wide-scale implementation of a collaborative care model that demonstrated it can be used in a variety of health care settings with positive effects for providers and patients," Karen J. Coleman, PhD, MS, Kaiser Permanente Southern California Department of Research & Evaluation, said in a statement.
Coleman also said the work indicates that patients with mild and moderate depression can be cared for in the primary care setting.
"Depression is a chronic disease like diabetes," Coleman said. "Healthy behavioral changes like sleep, exercise, and better eating can improve diabetes and depression.
"If medications are given for depression, they can be managed in a collaborative care model, just like medications for diabetes."
Survey data confirms that Americans are deeply worried about increases in out-of-pocket expenses for healthcare, and that they have little confidence in making healthcare decisions.
Just as health plans are gearing up for open enrollment and the opportunity to woo new customers, consumers are struggling to understand their options and worried about how to pay high deductibles and other out-of-pocket expenses, research suggests.
The "Moments of Truth" research report from Alegeus is derived from a survey of more than 4,000 U.S. healthcare consumers. It confirms that Americans are deeply worried about increases in out-of -pocket expenses for healthcare, with 66% of consumers saying that "planning for out-of-pocket costs" was the most challenging and stressful aspect of managing their healthcare.
Respondents also said they had little confidence in making healthcare decisions, with 69% saying that deciphering healthcare jargon is a significant barrier to decision-making.
Forty-nine percent of consumers said they don't understand the cost implications of different health plan choices.
The report also indicates that consumers value human interaction above all other types of support, at least until they become more familiar with their health plan options. As consumers build confidence, their interest in human support declines and their interest in digital tools and self-service support grows.
Consumers have been conditioned to disengage from healthcare decisions by years of having insurance coverage that paid for most healthcare costs and having what are now viewed as relatively small deductibles, the report says.
Now they have to take a more active role and make decisions beyond just selecting a health plan, and many are not ready. They are trying to learn about an industry that seems to have its own language and which demands that many decisions be made, some with potentially significant financial consequences.
Forty-four percent of respondents said "making savings and investment decisions" was challenging or extremely challenging, and 41% had the same view of "understanding and managing my benefit accounts."
Thirty-six percent found "knowing what type of expenses are eligible for my benefit account" to be challenging or extremely challenging, and 34% felt that way ab out "using payment and reimbursement tools."
The report says the research "affirms that consumers feel the impact of the consumerism movement in healthcare and they are struggling to manage their increased financial responsibility."
It also says the survey "clearly signals the need for significant education, tools, and support that engages and empowers consumers to take ownership and make savvier healthcare decisions."
The survey results come as the Centers for Medicare & Medicaid Services launched a new campaign to enroll young adults, which is viewed as vital to the success of the health insurance marketplaces.
The campaign is focusing on educating young people about their options, especially since nine out of 10 marketplace-eligible young adults without health insurance have incomes that would make them eligible for tax credits.
As CMS works with other federal agencies and private partners to enroll young adults, the 11 million Americans who already receive health insurance from an ACA exchange are bracing for expected premium increases and less coverage, brought partly by the exit of the insurance giants Aetna and Humana from the ACA marketplace.
What works at hospitals with many privately insured patients may not work at facilities serving the poor and uninsured.
Disparities in surgical outcomes at safety net hospitals (SNH)—both real and perceived—are the result of a complex series of factors, say three Boston Medical Center surgeons in a paper published in the current JAMA Surgery.
Outcomes at these hospitals are influenced by factors at the individual, organizational, and policy levels, said Ryan Macht, MD, David McAneny, MD, and Gerard Doherty, MD.
At the individual level, risk-adjustment models used to evaluate quality fail to account for numerous factors that can influence outcomes at SNHs.
These include:
Language and cultural barriers
Social support
Environmental characteristics
Trust in the healthcare system
Substance abuse
Psychiatric diagnoses
"It is easy to appreciate that the risk for certain complications, such as a readmission for dehydration after a new ileostomy, differs between an illiterate, non–English-speaking patient with poorly controlled schizophrenia and a highly functioning patient," they wrote.
Efforts to improve quality metrics that work at some hospitals may not work at safety-net hospitals. For example, it can be too costly for SNHs to address the risk of venous thromboembolism among high-risk patients with postoperative prophylaxis.
Some SNHs have set up such programs, but it takes "significant institutional resources" to ensure that uninsured and Medicaid patients receive prophylaxis regimens on discharge, consistent with the standards for all patients and regardless of ability to pay, the authors stated.
In addition, the authors noted that SNHs have limited resources to improve pay-for-performance metrics. The authors advocated changing policies that disproportionately penalize these institutions
The number of preventable readmission at U.S. hospitals dropped by 8% over the past five years, according to data released by the Centers for Medicare & Medicaid Services.
Between 2010 and 2015, hospital readmissions dropped in 49 of 50 states. The reduction amounted to approximately 100,000 readmissions in 2015. Since 2010, there have been 565,000 fewer readmissions, CMS estimates.
CMS credits two of its initiatives for the readmission reduction:
The Hospital Readmission Reduction Program, established under the Affordable Care Act, reduces payments to hospitals with "excess" readmissions as determined by CMS.
The Partnership for Patients program, which is testing approaches to improving transitions from the hospital to community settings.
The data show these efforts are working, according to a Sept. 13 blog post by Patrick Conway, MD, chief medical officer of CMS; and Tim Gronniger, deputy chief of staff of CMS.
While hospitals have been working to reduce readmission and avoid penalties from CMS, new data questions the use of readmissions as a quality measure.
Researchers at Johns Hopkins Medicine compared hospitals readmission rates and mortality rates in six areas: heart attack, pneumonia, heart failure, stroke, chronic obstructive pulmonary disease, and coronary artery bypass.
They found that hospitals with the highest readmission rates earned better mortality scores in patients treated for heart failure, COPD, and stroke.
DOJ says its settlement with the ex-CEO at Tuomey Healthcare System demonstrates that individual decision makers will be held personally accountable for their involvement in their businesses' unlawful activities.
Former hospital executive Ralph J. Cox III will pay $1 million to settle Stark Law violations for orchestrating illegal "sweetheart deals" with referring physicians during his tenure as CEO of Tuomey Healthcare System in Sumter, SC, the Department of Justice said Tuesday.
As part of the settlement, Cox is banned for four years from participating in federal healthcare programs. Cox was fired as Tuomey's CEO in the fall of 2013.
Federal prosecutors said that Cox, fearing that Tuomey could lose lucrative outpatient procedure referrals to a new freestanding surgery center, entered into contracts with 19 specialist physicians that required the physicians to refer their outpatient procedures to Tuomey.
Risk and Red Flags Observed
In exchange, the hospital paid them compensation that far exceeded fair market value and included part of the money Tuomey received from Medicare for the referred procedures. During the trial against the hospital, the government argued that Cox ignored and suppressed warnings from one of Tuomey's attorneys that the physician contracts were "risky" and raised "red flags."
On May 8, 2013, after a month-long trial, a South Carolina jury determined that the contracts violated the Stark Law. The jury also concluded that Tuomey had filed more than 21,000 false claims with Medicare.
On Oct. 2, 2013, the trial court entered a judgment under the False Claims Act in favor of the United States for $237.4 million. The United States Court of Appeals for the Fourth Circuit affirmed the judgment on July 2, 2015.
On Oct. 16, 2015, DOJ resolved its judgment against Tuomey for payments totaling $72.4 million, and the hospital was sold to Columbia, SC-based Palmetto Health.
"Sweetheart deals between hospitals and referring physicians distort medical decision making and drive up the cost of healthcare for patients and insurers alike," said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department's Civil Division.
"Patients have a right to be confident that a physician who orders a procedure or test does so because that service is in the patient's best interest, and not because the physician stands to gain financially from the referral. Today's settlement demonstrates that the Justice Department and its law enforcement partners will hold individual decision makers accountable for their involvement in causing the companies and facilities they run to engage in unlawful activities."
A small Michigan hospital will add seven rooms to its emergency department and will make improvements to its ambulatory care department with donated funds.
Otsego Memorial Hospital's capital campaign for a $13.1 million expansion and renovation has received its largest donation from a surprising place—an oil company.
Johnson Oil Company and the Johnson family donated $750,000 toward the effort, and as a result the Gaylord, MI hospital's new ED will be named The Dale E. Johnson Emergency Department in honor of the family's patriarch.
The expansion will add seven rooms to the ED, for a total of 19, and will add a new and larger operating room. Improvements will also be made to hospital's ambulatory care department to improve privacy, patient security, and comfort, officials said.
"We see a lot of varied needs here at this hospital. We're a small, rural hospital, yet we see a lot of high traumas. We see a lot of surgical patients," Christie Perdue, Otsego Memorial Hospital's foundation and marketing director, told the Gaylord Herald Times.
"We have a lot of people that can't travel very far, and so Otsego Memorial Hospital is their destination for care. We are honored to serve them, and we want to do that in a larger space, make it more accessible and enhance the privacy and security they feel when they are here."
During a community meeting about the expansion capital campaign last week, Otsego CEO Tom Lemon reported that ED visits have risen 6% annually in the last four years, and outpatient surgeries have experienced 12% annual growth.
So far, the hospital has raised $3 million that it will put toward the campaign's $4 million goal. Administrators said they hope to raise the remaining $1 million by next summer so they can break ground on the expansion.
Otsego marketers have been sharing news coverage on the capital campaign via its Facebook page. They also appeared to tease the expansion announcement by posting a photo of the barn where the community meeting was held.
"Sneak preview of some exciting OMH news…" they wrote. "Stay tuned!"
Along with restructuring its organization nationwide, Ascension has launched a rebranding campaign to unify its facilities under the Ascension name.
The rebranding campaign will start with Ascension's 24 hospitals in Wisconsin and 15 hospitals in Michigan.
As of last week, each of the hospitals were rebranded under the Ascension name; for example, Borgess Medical Center in Kalamazoo, Michigan is now Ascension Borgess Hospital. Temporary signs have been installed at each hospital site.
Ascension will also launch advertising campaigns in Wisconsin and Michigan—its largest markets—to promote its new identity to patients, staff, and the community, officials said.
"We've been on a journey now for two years to be one Ascension," Nick Ragone, chief marketing and communications officer for Ascension, told the St. Louis Business Journal. "Part of that journey is now having an integrated identity."
The campaign theme will center on "doing things better" and will run for three weeks. All in all, replacing the facilities' signage and other rebranding efforts will take about 12 months.
Ascension, one of the largest nonprofit health systems in the U.S., then plans to roll out the integrated brand to its 141 hospitals across 24 states. The health system is in the process of evaluating which markets will be next for the rebranding campaign, said Ascension's President and CEO Tony Tersigni.
"Years ago when we created Ascension, we made the decision that there was brand equity in the local names," he said.
"We still believe that, but over the past 16 years, we've developed a reputation nationally as Ascension. Now we want to bring those brands together and leverage both into one Ascension."
Ascension officials have been tight-lipped on what the rebranding effort will cost. The St. Louis Business Journal reported that Ragone declined to disclose how much Ascension is investing in the rebranding effort and ad campaign.
Bernie Sherry, Ascension's top Wisconsin executive, was equally vague.
The alliance, resulting from a partnership between Dignity Health and Catholic Health Initiatives, is billed as the largest community-based precision medicine program in the country.
Precision medicine is coming to millions of patients at two of the nation's largest health systems, thanks to the newly launched Precision Medicine Alliance, LLC. The program—a result of a partnership between Dignity Health and Catholic Health Initiatives—aims to offer patients from both systems faster and more accurate diagnostic and treatment protocols based on their genetic and molecular profile information.
Dignity Health is headquartered in San Francisco and is a 21-state network of nearly 9,000 physicians, 59,000 employees, and more than 400 care centers. The Englewood, Colorado-based-based Catholic Health Initiatives is the nation's second-largest nonprofit health system with 103 hospitals and other facilities operating in 18 states.
The Precision Medicine Alliance will be available at nearly 150 hospitals and care centers serving approximately 12 million patients annually. It is billed as the largest community-based precision medicine program in the country.
The PMA will initially focus on advanced diagnostic tumor profiling in cancer treatment and will later expand into other areas such as cancer and cardiovascular risk, and pharmacogenomics. The program will also support oncology research by populating a database that the health systems say will become the largest collection of clinical cancer data ever compiled by a single organization.
The two health systems will partner with laboratories and bioinformatics companies nationwide to develop molecular tests to meet the specific needs of patients and clinicians.
By combining the data from diagnostic tests with an individual's medical history, the program aims to help healthcare providers develop individualized treatment and prevention plans.
The program will also integrate EMRs into a data-management infrastructure that promises quick access to the right clinical expertise and clinical trial information.
'More Accurate Diagnoses'
"The Precision Medicine Alliance will provide community physicians with access to a wide range of diagnostic technology that is currently only available in academic medical centers. This will provide more accurate diagnoses, with personalized therapies tailored to each patient through community providers, where the vast majority of care happens," Lloyd Dean, president and CEO of Dignity Health said in a statement announcing the program.
"Through our partnership with CHI, we are using the latest technology, especially in genomic sequencing, to deliver the right care, to the right patients, quickly and efficiently."
The Precision Medicine Alliance is aligned with the White House's $215 million national Precision Medicine Initiative to accelerate biomedical research. In July, Vanderbilt University Medical Center was awarded a $71.6 million federal grant to establish a precision medicine data research center.
The top-rated plans were almost evenly split among commercial, Medicare, and Medicaid plans. Health plans were evaluated on customer satisfaction, prevention, and treatment.
Only 105 of the 1,012 private/commercial, Medicare and Medicaid plans assessed by the National Committee for Quality Assurance (NCQA) achieved the highest quality scores.
The NCQA Health Insurance Plan Ratings 2016-2017 report indicates that 10% received a top rating of 4.5 or 5.0 out of 5. Of those 105 plans, 23 received the highest score of 5.0. The stop scorers include 13 commercial plans, eight Medicare plans, and two Medicaid plans.
On the other end of the scale, 27 plans (3%), earned the lowest ratings of 1.0 to 2.0.
The top-rated plans were almost evenly split among commercial, Medicare, and Medicaid plans.
The lowest-rated plan was Hawaii Medical Service Association with 1.5. The PPO received a 3 in customer satisfaction, 1 for prevention, and 0.5 for treatment. An NCQA statement noted, however, that the low score might be partially attributable to a lack of data.
NCQA has scored health plans for quality annually since 2005. Some of the top finishers this year were The Kaiser Foundation, University of Pittsburgh Medical Center, Capital District Physicians, Tufts, and Blue Cross Blue Shield of Massachusetts, each has at least two plans that received a 5.0 rating.
NCQA did not rate plans offered in the Affordable Care Act marketplace because the government will release ratings on those separately. NCQA derives the quality scores from three broad categories:
Customer satisfaction
Prevention
Treatment
10 States with Highest-Scoring Plans
The percentage of plans receiving a good or very good rating was slightly smaller this year than last, 10.4% vs. 11.4%. There were similarities among the 23 top-rated plans, with all but one being HMOs or offering HMO plans. Many of the top-rated plans were in New England and in the Great Lakes region.
The 10 states with the highest percentage of plans receiving a 4.5 or 5.0 out of 5 rating were
Massachusetts
Rhode Island
Wisconsin
Maine
New Hampshire
Minnesota
Vermont
New York
Hawaii
Iowa
Like all quality ratings, the NCQA scores must be interpreted carefully so as to avoid reading more into them than intended.
A person seeking care under a plan that is highly scored is not guaranteed to see a provider who would be similarly scored on an individual level, because the scores reflect quality at the plan level, not the patient's interaction with a particular doctor or other clinician, the NCQA notes in its report.
Part of the overall plan score is an average of the individual performance ratings, so that one bad doctor wouldn't bring down the plan's score. But if a plan has a very low score, it is more likely that the score is an accurate reflection of most of the individuals because there weren't enough highly related clinicians to raise the score.