In early 2011, federal and state officials asked 200 Southern California hospitals to provide information about their ability to survive a catastrophic earthquake along the southern San Andreas Fault. The hospitals were asked, for example, how many backup generators they had on hand, what fuel they burned and whether their water tanks could survive the deadly rupture long predicted for one of the nation's most dangerous faults. But nearly two years later, almost half of the hospitals still have not responded, leaving some disaster officials frustrated over their inability to help the hospitals plan for the worst.
Federal health officials are now encouraging health systems to be innovative in developing cost-efficient ways to treat Medicare patients. One of the government's latest tools is "the accountable care organization," or ACO—a network of providers that manages the health of a specific population of Medicare patients. There are built-in financial inducements to keep the patients well, not just to treat them when they are sick. Providers share with the government in any cost savings from managing a healthier population. The St. Louis area's leading health systems are experimenting with ACOs and related models of coordinated care.
The leader of the California Senate says holes in the state's oversight of physicians, exposed in recent Los Angeles Times articles about prescription drug deaths, are "extremely troubling" and need to be corrected "as quickly as we can." Darrell Steinberg (D-Sacramento) said he would put his political muscle behind legislation to give the Medical Board of California more investigators and broader authority to stop reckless prescribing of addictive medications.
The "bodega clinicas" that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor's visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.
Beth Hanlon grabs the stethoscope she keeps roped around the headrest of her car's passenger seat and strides through the double doors of a Salt Lake City nursing home, her first "house call" of the day. It's not every day that Hanlon makes house calls. But she's making more exceptions these days, now that she's seeing a fraction—about 350—of the 2,500 patients she had a year ago. In late December 2011, Hanlon and another internist at Alpine Medical Group, Yong Hui Ahn, joined a growing number of doctors embracing "concierge" health care.
An early outbreak threatens to makes this year's influenza season one of the most difficult in recent years as public health officials brace for the worst. Hospitals in the Northeast, from New Jersey to Massachusetts, are reporting record numbers of emergency room visits related to flu-like illnesses, and Boston has declared a public health emergency. At least 41 states have reported widespread flu outbreaks, more than 2,250 people have been hospitalized and 18 children have died, according to the federal Centers for Disease Control and Prevention in Atlanta. Updated national statistics are scheduled to be released Friday.