A computer programming error led the Centers for Medicare & Medicaid Services to miscalculate financial penalties against hospitals that have high rates of patients returning within 30 days. The Hospital Readmissions Reduction Program, established by the 2010 health care law, kicked in Monday, with 307 hospitals losing 1 percent of their regular reimbursements. Medicare published a list of the penalties in August. But on Friday, the last workday before the penalties started, Medicare published new rates after discovering it inadvertently included data in its calculations that were too old. As a result, 1,422 hospitals are getting hit with slightly higher penalties, while 55 hospitals are getting slight reprieves. A total of 2,217 hospitals will lose some money.
The federal government wants many hospitals to adopt a model like Denver Health, which doesn’t readmit many patients. Dr. Thomas MacKenzie, the chief of quality at Denver Health, says a big reason is because the hospital is able to help patients get follow-up care once they leave. Denver Health does this through its own network of neighborhood clinics, which are all linked by a computerized record system. The hospital can let them know a patient who needs follow-up care is coming, and can help that patient get a priority appointment. But many hospitals don’t have close relationships with their patients' primary care doctors. Dr. Atul Grover is with the Association of American Medical Colleges, which represents hundreds of hospitals nationwide. He says setting up a more integrated system requires resources.
Hartford Hospital and UnitedHealth Group, the nation's largest health insurer, are in a hard-fought contract negotiation that could leave thousands of customers facing higher out-of-pocket expenses if the current agreement expires Oct. 28. "Hartford Hospital wants consumers to pay 30 percent more over the next three years for services received at their facilities," said Daryl Richard, spokesman for UnitedHealth Group. The contract affects both Hartford Hospital and its affiliate, The Hospital of Central Connecticut in New Britain and Southington.
Louisiana's public hospital safety net will have to cut back dramatically the services it offers to uninsured patients across the state under a plan approved Thursday by the LSU Board of Supervisors. In New Orleans, a $49 million reduction at the Interim LSU Public Hospital will mean that 432 workers lose their jobs, while the number of patient beds will shrink from 201 to 155. Some clinics associated with the hospital will close, while others will reduce their hours. Dr. Frank Opelka, the new head of the seven LSU system hospitals in south Louisiana, told the board and legislators later in the day that the current model of delivering safety net care through the state hospitals is "unsustainable" over the long term.
There has never been any medical treatment available to prevent Clostridium difficile. But in findings presented Thursday at the 2012 Annual American College of Surgeons Clinical Congress in Chicago, surgeons report success using a medicine called intestinal alkaline phosphate (IAP) to prevent C. difficile infections in tests on mice. "According to the CDC, C. difficile is linked to about 14,000 U.S. deaths every year," says Dr. Richard Hodin, a surgeon at Massachusetts General Hospital and the principal investigator of the study. In the study, Hodin and colleagues found that giving IAP to mice on antibiotics resulted in a 10-fold decrease in C. difficile bacteria in their stool, as well as a 10-fold decrease in in inflammatory marker called IL-1.
Since 1996, when Congress passed the Health Insurance Portability and Accountability Act, or Hipaa, patients have had the right to read and even amend their own records.In fact, few patients have ever consulted their own records. Many physicians also remained hesitant to share their notes, part of the patient’s records, because of concerns that such openness might have harmful effects on both their patients’ well-being and their own practices. Some worried that mention of minor abnormalities in laboratory values—for example, a slightly elevated prostate specific antigen or white blood cell count—could cause patients to worry unduly about some dread disease. Those fears, it now turns out, were largely unfounded.