When officials at The Jewish Hospital-Mercy Health in Cincinnati launched a high-priority initiative in 2009 to bring down its skyrocketing C. diff rate, it took far less time and money than they expected to get dramatic results. With better controls on antibiotic use, new room-cleaning strategies, and revamped standards of care, the hospital cut its C. diff infection rate 50% in just six months—a period when the average number of cases dropped from about 16 a month to fewer than half that number. And the decline continues: From January through March this year, the infection rate was down nearly 80% since the initiative began, with no change in occupancy rates.
Two nonprofit hospital companies with a major presence in Orange County announced plans for a partnership as the federal healthcare law spurs more consolidation nationwide. St. Joseph Health System and Hoag Memorial Hospital Presbyterian said Wednesday they have agreed on an affiliation among seven of their hospitals in Southern California. They emphasized it was not a merger, but a new holding company will be formed to better integrate medical care and to eliminate duplicative services. The affiliation is subject to approval by the California attorney general's office.
The healthcare law makes a big bet: Tethering providers' salaries to the quality of care they provide will improve outcomes. A team of researchers at the British Medical Journal, however, sound a note of caution. Where some see potential for cost savings, they see a system that doctors could easily game. Steffie Woodhandler, Daniel Ariely and David Himmelstein have an editorial (that goes with an accompanying article) outlining all the reasons that pay-for-performance may not work in healthcare. Chief among them is the problem of "up-coding."
HCA's robust profit growth has raised the value of the firms' holdings to nearly three and a half times their initial investment in the $33 billion deal. The financial performance has been so impressive that HCA has become a model for the industry. Its success inspired 35 buyouts of hospitals or chains of facilities in the last two and a half years by private equity firms eager to repeat that windfall. HCA's emergence as a powerful leader in the hospital industry is all the more remarkable because only a decade ago the company was badly shaken by a wide-ranging Medicare fraud investigation that it eventually settled for more than $1.7 billion.
The Obama administration this week will try to encourage reluctant U.S. states to move forward with health insurance exchanges amid fears that time is running out for states to act on a reform provision meant to extend coverage to millions of low-to-moderate income uninsured Americans. The U.S. Department of Health and Human Services has scheduled four regional meetings this month to discuss the exchanges and other aspects of President Barack Obama's healthcare reform law with state officials and others.
Physicians and attorneys have both expressed support for the changes, saying they will help reduce unnecessary lawsuits and improve patient safety. The changes, which were included in high-profile legislation recently signed by Gov. Deval Patrick to reduce healthcare costs, include establishing a 182-day "cooling-off" period as both sides try to reach a settlement, requiring the plaintiff and defendant to exchange information and allowing healthcare providers to acknowledge making a mistake without it being used as an admission of liability. Additionally, it will increase the maximum amount of compensation for patients who are legitimately injured by a non-profit hospital and not a doctor or nurse from $20,000 to $100,000.