The daily life of a large, under-resourced, urban public hospital, a new documentary offers no experts and no statistics, just a rare fly-on-the-wall look inside an overwhelmed and at times overwhelming system and its impact on patients and staff. "The Waiting Room"—and there is indeed a lot of waiting going on—is set in Highland Hospital in Oakland, California. The film has been screening at film festivals around the country and has already won several awards. It will get a national theater release in the fall, and will air on PBS' "Independent Lens" next year.
Anchoring bias is often considered the Achilles' heel of diagnostic reasoning. It's as though our brains close ranks around our first impression, then refuse to consider anything else. Once a patient is "billed" as a heart attack, or gastroenteritis, or anxiety, we view every data point through that particular lens. If the data doesn't fit, we tend to assume that it's merely because the illness is presenting atypically rather than that our diagnosis might be wrong or incomplete. Anchoring bias casts an even longer shadow in today's shift-oriented medical world, in which patients are serially handed off from one team to another. The label that is attached to them takes on a life of its own.
States that reject the law’s Medicaid expansion risk leaving behind many of their low-income uninsured residents in a coverage gap already being called the new "doughnut hole"—a reference to a Medicare gap faced by seniors. If every state were to reject that Medicaid expansion—as the Supreme Court ruling now allows—some low-income people would still be picked up by other coverage provisions meant to help the middle class. But nearly 11.5 million uninsured people below the federal poverty line would be left behind in a new coverage gap, according to recent estimates from the Urban Institute.
Disappointing near-term revenue and profit trends could take a back seat to optimism about Obamacare leading to mergers and acquisitions. The nation's top court upheld Obamacare in June, and on July 9 managed care giant WellPoint said it would buy Amerigroup, a managed care specialist focusing on Medicaid and Medicare plans, for $4.9 billion. That deal sparked speculation other sector giants, including Humana, Cigna, Aetna and UnitedHealth, would also look to make acquisitions. With a weak earnings outlook for healthcare providers as they brace for the impact of Obamacare, M&A is expected to be one of two key topics of discussion for CEOs.
TriStar Health and National HealthCare Corporation have announced an alliance aimed to provide patients across Middle Tennessee with a higher level of care as they transition from hospitals to recovery. The organizations will work together to devise new practices and protocols not only to streamline the discharge process but also to help post-acute facilities, like skilled nursing facilities and home healthcare workers more effectively manage and treat conditions. Both organizations will develop integrated intervention strategies that will span the transition of patients' care from acute to post-acute care and vice versa.
Circuit Court Judge Jimmy Pool last week reversed regulators who previously had approved Trinity Medical Center's relocation, saying it would violate the State Health Plan and Alabama law. Trinity wants to spend more than $280 million to buy and complete the unfinished hospital U.S. 280, and relocate there from its Montclair Road campus. Regulators approved the plan in 2010, but Brookwood Health Services and St. Vincent's Health System filed suit to block it, arguing that it would cost them tens of millions of dollars in lost business and that Trinity misled regulators in seeking the hospital's approval.