After a very bitter and public feud, the Bayonne Medical Center and Horizon Blue Cross Blue Shield of New Jersey announced an agreement last month that made the hospital in-network for subscribers. The dispute cast a large shadow on a bid by the ownership group of Bayonne Medical Center to purchase Hoboken University Medical Center. Some feared that customers of the state's largest insurer -- Blue Cross Blue Shield of New Jersey -- would be shut out of the the Hoboken facility. The parties said last month's agreement would extend to Hoboken and quelled some of those fears, but the fine print of the agreement has raised new concerns. Under the agreement, Bayonne Medical Center will not accept Horizon's NJ Health, an insurance plan available to the neediest residents under Medicaid, according to the insurer.
When it comes to paychecks, there are some pretty hefty ones on both sides of the fight between health care giant Sutter Health and its hospital nurses. According to Sutter pay records, 20 nurses at Alta Bates Summit Medical Centers in Oakland and Berkeley pulled in between $200,000 and $291,000 last year, thanks in part to overtime - way above the $136,000 average pay for the centers' 1,800 nurses. What's more, of the highest-paid nurses, five received more than $100,000 apiece in stand-by pay - just to be on call. But if you want to see some really hefty paychecks, look at the ones going to Sutter Health execs. Records that the company filed with the Internal Revenue Service in 2009 show that 20 Sutter Health bosses were paid more than $1 million. Topping the list, at nearly $4 million, was company CEO Pat Fry.
A data breach involving nearly 5 million people treated at military healthcare facilities over a 19-year period is raising questions about whether U.S. Federal Trade Commission rules supersede Health Insurance Portability and Accountability Act regulations. Last week, Tricare, the managed care arm of the U.S. government's Military Health System, disclosed that contractor Science Applications International Corp. had lost backup tapes containing personally identifiable information--including some health data--of about 4.9 million people. The tapes contained data from electronic health records used at military hospitals, clinics, and pharmacies in the San Antonio area from 1992 until Sept. 7, 2011. Unlike HIPAA, FTC regulations don't require entities to sign agreements with "business associates" that hold third parties to the same standards when handling sensitive data.
Hospitals that meet performance standards for treating kids with asthma aren't any better at keeping those kids from showing up in the emergency room with asthma problems in the future, according to new research. The results call into question whether the standards, used to grade the hospitals on their asthma care, are helpful if they don't translate into real patient improvements, researchers said. Specifically, hospitals following so-called process measures that encourage sending young asthma patients home with a plan for managing their condition did not result in the kids having fewer hospitalizations and ER trips. The problem, researchers said, may be that there's no way to make sure those asthma management plans were explained in a way that families understood, or that they followed doctors' recommendations at discharge.
Two mainstays of the Memphis community -- the Methodist Le Bonheur hospital system and nearly 400 local churches -- have teamed up for an innovative program that keeps church members healthy while reducing health-care costs. If not actually made in heaven, it's a match that has significantly benefited all parties. Other health-care systems are taking note. Methodist says 70% of its patients belong to churches. To help people get the care they need when they need it, the system assigns hospital staff, appropriately called "navigators,'' to work with volunteer liaisons at area churches that have joined the health system's Congregational Health Network. When a member of one of these congregations is admitted to the hospital, the navigator notifies the liaison. The liaison then plans a visit, if the member wishes, "so they have a support structure, not just the nurse and doctor," says Valerie Murphy, the liaison for her small church of six families in Millington, a rural area north of Memphis.
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted on-line by the Archives of Internal Medicine. Doctors' prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient's cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors' offices and hospital outpatient departments in 2009.