An unlikely battlefield in Texas' budget war is a hushed pink-and-blue hospital nursery, where 1- and 2-pound babies bleat like lambs under heating lamps and neonatal nurses use tiny rulers to measure limbs that are no bigger than fingers. State health officials, searching for solutions to Texas' multibillion-dollar budget shortfall, have set their sights on these neonatal intensive care units, or NICUs, which they fear are being overbuilt and overused by hospitals eager to profit from the high-cost care and by doctors who are too quick to offer pregnant mothers elective inductions and Caesarean sections before their babies are full term.
Although nearly 80% of domestic violence victims who report the incidents to police seek healthcare in emergency rooms, as many as 72% are not identified as victims of abuse. Of those who are, very few are offered adequate support. These findings from a new study point to a missed opportunity to intervene and offer help to women who suffer violence at the hands of an intimate partner. Karin V. Rhodes, MD, directs the Division of Emergency Care Policy Research in the department of Emergency Medicine at the University of Pennsylvania School of Medicine. She says "Emergency departments are a safety net for women with health issues of all kinds, but our study shows we're not doing a good enough job of assessing our patients' entire situation."
Urgent care centers, which handle a variety of acute and severe maladies from broken bones to flu and lacerations, are proliferating nationally. The industry has grown to 8,800 urgent care centers nationwide with $13 billion in revenue. They typically require no appointments and charge prices lower than emergency rooms but higher than family doctors. The number of urgent care centers has ebbed and flowed in recent decades and is now enjoying a resurgence, said Sam Steinberg, a Florida-based independent financial consultant for the healthcare industry. The centers, he said, are taking market share. "They're skimming a lot of business from the emergency rooms and from primary care doctors,? he said. ?And they're taking away good business: middle-class people with insurance who can go where they choose to go."
No one expects Landmark Medical Center in Woonsocket, RI, to suddenly shut down. Indeed a massive effort has been under way to assure its survival, in some form. The big question is what form that will be. It's a question made especially difficult by the absence of a statewide health plan. There is no consensus on which services are needed, in which locations, to best serve Rhode Islanders. Instead, the 11 acute-care hospitals compete based on their separate interests. All community hospitals in Rhode Island have been struggling financially. But Landmark is in an especially difficult position, serving many poor and elderly people with a high burden of illness. Half its revenue — an unusually high proportion — comes from the federal Medicare program for the elderly, which pays less than private insurers. Some 16% comes from the state Medicaid program for the poor, which pays even less. And for the minority of patients with private insurance, a state-sponsored study found that Landmark and other independent hospitals collect significantly lower rates than hospitals that are part of groups with clout.
As officials examine a proposal to sell three nonprofit hospitals and a number of outpatient clinics to Community Health Systems Inc., members of SEIU Healthcare PA are seeking to make the for-profit company?s past legal and labor relations troubles an issue. Last month, Mercy Health Partners President and CEO Kevin Cook announced plans to sell Mercy Hospital in Scranton, specialty hospitals in Tunkhannock and Nanticoke and a number of outpatient clinics to CHS, a Franklin, TN-based company that operates or leases more than 130 hospitals in 29 states. Officials at CHS and at Mercy have declined to comment on the sale price. SEIU Healthcare PA represents about 950 workers at Mercy Hospital. For months, it has been criticizing CHS through public meetings, billboards and a website. Among the union's concerns is that CHS has had rocky relationships with labor unions at several hospitals, most notably at Wilkes-Barre General.
Marcia Kravis is the rare conservatory-trained musician who loves it when her audience falls asleep. Thursday afternoons you can find her sitting in a corner of the emergency room at Thomas Jefferson University Hospital in Philadelphia, tapping a hammered dulcimer to set a mood of tranquility. She studied harpsichord at the New England Conservatory of Music and, after years of performing and teaching, trained as a music practitioner. She picked up the dulcimer in part because of something she'd heard in music-therapy class. She found the hammered dulcimer relaxes people who are stressed without suggesting the heavenly gates.