Blue Cross Blue Shield of Massachusetts has captured the public's attention, although not the way it would have liked, as reports of millions paid to the insurer's former CEO and hefty stipends paid to board members sparked outrage. The outcry grew big enough to force Blue Cross board members to vote to suspend their own payments and to lead the insurer to make promises to curb excessive payouts to executives. There's just one problem: Those steps will do little to fix soaring healthcare costs. US health care spending hit $2.5 trillion in 2009, increasing by about $600 billion from 2004, according to the Centers for Medicare and Medicaid Services. Nearly two-thirds of the increase was driven by rising costs in three areas: hospitals, which accounted for 33% of the increase; doctors, which accounted for 19%; and prescription drugs, which accounted for 10%. Administrative costs, which would include payments to board members, accounted for about 5% of overall healthcare cost increases.
At Saint Anne's Hospital in a struggling mill town south of Boston, MA, an emergency room designed for 20,000 visits a year handles double that. Patients lie wrapped in blankets in doorless examination rooms a few steps from the ER's reception desk. Storage gets so tight in the surgery center that diagnostic equipment sits behind a line of red tape in a hallway. "It's so cramped," said CNO Carole Billington, who started working at Saint Anne's 26 years ago in her hometown of Fall River, where unemployment recently hit 17%. But Billington believes the situation at St. Anne's is improving — thanks to the deep pockets of Cerberus. The Wall Street buyout firm last fall acquired Caritas Christi, the hospital chain that included Saint Anne's and five other hospitals in the Boston area. Now Cerberus wants Miami-Dade's beleaguered Jackson Health System.
President Barack Obama is encouraging states to develop their own healthcare plans if they want to, but his announcement of that policy didn't mean much to most governors; right now, they haven't shown signs that they've got alternative plans. For two governors, however, the president's announcement carried real significance. Those two are Democrats Peter Shumlin of Vermont and John Kitzhaber of Oregon. Shumlin is promoting a single-payer system that would cover every Vermonter free of charge; Kitzhaber is drawing up a radical change in the way health services are delivered. Both would gain from greater flexibility. Under congressional legislation that the president now endorses, states could apply for an exemption from key provisions of the federal law that would otherwise take effect in 2014.
Even amid budget pressures, the economic downturn has been beneficial for Howard County General Hospital in one key area: nurse staffing levels. During boom times, the Columbia-based facility, like many hospitals around the country, suffered from lingering nurse vacancy rates that required temporary workers to fill in. But since the recession, the hospital has eliminated vacancies and increased the number of full-time permanent nurses. That's helped the hospital's bottom line, allowing it to expand services that generate revenue at a time when operating profits and investments are struggling to rebound. The reason: Retired nurses suffering financially -- perhaps from having lost jobs in second careers or having spouses who did -- returned to one of the precious few sectors that is hiring in large numbers. Meanwhile, part-timers applied for full-time positions and those on the verge of retiring postponed their plans.
No more anxiously waiting on hold for a doctor's office to make an appointment, refill a prescription, check test results or ask a question. All of that can now be done on-the-go. MyChart — an iPhone, iPad, iTouch application that provides easy access to medical records — made its local debut last week, to anyone who is a patient within the University of Utah Health Care system of hospitals and clinics. "We just view this as another opportunity to put the patients first in terms of care and to be able to provide additional services for patients that make receiving and monitoring their care more and more convenient," said Rob Lloyd, executive director for the U.'s ambulatory services and community clinics. For the past 10 years, physicians within the university's healthcare system have been using an electronic medical record to organize patient information. In the past year, that information has been made accessible to patients online, and now, "we've gone from the computer to in my pocket," said Curtis Newman, U. Health Care information services director.
When one of Nashville?s biggest physicians groups wanted to start offering MRI scans in-house, it had to secure the approval of a state agency that governs whether new hospitals, medical equipment and health services can be added in a community. Mark Grasela, CEO with Heritage Medical Associates PC, estimates the company spent at least $35,000 in legal costs and application fees to win the required clearance for its MRI project. Now, Grasela leads a coalition of 25 medical practices with a total of 1,100 doctors around the state that hopes to get a bill through the legislature to remove medical equipment and services from the state's certificate of need requirements. If the rules change, only building brand-new hospitals and clinics — or expanding or moving them to new locations — would require review by the state Health Services and Development Agency.