Three patients have died since January at Eastbourne District General Hospital in England after being infected with the C.diff superbug; officials say the superbug has contributed to another 10 deaths. Seventeen additional patients are now being treated for the infection. Hospital officials blame the incidents on a higher than average number of admissions over the winter months for "flu-like symptoms and chest infections," making patients more vulnerable to contracting the superbug.
The Certification Commission for Healthcare Information Technology plans to speed development of its advanced technology certification programs to keep pace with federal health IT initiatives. The Commission said that it will accelerate the rollout of its Advanced Clinical Decision Support and Advanced Security programs. Originally slated for completion in 2011, those programs will now be finished in the 2009-2010 development cycle, which begins July 1 and runs through June 30, 2010.
For the past three and a half years, Jason Yap, MD, has promoted Singapore as a destination for medical travelers seeking advanced patient care.
During that period, Yap led international marketing at SingaporeMedicine, a partnership committed to strengthening that country's position in Asia's medical industry.
Yap continues to see Singapore as a medical travel destination, but now from the provider's point of view. He recently took over as marketing director for Raffles Hospital, a 380-bed tertiary care hospital and the flagship hospital of the Raffles Medical Group, a private healthcare provider in Singapore and South East Asia. In his new position, Yap will try to integrate Raffles "into the newly globalizing healthcare networks" around the world.
"When I started, the media talk was all about Thailand and India, and Singapore was barely mentioned—a strange situation considering that Singapore has been the destination of choice in the region for many decades," Yap said in a recent e-mail to me. "Today, it would be fair to say that Singapore is much better known . . . countries like South Korea, Taiwan, Australia, and even Armenia have publicly commented that they like or will follow Singapore's example."
Yap is responsible for marketing Raffles Hospital to both local and international customers. The facility sees patients of more than 120 nationalities, including expatriates in the region, and Yap estimates patients come from more than 60 countries.
He says medical travel growth in the region has the potential to help, rather than hurt, the business of healthcare in the United States.
"While outsourcing is considered a bad word by many, it does offer a way to reduce the sheer number of dollars spent on healthcare, and may provoke compensatory adjustments that bring the cost structure of healthcare in the U.S. more in line with the rest of the world," Yap said.
Although there are some in the United States who are actively working against medical travel to Asia, for example, Yap says they need to understand the relative sizes of the nations' healthcare economies.
"There simply isn't enough capacity in the rest of world to really threaten the U.S. healthcare economy," Yap said, although adding that some providers, like orthopedic surgeons, may suffer some loss if medical travel becomes more common.
"The bottom line here is that the total value of all global medical travel today is possibly less than the year-on-year inflation of U.S. healthcare costs," he said.
The dire state of the U.S. economy has led some to put off doctor visits, and the high cost of American healthcare has led to reform efforts by the Obama administration. But while it's true that many people have much less money and therefore less ability to travel specifically for medical treatment, some have found that seeking cheaper, good quality healthcare becomes all the more important, Yap said.
"Patients travel because their home country does not provide the healthcare they seek in terms of availability, affordability, quality, and accessibility, and experience," Yap said.
Each medical travel destination has different dynamics, he adds: Singapore receives patients from Indonesia for higher quality and reliable healthcare, from the United States for cheaper procedures, from India for procedures unavailable there, from the whole of Southeast Asia for plastic surgery.
"In a sense, there is no single market for medical travel as it is a mass of niche markets," Yap said. "There are many niches which can continue to grow."
Yap says he is confident the medical travel business will expand in the future and possibly see a huge increase once the economy improves.
"Some healthcare providers have reported a flattening of demand," Yap said of the medical travel business. "Just as during the SARS year of 2004 and the Asian financial crisis in 1998, many elective procedures are postponed. Incidentally, we saw booms following both of these two down periods as the pent-up demand is released."
With the global healthcare business continuing to attract medical travelers, accreditation by organizations such as The Joint Commission International may be more important to travelers looking for a legitimate destination for their medical needs.
Raffles Hospital, for example, began looking at the JCI system in 2004 and implemented many of its constructs, Yap says. He adds that while there was much less attention paid to obtaining the actual certification itself because local patients did not demand it. Earlier this year, Raffles achieved JCI accreditation after having already implemented much of its processes.
"In the coming healthcare globalization, the ability to explain and assure the patients of the quality of care will become increasingly important, especially for newcomers to international healthcare and to newly-built facilities," Yap said.
Ben Cole is an associate online editor with HealthLeaders Media. He can be reached at bcole@healthleadersmedia.com.Note: You can sign up to receiveHealthLeaders Media Global, a free weekly e-newsletter that provides strategic information on the business of healthcare management from around the globe.
Congress is poised for a battle over whether a healthcare overhaul should include a new government-run health plan to compete with private companies in the effort to cover the uninsured. Democrats typically see more government involvement as a good way to check the private sector and help control costs, while Republicans fear the government will have unfair power over the market. The matter is likely to come to a head first in the Senate Finance Committee, where Chairman Max Baucus has pledged to write a bipartisan bill.
Doctors working at Texas-based JPS Health Network clinics are often forced to send patients to the emergency room to get them admitted. Necessary equipment and medical supplies are also missing, and JPS doctors still would not recommend family or friends to seek treatment at JPS facilities, according to a recently released survey of the physicians working for the taxpayer-supported public hospital system. But the physicians gave JPS' new administration high marks as doctors and hospital executives have formed teams in recent months to address the widespread deficiencies identified in the survey.
Proposed Medicare Advantage cuts and subsequent premium increases could force millions of seniors into traditional Medicare plans without care coordination and would shift more costs onto beneficiaries, according to a Blue Cross Blue Shield Association official.
Alissa Fox, senior vice president in the office of policy and representation at BCBSA, which covers 1.6 million Medicare Advantage enrollees in 42 states, the District of Columbia, and Puerto Rico, said the Obama administration's proposed 5% Medicare Advantage payment cuts to private insurers could increase beneficiary premiums by $50-$80 per month, which will force many, particularly low-income seniors, into traditional Medicare without supplemental coverage. That $50-$80 premium increase would happen if insurers passed the full payment cuts onto members, although they could also combine a smaller premium increase with service reductions, said Fox during a Monday press conference.
The Obama administration and Democrats have criticized the Republican-backed Medicare Advantage programs because they cost 14% more on average to care for than Medicare fee-for-service beneficiaries.
However, Medicare Advantage supporters, including Fox, said a benefit to Medicare Advantage is that it coordinates care for 10 million beneficiaries, which is especially important for seniors with multiple chronic illnesses, who take multiple medications and visit various doctors. That coordination of care is not present in traditional Medicare because it doesn't pay doctors for care coordination, Fox said.
Rather than across-the-board Medicare Advantage cuts, Fox said CMS should review how it pays for services, improve quality through pay-for-performance programs, and target insurers that are upcoding as a way to make more money.
"We think that there are ways to reform the program. We think it should be made more efficient. We think it should be rewarded for demonstration quality," said Fox. CMS must finalize rates by April 6, and BCBSA has already sent its comments regarding Medicare Advantage payments cuts to the federal government, said Fox.
However, beyond the 2010 payment cuts, Fox said she is also concerned about future hits to Medicare Advantage. For instance, as part of his proposed 2010 $3.1 trillion budget, President Barack Obama proposed that one-third of a $634 billion healthcare reform fund come via Medicare Advantage cuts.
"When you look at this, you need to really look at what it does to Medicare beneficiaries, and you need to make sure that the premiums are stable and predictable," said Fox.