Audits that found wasteful spending in New Jersey's healthcare programs for the poor are raising questions about whether the state could manage a universtal health-insurance program for residents. The audits found wealthy people enrolled in health programs for the poor, paltry oversight of healthcare programs, and wasteful spending. "If the state can't handle a small health-insurance program, then what confidence can anyone have that it will do a better job when it tries to cover everyone in New Jersey?" asked New Jersey Assemblyman Richard Merkt.
In parts of the United States, market and medical forces has been widening the gap between the supply of primary care physicians and the demand for their services. Now in Massachusetts, the imbalance is being exacerbated by the state's new law requiring residents to have health insurance. About 340,000 of Massachusetts' estimated 600,000 uninsured have gained coverage when the law took effect. Many of these patients are now searching for doctors and scheduling appointments for long-deferred care.
An experiment to see whether the Medicare system could prevent expensive hospital visits for people with chronic conditions has suggested that such an approach may cost more than it saves. Under the experiment, nurses periodically place phone calls to patients to check whether they are taking their drugs and seeing the right doctors. Medicare says the experiment so far has not reduced medical bills enough to offset the program's fees--as much as $2,000 a year for each patient.
The Maryland General Assembly has passed legislation that is intended to provide long-term stability for the Prince George's County hospital system. The bill envisions a series of steps county and state leaders must take cooperatively within days and months of its signing by the governor. The agreenents might prove difficult, however, because county and state leaders have tussled over the legislation. Senators were concerned with a mandate in the bill that county and state leaders agree to a long-term funding plan for the system within 60 days. Otherwise, the county and Maryland might be released from the obligation to provide interim funding to keep the system running.
A new detection method finds that medicine mix-ups, accidental overdoses and bad drug reactions harm roughly one out of 15 hospitalized children, a number is far higher than earlier estimates. The findings bolster concerns already heightened by well publicized cases like the accidental drug overdose of actor Dennis Quaid's newborn twins.
For chronically ill patients in their last two years of life, Medicare spends an average of $59,379 in New Jersey but only $32,523 in North Dakota. The difference is due primarily to patients getting more hospital care, but not necessarily better care, according researchers at Dartmouth Medical School. Vast differences such as this in spending patterns nationally points to why policymakers need to focus on volume when it comes to restraining costs, instead of just on the price of a particular service or on expanding health coverage to the uninsured, researchers say.
In an effort to alleviate the local and national shortage of healthcare workers, Bellevue (WA) Community College has received a $1.8 million federal grant from the U.S. Dept. of Labor. The funds will be used to expand the school's nursing program and add training in healthcare programs.
A report from the Massachusetts Health Quality Partners shows that the the state's primary care physicians continue to outperform many of their national peers in terms of offering preventative care and helping patients manage their chronic conditions. The report suggests, however, that there's plenty of room to both improve outcomes and better manage healthcare spending.
The Orlando, FL, area's two largest hospital chains are using a promotional blitz to tout their respective cardiology services and attract heart patients. Both Florida Hospital and Orlando Regional Healthcare are trying to position itself as the region's leader in heart services. Both hospital chains have also made changes to speed care for heart-attack patients.
Joel Spolsky, one of my favorite Inc. magazine columnists, writes this month about the military tactic of "fire and motion"--firing at the enemy, then moving forward. As Spolsky writes, this concept is critical on the battlefield because, if you're the one shooting, your enemy can't shoot back because he's too busy diving for cover. And, as you move closer to your enemy, you've got a better chance of hitting him. Shoot and advance; shoot and advance.
Spolsky, who served in the Israeli Army and now runs a software company, says this fire and motion tactic serves him as well in the business world as it did on the battlefield. Successful companies constantly "fire and move," meaning they set their own agendas and force competitors to react.
There's a lot of shooting going on right now in healthcare. Retail clinics, complex service lines, spa-like services, and futuristic renovations--some healthcare leaders spend more time ducking for cover from their competitors than they do firing and moving. CEOs may be overwhelmed with the urge to follow their competitor's agenda, but small hospitals, like small companies in any industry, can't afford to spend their time and energy responding to someone else's fire, especially when their enemies have bigger guns.
Instead of spending so much time responding to your competitor's agenda, Spolsky says, you should spend more time focusing on your own. Sure, you need to know what your competitors are up to, but many organizations focus more on their competitors than they do their own customers.
Here's an example: About a year ago, two large Boston hospitals announced their plans to partner with the New England Patriots and open a sports medicine and outpatient surgical clinic in Foxborough, a town 30 miles from Boston and home to the Patriots' stadium. Community hospitals in the area had mixed responses.
One, Sturdy Memorial Hospital, told the local media they weren't really concerned about the move and announced plans of their own to open an advanced oncology radiation center nearby. Another, Caritas Norwood Hospital, spent its time protesting the arrangement in local newspapers. One hospital returned fire, and moved forward with its own successful strategy, while the other dove for cover.
As Spolsky writes, "A minute spent understanding competitors is a minute spent not listening to customers, potential customers, and near-miss customers." Rather than opening, say, a new retail clinic because your competitor has one, you might be better served researching your customers' needs and developing your own artillery. What are the underlying reasons for the clinic's popularity? What does the convenient care model say about your customers' needs? If customers want to get in and out quickly--day or night--what can you do to address this need?
You're more likely to come up with a service line that meets your customers' actual needs if you focus on your customer rather than blindly adding new services based on your competitors. And those new services are what will enable you to shoot and advance rather than hiding behind a bunch of sandbags, waiting for your competitor's next shot.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
