CMS recently granted an extension for LifeMasters Supported Selfcare's Florida demonstration project. The news was quite a departure from other recent CMS developments in DM. Chris Selecky, CEO of Lifemasters, speaks about the company's Florida demonstration project and what Lifemasters learned from the demo.
Many community and rural hospitals rely heavily on Medicare and Medicaid reimbursement, so I doubt that any of you were too surprised by President Bush's budget proposal, which seeks to rein in Medicare costs by reducing payments to hospitals. Even if hospitals receive a reprieve from reimbursement cuts this year, the current reimbursement rates likely won't last too much longer. Medicare's projected 75-year shortfall is $34 trillion, and according to a recent article in Fortune, Alan Greenspan cited Medicare as the greatest threat to the U.S. economy.
So you know that one of your largest payers will probably be paying you less in the near future. What are you going to do about it?
If you answered "I don't know," you'd better figure it out soon. But the thing is, focusing on long-range issues is easier said than done for many small hospital leaders. One of the phrases that I hear repeatedly among hospital executives and industry experts is, "Rural hospital leaders wear multiple hats." Yes, that's one of the most overused phrases in healthcare--right behind, "There is no silver bullet." But that doesn't make it any less true. Senior leaders in small community and rural hospitals do in fact juggle multiple responsibilities that can leave them mired in the daily operations of the hospital.
But an effective leader needs to spend more time focusing on the future than solving day-to-day problems, industry experts say--even though breaking free from the daily grind can be a challenge. Last year I spoke with Jill Fuller, chief nursing officer at 70-staffed-bed Prairie Lakes Healthcare System in Watertown, SD, on what is needed for hospitals to be successful. She says that executives have to learn how to give up control and quit viewing the organization as a machine, because the delivery of healthcare is a complex system with many moving parts. "I think that a lot of us are out of the old machine age, and we have to change that," says Fuller.
Experts contend that senior leaders should set the direction of the organization, motivate employees around those goals, and empower managers to figure out the details. This means that hospital executives should be prepared to be surprised every once in a while, notes Fuller, whose hospital is actively involved in the Transforming Care at the Bedside initiative sponsored by The Robert Wood Johnson Foundation and the Institute for Healthcare Improvement. TCAB seeks innovative ways to improve the quality of patient care and increase nursing staff engagement.
Surprises or not, senior leaders have bigger things to focus on than hashing out the details of a new nursing-care delivery model or a plan to reduce inpatient falls--like, how to keep the lights on when your largest payer cuts your reimbursement.
I would like to hear how you plan to diversify your hospital's revenue stream in the face of reduced Medicare payments. Please drop me a line at the e-mail below.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com
Is your fundraising or awareness campaign not going as well as you may have hoped? St. Baldrick's, the world's largest volunteer-driven fundraising event for childhood cancer research, has found a unique way to educate the masses and get people involved.
St. Baldrick's started in March of 2000 as a fundraising event centered on volunteers raising money to "go bald" in support of children and families affected by cancer. Now in its ninth year, the event has successfully raised more than $34 million for childhood cancer research and has shaved over 46,000 heads from 18 countries and 46 U.S. states in the process.
According to the St. Baldrick's Foundation, "Thousands of brave, bold, and bald shavees step up to be shorn year after year, becoming walking billboards for the cause of childhood cancer."
Another St. Baldrick's fundraising strategy allows supporters to raise awareness all year round. A company called ReActee.com has developed a system of raising awareness through T-shirts and texting. The T-shirts all have different sayings and different keywords on them. One T-shirt says, "Ask me why I'm bald" with a call-to-action: "Text Bald to 41411 to find out why."
Playing on people's sense of curiosity in an age of technological advancement, texting the keyword prompts an automatic response: "Because I stand in solidarity w/ the 160,000 kids who are diagnosed w/ cancer each year. Go to StBaldricks.org to help!"
Another shirt says, "Get Bald" with the call-to-action, "Text Baldie to 41411." That keyword prompts the message: "Cancer's the #1 disease killer of kids in the U.S. Be brave, get bald, & help Conquer Kids Cancer. Go to StBaldricks.org to help."
"So far it's been a big hit," says Rachel Black, media relations coordinator for St. Baldrick's. "Looking at our numbers from ReActee we've had nearly 80 transactions. That means this alone has raised nearly $800. It's really a great opportunity and a new way to spread the word." In addition to be an inventive way of raising awareness, 20 percent of each T-shirt sale goes to the foundation's cause.
Kandace McLaughlin is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kmclaughlin@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
In a meeting near Washington, DC, leaders from the Mayo Clinic listed the steps they hope the next president will take to fix the U.S. healthcare system. Mayo's list touches on issues regularly debated by presidential candidates, but also ones that are not, such as changing the way care is paid for to reward better-performing doctors and hospitals.
Florida's hospital leaders are urging state legislators to reject a proposal to eliminate the state's planning process for new hospitals. The hospitals warn that the proposal would further destabilize a healthcare system already bracing for cuts in funding to care for the elderly and poor, and one that is grappling with serious shortages of doctors and health workers. Eliminating health planning for new hospitals would lead to an explosion of small, "limited service" hospitals and a two-tiered hospital system in the state, the hospital leaders said.
According to a study from researchers at the Harvard School of Public Health, elderly Hispanics throughout the United States tend to get inferior care. The study reported that Medicare data from 2004 reveals that hospitals with high percentages of Hispanic patients tend to have slightly lower quality indicators for heart attacks, congestive heart failure and pneumonia.
Texas health insurance rolls for children of the working poor swelled by about 7 percent in the past month, but much of the gain was offset by having fewer children on Medicaid. Enrollment in the Children's Health Insurance Program increased by some 24,000 youngsters to about 382,000 in that time. This marks the highest enrollment level in three years, the state reported.
Advocates for Grady Memorial Hospital in Atlanta are protesting the planned appointment of several prominent Atlanta businessmen to the new nonprofit hospital board. The activist group said some proposed board members have conflicts of interest and are not concerned about the hospital's poor patients. The existing board will soon announce members of the new nonprofit board, which will have power over decisions regarding budget, policy and the hospital's top managers.
A new study in the Journal of the American Medical Association found that widespread screening of patients for MRSA in a Swiss hospital did not reduce the number of hospital-acquired infections and wasn't cost effective. The results are sure to fuel an ongoing debate in over how best to control the growing epidemic of MRSA infections. Some experts believe hospitals need to test large numbers of patients and isolate and treat people who prove positive, but other experts argue this approach is inefficient.
A study demonstrates there are security risks with implanted devices that help regulate heartbeats and use wireless technology, say researchers. Authors of the report said that they were able to "hack" into implanted devices and retrieve information from the device in an unauthorized fashion. Researchers downplayed the immediate risks of the findings, but added that it is important to start thinking about computer security and privacy measures as medical devices use increasingly complex technology.
