Forums held in Minneapolis and St. Paul, MN, were among thousands held across the nation in response to Obama's health transition team's request on his Change.gov website. The website outlines healthcare problems and provides discussion questions. Moderators are asked to e-mail feedback and suggestions from the public meetings to the team, led by Health and Human Services Secretary-designate Tom Daschle.
Despite a stiff upfront cost, officials lauding a new health clinic within Dallas City Hall as both an elixir for lost labor hours and a practical method for promoting general employee wellness. Through the clinic, which provides primarily free services to employees, their immediate families and some municipal retirees, Dallas officials aim to reduce the city's overall healthcare costs by 20%. The city is contracting with medical service provider Concentra to operate the clinic.
Texas lawmakers may be ready to force pharmaceutical companies to disclose payments to doctors. Mirroring a national trend, two Texas lawmakers have filed bills to require drug manufacturers to report all payments to Texas healthcare providers, including consulting fees and honoraria, gifts, and travel perks.
Texas Health Resources Inc. will announce that it is creating a new company with an Irving-based partner to help doctors better manage their businesses. The new venture, Texas Health MedSynergies, is expected to save THR and physicians money by implementing electronic health records and eliminating communication miscues among general practitioners, specialists and hospitals, said THR officials. MedSynergies Inc., a privately held medical revenue management company and THR's partner, also is expected to help physicians improve their patient billing and insurer reimbursement tasks.
Des Moines, IA-based Mercy Hospital Medical Center offered its employees the chance to voluntarily resign from their jobs or switch from full-time to part-time status, according to a memo sent to Mercy's more than 6,900 employees. The voluntary staff reductions come as many Des Moines-area businesses face cutbacks and job eliminations in the face of an economic recession. However, Mercy officials emphasized that the offer was not strictly about the economy: The hospital views the offer as a benefit to employees who are planning to change their status with the company.
Efforts to use information technology to improve U.S. healthcare will fall short of the potential seen by health leaders and could even set back the cause, according to a National Research Council report. A committee of academic and industry experts found the information systems at eight U.S. medical centers noted for leadership in information technology failed to provide timely, efficient, safe, and patient-centered care. "The committee observed a number of success stories in the implementation of healthcare IT," the report noted. "But although seeing these successes was encouraging, they fall far short, even in the aggregate, of what is needed to support the Institute of Medicine's vision of quality healthcare."
You readers have been especially prolific lately. I've wanted to share your thoughts with everyone else for some time now, but I've been running off at the mouth myself so much lately with predictions for the new year and recaps of the one just past that I haven't had the space. But that all changes this week.
Allow me to thank you, belatedly. In the past 18 months, this e-newsletter has become an invaluable connection for me to many important and influential folks that I would otherwise never have met. That helps me keep my finger on the pulse of what's important to you, and also helps me improve my coverage in HealthLeaders magazine each month. So without further delay, here are some of the most interesting comments I've received in recent months.
On my snarky news commentary about a "monument to healthcare excess" that may soon rise in Manhattan, one person in particular was perturbed. I'll admit my shot was fired in haste, but I stand by it. I also take issue with NYC being the "world's leading healthcare hub," but it's clearly not something that can be proved or disproved. Since I can't link to my original commentary, I'll reprint it here. The response runs after. I'll let you all judge who has the bigger conflict of interest—the writer or myself.
Developers in Manhattan are pitching a 60-story glass-and-steel tower on the island's West Side as an international showcase and permanent conference center for the healthcare industry. Supporters envision the building as a permanent exhibition center for hundreds of vendors to the medical industry, from hospital food and furniture suppliers to pharmaceutical companies and makers of X-ray machines and surgical devices, according to the article. Call me a cynic, but as the article describes it, I envision the building as a permanent version of the nauseating temporary booths vendors try to outdo each other with at the big healthcare trade shows—most of which are simply expensive tributes to excess. Perhaps they could add some penthouse apartments to house those ubiquitous "booth babes?"
Dear Mr. Betbeze:
Your Dec. 1 item about the highly-anticipated World Product Centre now being developed in New York missed the mark.
The World Product Centre is a visionary project that will reshape global healthcare. The 60-story, 1.5 million-square-foot center will be the world's first permanent international healthcare marketplace and education center. It will bring the most innovative medical devices, diagnostics, technology, pharmaceuticals, and healthcare services under a single roof. It will increase transparency in medical sales and lower healthcare costs worldwide.
Medical meetings and tradeshows are critical components of the international healthcare industry with more than 2,000 medical meetings and continuing medical education courses held in the United States each year. They should continue to operate as they currently do. The World Product Centre will complement these shows and meetings by adding a single location where a full array of medical products and services can be showcased on a year-round basis, and will provide a central meeting ground where technological synergies can take place.
New York already is the world's leading healthcare hub, so it is the logical location for a center of this kind. With close to 9 million international visitors to New York last year, it is the nation's No. 1 international destination, with more than 100 million passengers traveling though our airports.
The World Product Centre is scheduled to open in 2013. It will be a commanding addition to the global healthcare market.
Cristyne L. Nicholas, Former President and CEO of NYC & Company, the city's convention & visitors bureauThis one's a gem of a response to my Nov. 10 article on community benefit.
Dear Phil:
I think we can all agree that the original concept of the nonprofit community hospital run as a charitable cause by religious organizations has long since vanished. In its place are corporate businesses indistinguishable from their for-profit brothers and sisters (except for equity value).
Many nonprofit hospital/health systems report their "profits" in the media and talk about their "profitability." Ascension Health, the largest Catholic nonprofit, recently reported that it delivers charitable care valued at just over 2% of revenue. Fortune 500 corporations have records of giving that rival that. Of course, 2% is better than nothing, and this doesn't make them bad people. It does, however, further expose the nonprofit masquerade. Many hospital organizations operate the same as for-profit companies and should logically be converted to for-profit corporations. But it is a separate issue over whether these healthcare "corporations" should be subject to federal and state income taxes. A significant percentage of hospital revenue (indeed healthcare revenue) comes from state and federal government, which now accounts for more than $1 trillion in annual payments into the healthcare system.
It makes marginal sense for any hospital or healthcare provider to be subject to income taxes on profits derived from revenues received from government. The real issue Congress should be addressing is whether any healthcare player, profit or nonprofit, should be subject to income taxes at all. We have runaway healthcare costs with government the largest single payer and seeking to play a greater role by establishing universal healthcare. Wouldn't it make more sense to suspend income taxation on all healthcare facilities, possibly physician practices, and yes, even health insurers; for-profit or nonprofit? We know that taxation throughout the healthcare industry is as flawed as its financial incentives. Employers get deductions, but individuals do not; one hospital in town pays, the other does not; and on it goes.
Congress can relieve a degree of financial pressure in the industry just by changing how healthcare is taxed, which is within its power; rather than trying to distinguish whether a healthcare organization is operating for profit or not. The constant trading of dollars back and forth among healthcare providers, health insurers, and government is a waste of time and resources and does not give us the most healthcare for the dollar. I'll leave the issues of local property real estate taxes, charitable contributions, and equity value for another day. We should not have to have discussions over which organization provides the greater community benefit—and healthcare is different from Wal-Mart. The federal government isn't Wal-Mart's biggest customer.
Robert L. Trinka, Chairman & CEO PhyhealthFinally, here is a quick hit in support of my column Good Thing Hospitals are Closing. And by the way, I'll run a rebuttal column from a hospital CFO in my "Finance Forum," section in an upcoming issue, just in case you thought I was cherry-picking the responses that agreed with me.
Phil,
Excellent article and very refreshing to read the truth—if businesses can't make it, then they should be allowed to fail and fade away. New healthier businesses (healthcare delivery systems) will emerge from the ashes and we will be better off for it.
Patrick D. Barron,President and CEO Emergency Medical Care, LLC
Philip Betbeze is finance editor with HealthLeaders magazine. He can be reached at pbetbeze@healthleadersmedia.com.Note: You can sign up to receiveHealthLeaders Media Finance, a free weekly e-newsletter that reports on the top finance issues facing healthcare leaders.
Hospital emergency departments are full of patients who don't belong there. I'm amazed at some of the stories I hear from a friend of mine who is a nurse practitioner in an ED. For instance, the mother who showed up with her child who had lost a tooth—she wanted to make sure it wasn't going to get infected. Or the parents who brought in a child who'd had a fever for all of five hours (and hadn't given him Tylenol yet). It's not just neurotic parents, either; there are scores of people who come in for a sniffle or sore throat.
It's not news that EDs are overcrowded, plagued by long waits, and have patients lining the hallways. Unfortunately, the current economic downturn means that the uninsured ranks will likely grow, prompting even more patients to use the ED as their primary-care provider. Still, I'm not sure what senior leaders can do to prevent patients who don't even need a doctor's visit from coming to the ED. It's not like they can post a sign listing the ailments that don't warrant a trip to the emergency room.
According to recent reports, uninsured patients seeking primary-care at hospital EDs are not the main culprit behind the overcrowding issue, anyway. In an August 2008 report, the Centers for Disease Control and Prevention found that the uninsured make up 17.4% of ED visits. Patients with government-sponsored health plans and privately insured patients make up about 42% and 40% of the ED volume, respectively.
Spikes in the number of insured patients seeking treatment in the ED—especially the aging population—are the main driver behind the increase in ED visits, which has grown by 36% since 1996to about 119 million, the report says.
Senior leaders may not be able to post a sign banning patients with nonurgent conditions, but there are some steps they can take to ease overcrowding. For example, a growing number of hospitals have implemented fast-track EDs to help manage patients with nonemergent conditions in a more timely fashion. Memorial Hermann Memorial City Medical Center in Houston, TX, actually strives to give every patient a quick examination by a nurse or other health professional within five minutes of arrival and then get the patient to a physician within 30 minutes. Other health systems have policies in place to redirect patients who show up at emergency departments without emergency symptoms to local community health clinics or urgent care centers—or, at the very least, educate them about local clinics where they can seek treatment for nonurgent conditions next time.
When designing these programs, hospitals should consider ways to educate or better meet the needs of a growing elderly population that is frequenting the ED more than ever. Hospitals may also want to reevaluate their patient education materials for new parents, because the highest ED rates per population were for children under the age of 1, according to the CDC report. There are more than 900 visits per 1,000 population for children 12 months of age and younger, so essentially almost every newborn visits the ED during their first year of life.
On the other hand, if you are a cash-strapped hospital, perhaps the neurotic parent may not be such a bad thing—but only if they're insured.
Carrie Vaughan is leadership editor with HealthLeaders magazine. She can be reached at cvaughan@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Corner Office, a free weekly e-newsletter that reports on key management trends and strategies that affect healthcare CEOs and senior leaders.
Many employees and managers are concerned about what will happen with the global economy, the U.S. economy, or even their own careers. According to experts, 2009 will likely be a tough year, which is something managers and administrators must prepare for.
In this economic downturn, leaders must emerge stronger and more resilient. Business advisors urge leaders to watch the external forces that are driving change and be able to anticipate changes that will impact them and their organization.
