Marya Chaisson, MD, and Todd Liu of Griffin Hospital, in Derby, CT, talk about involving the community in Griffin's Patient Centered Care Council, which ensures services meet the culturally diverse needs of patients.
UBS investment banking firm has agreed to pay $100 million to HealthSouth of Birmingham, AL, to settle investor claims related to a 2006 class-action lawsuit over HealthSouth's accounting and financial reporting. This settlement, reached last month, answers investors' claims that UBS, as HealthSouth's investment bank, was aware of the accounting fraud. Along with the financial settlement, HealthSouth will receive a release of all claims by UBS.
University of Miami President Donna Shalala told 100 South Florida healthcare leaders that the key to making major changes was getting a consensus. Shalala, the former leader of Health and Human Services in the Clinton administration, noted the country had never "taken a giant leap" in any large social change without first getting agreement that there was a problem and then getting agreement on what the solution should be. The seven panelists who followed her during a discussion at UM's Wellness Center agreed that the system needed huge reforms, but there was no consensus about what should be done.
Global microfinance leaders met in San Francisco to discuss a new strategy to get the world's poorest borrowers to repay their loans: Keep them healthy. In 2007, Freedom from Hunger started its Microfinance and Health Protection Program at microfinance institutions in five nations, offering discount doctor visits, healthcare savings accounts, affordable medicines, and emergency healthcare loans. In most cases, customers were required to attend healthcare classes in order to get the small business loan. Philanthropists and anti-poverty experts who use microloans have noticed illness is the most common reason for default.
A massive computer crash that destroyed hundreds of the Texas attorney general's confidential documents may prevent scores of Medicaid fraud prosecutions. As much as 50% of the Tyler Medicaid fraud division's files were destroyed in July when a server being repaired by a state vendor would not restart. In an apparent oversight, the documents lost were not backed up. As a result, evidence crucial to convicting dishonest healthcare providers who ripped off the state's health insurance program for the poor may never be recovered.
The new independent board overseeing Cook County, IL's vast public health system wants an extra $103 million next year and permission to hire more than 400 new workers. The panel's chairman is defending the request as a needed first step before the troubled operation can be made more efficient, with fewer employees and more money collected from patients and their insurers. The board is also conducting studies to determine how to cut about 500 employees, although the 2009 spending plan calls for adding about 415 workers, mostly doctors and nurses. This is because the skills of those who are needed in new spots and those who aren't needed in their current posts don't match, said the health board chairman.
The U.S. government's $700 billion plan to bail out Wall Street will likely take a toll on both Democrat Barack Obama and Republican John McCain's plans to reform healthcare, according to a report in the journal Lancet Oncology. Policy experts quoted in the report said plans proposed by the candidates would need to be scaled back, but people quoted by the journal disagreed over which plan would take the biggest hit.
Kindred Healthcare, a Louisville, KY-based hospital operator and healthcare services company, has lowered its outlook for earnings in the third quarter and for the full year because of weaker-than-expected hospital performance. The company expects third-quarter earnings of between 1 and 3 cents a share, drastically lower than its previous guidance calling for earnings of 20 to 25 cents a share.
There is a nagging myth out there that it is the approximately 47 million uninsured people in this nation who are clogging hospital emergency rooms for routine care better suited to a doctor's office or a walk-in clinic.
A new study in the current issue of the Journal of the American Medical Association reaffirms what many already know—this is not the case.
The JAMA study, Uninsured Adults Presenting to US Emergency Departments: Assumptions vs. Data, looks at 127 previous studies of emergency medical and surgical care for uninsured adults and found that 53 of those studies carried assumptions about uninsured ED patients that weren't borne out by facts.
"The uninsured have become a scapegoat," says Manya F. Newton, MD, an emergency physician at the University of Michigan and an author of the study. "There is a belief among some people that the uninsured are choosing to be uninsured because they are lazy, and that if they worked harder they could get insurance and all our problems would be solved."
The JAMA study acknowledges that the uninsured population is growing. The numbers of uninsured in hospital EDs are growing, too. And yes, many uninsured use the ED because they lack access to primary care. All true.
However, the JAMA study identifies unsupported assumptions in a number of studies about the uninsured; namely, that they were the main cause of ER overcrowding; and that they have less-serious conditions than insured patients and use the ED as a matter of convenience.
"These studies weren't subtle at all," Newton says. "We see in quotes 'uninsured patients realize that no matter what complaint they have, even if it's not an emergency, they can get care in ED for free.' Or 'it is widely understood that the uninsured show up for non-urgent problems.' These statements are made with no citations," she says.
The CDC in August 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. The CDC also reports that ED visits increased 32% nationally from 1996 to 2006, from 93 million to 119 million visits. At the same time, the number of EDs decreased from 4,019 to 3,833, exacerbating crowding.
It's easy to understand why the general public—especially someone who's just waiting three hours for emergency care—might have an exaggerated sense of the problems that the uninsured are creating in the nation's EDs. Newton says it's difficult to explain why the myth continues to thrive among well-educated healthcare professionals who really should know better.
"It's easy to confuse anecdotes with data," Newton says. "If you are on the front lines of a busy emergency department, it's easy to remember the person who shows up for the sniffles who makes you mad rather than the 300 people who showed up appropriately."
"It becomes part of the common culture," Newton says. "I was guilty of some of these assumptions myself. And I hear them repeated again and again from my colleagues. Then it becomes something that everybody knows and nobody questions."
John Commins is the human resources and community and rural hospitals editor withHealthLeadersMedia. He can be reached at jcommins@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Community and Rural Hospital Weekly, a free weekly e-newsletter that provides news and information tailored to the specific needs of community hospitals.
As Senators Barack Obama and John McCain battle over how best to control spending and cover the uninsured, they are both filling their speeches, advertisements, and debating points with statistics about the money they would save and the millions of Americans they would cover. But the figures they cite are invariably the roughest of estimates. Over time, these forecasts have become so disparate and contradictory as to be almost meaningless, according to this article in the New York Times.
