New Orleans Mayor Ray Nagin expressed optimism that the city will find a way to buy Methodist Hospital and restore much-needed healthcare in eastern New Orleans, but he cautioned that his administration is leery of paying too much. "I can't in good conscience pay fair market value for a shuttered hospital," Nagin said, offering an update on negotiations with Universal Health Services, owner of the hospital and two nearby facilities that have been closed since Hurricane Katrina. Nagin said the hospital's owners rejected an original city offer of $15 million as well as a subsequent offer of $30 million.
United Healthcare Workers and Catholic Healthcare West, the parent company of Mercy General Hospital in Sacramento, reached what both sides tout as a historic labor pact that would give 14,000 workers some of the industry's best wages and benefits. The agreement could put pressure on other companies, such as Sutter Health, to negotiate similar contracts. It provides an average wage increase of at least 24% over four years, with some workers getting as much as a 35.4% raise, according to the Service Employees International Union.
Barack Obama and John McCain both have big-ticket proposals to change how people obtain and pay for health insurance, and a long history of failed health-reform plans shows how difficult it is to achieve that goal. But despite the worsening economic picture, neither candidate has signaled any intention to scale back his plans. And the head of the Senate Finance Committee, which would have a big say in what the next president hopes to accomplish on healthcare, says he won't let the current financial crisis stop the committee from tackling it.
There is a relatively low-cost way that health plans can improve patient outcomes, lower costs, and repair relations with physicians.
I attended CMS' National E-prescribing Conference in Boston last week along with more than 1,400 healthcare professionals and leaders. CMS hosted the event to help folks prepare for the newly enacted federal e-prescribing incentive payment program that will begin in 2009. The program will use the carrot and stick approach. CMS will pay successful e-prescribing physicians a 2% bonus in 2009-2010, 1% in 2011-2012, and 0.5% for 2013, while also reducing payments for those not e-prescribing by 1% in 2012, 1.5% in 2013, and 2% in 2014 and each subsequent year.
"Talking about it is one thing, putting money on the table is another. And we are putting money on the table," said CMS' Acting Administrator Kerry Weems during a briefing at the conference.
CMS is gung ho for e-prescribing because supporters say it saves money, reduces errors, and improves quality. The Institute of Medicine reported that more than 1.5 million Americans are injured each year by drug errors.
However, only 6% of physician offices had e-prescribing capabilities at the end of 2007. This is where health plans can help out.
The eHealth Initiative—a nonprofit organization that promotes information technology as a way to improve healthcare quality, safety, and efficiency—suggests payers should support electronic prescribing.
Here are three benefits health plans can enjoy by getting involved in e-prescribing:
Quicker access to claims data. Rather than waiting weeks for claims data to come to the health plan, e-prescribing would provide immediate access to pharmacy data. This will allow the health plan, its pharmacy benefit manager and/or population health vendor to reach out to those patients faster.
Say goodbye to chicken scratch. I relate with this benefit as someone who used to receive "Unsatisfactory" grades for penmanship in elementary school. The stereotype about doctors' handwriting is a running punch line, but it isn't funny to those who have been hurt because of a doctor's chicken scratch.
E-prescribing pushes generics and avoids prescription errors. E-prescribing programs suggest generic drugs to physicians when they prescribe brand name drugs that have a lower-cost alternative. Plus, the system will analyze prescription data to make sure that drugs prescribed will not interact with a patient's other medication.
There are a growing number of instances in which health plans have played a key leadership role in implementing e-prescribing programs. Probably the most successful program has been in Massachusetts where Blue Cross Blue Shield of Massachusetts, Tufts Health Plan, and Neighborhood Health Plan have come together to create the eRx Collaborative, which provides funding and incentives to physicians.
Blue Cross Blue Shield of Massachusetts alone has awarded more than $25 million in incentive dollars for e-technology measures since the collaborative began in 2003. The collaboration has helped make Massachusetts the No. 1 e-prescribing state in the nation. But even as the top-ranked state, a mere 14% of total prescriptions were e-prescribed in 2007.
The collaborative has reduced errors and costs. eRx Collaborative prescribers wrote 2.1 million electronic prescriptions during the first six months of 2008, and a total of 15.6 million since the collaborative began.
In 2007, the system changed more than 100,000 prescriptions because of possible problems, which prevented 724 potential adverse drug events, saving more than $600,000.
In 2006 alone, Blue Cross Blue Shield of Massachusetts saved about $800,000 in prescription drug copays by using generics based on prompts in the e-prescribing system. The project has also relieved office duties for physicians. Most prescribers say they spent one or two fewer hours per day on administrative duties associated with prescription drugs after implementing e-prescription technologies. Having that hour or two will open up physicians to see more patients, and that benefits all stakeholders.
All of these facts point to the need for health plans to get involved in e-prescribing. Even with CMS' incentives, small physician practices and independent pharmacies will have trouble paying for the software and hardware needed to e-prescribe.
Health plans can take these three steps either individually or as a collaborative with other insurers and payers:
Help physicians and pharmacists buy e-prescribing software
Incent prescribers to use the technology
Bring together the various stakeholders to share best practices and lessons
This system will engage physicians, pharmacies, and technology providers to create a seamless e-prescribing process.
CMS is wisely backing e-prescribing, but one has to wonder if the incentives the feds will offer are enough to offset costs—especially for struggling smaller practices that are already afraid of future payment cuts. This is a rare opportunity for insurers to be the good guy and a great chance for health plans to make some inroads into improving physician relations.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.
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The hospital industry is among those struggling with the credit scarcity that the federal government's latest financial bailout plan is meant to alleviate. Hospitals "are not immune," said Richard L. Clarke, chief executive of the Healthcare Financial Management Association, a professional group for hospital finance executives. He noted that hospitals, like any other business, relied on credit for building projects and to maintain overall liquidity.
Two Pennsylvania senators are trying to resurrect a state agency that has developed a national reputation for reporting trends in hospital, surgical, and medical costs. Sens. Wayne Fontana, D-Brookline, and Pat Vance, R-Cumberland, said they will introduce a bill to reauthorize the Pennsylvania Health Care Cost Containment Council. Since the Pennsylvania Senate has gone home for the year with no agreement with the governor on health costs, the cost containment council will die Nov. 30. The proposed bill, which will be introduced in January, would extend the Council's life for five more years.
Members of Humana's Medicare Advantage plan can now get care at Florida Hospital's seven locations in Central Florida. The hospital chain and Humana have agreed on a new contract that allows Medicare Advantage members to use Florida Hospitals in Orange, Osceola, and Seminole counties. The agreement includes Humana's Gold Plus and Humana PPO Choice plans, allowing those beneficiaries to access Florida Hospital Altamonte, Florida Hospital Apopka, Florida Hospital Celebration, Florida Hospital East Orlando, Florida Hospital Kissimmee, Florida Hospital Orlando, and Florida Hospital Winter Park.
When a health assessment showed that the community was having issues with preventable health issues and concerns, Exempla Healthcare in Denver decided to address things with a campaign that asked residents to "Be the One" to take control of their health.
"Among the different topics found in the assessment, we chose the ones that we felt would have the greatest impact on the community: access to preventative healthcare, activities for adults, diabetes, and cholesterol," says Colleen McLean Williamson, brand marketing manager for Exempla Healthcare.
Though Exempla hoped to reach out to the Denver community, it also needed to execute its plans on a fairly tight budget. "Because of recent budget cuts we didn't have enough to do a large media buy," says McLean Williamson. Instead, Exempla placed ads in local community papers and sent direct mailers offering a prize for the first 100 residents who signed up for an e-newsletter. Other efforts included cinema slides, press releases, and an interactive Web site.
To save more money, the team designed the marketing pieces in-house. "We do a lot of our own creative because we'd rather put dollars into the media buy," McLean Williamson says. The creative elements each feature a different spin on the "Be the One" theme of the campaign. One print element shows a family holding up watermelon slices with copy that reads, "Be the One… who makes fruit fashionable." The copy goes on to give basic health facts about managing diabetes and the call to action pushes the viewer to the Web site.
The Web site offered free health tools including downloadable information, audio podcasts from 20 physicians on various topics, and animated shorts for more than 50 different diseases or conditions to show viewers how the disease works. "We really felt that people would understand the disease or condition more if they saw it visually," says McLean Williamson.
Another unique Web feature was the ‘Healthy You' tool bar that can be downloaded to a user's Internet browser. When the user attempts to search for a condition or disease, the tool bar automatically provides the user with tabs from the top accredited health sources on the Web to save them the time and doubt of doing a general Internet search and also remembers the search in a no opt-in RSS feed which will thereafter send the user updates on the concept when new information has been found.
After a month and half run, Web site hits have increased by 5,000 visitors and more than 2,500 people have signed up for Exempla's e-health newsletter.
"This campaign was really about educating the community about prevention and managing their health, being in the know, and having the information and knowledge they need to talk to their physicians," says McLean Williamson.
Kandace McLaughlin Doyle is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kdoyle@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.
AdAge, founded less than 90 days after the crash of '29, has reported on every downturn since the Great Depression. So veteran writer Bradley Johnson dug through the archives to see what marketers, media, and agencies did right and wrong in past recessions. Here's his first report, offering 10 key insights from 1973 to 1975.
St. Mary Medical Center has commissioned a history of the hospital based on real patients' experiences to celebrate its 100th year in Galesburg, IL. The hospital has hired a former newspaper reporter and editor to interview present and past patients and tell St. Mary's story.
