California health officials have asked a federal judge to suspend her order requiring them to restore 10% cuts in Medi-Cal payments to doctors, dentists, and pharmacists, saying the ruling was unclear and legally flawed. Paying full fees to healthcare providers would cost at least $500 million a year and "will only worsen California's already dire financial situation," state lawyers said. They also said it would take at least three weeks to reprogram computers to increase the payments, and allowing the 10% reductions to remain in place for another month or two would not harm Medi-Cal's 6.6 million patients.
Health maintenance organization Health Net has paid $41 million in claims and fines for shortchanging 88,000 customers in New Jersey. State officials say the HMO underpaid claims to reimburse patients for out-of-network healthcare services between 1996 and 2006. Checks, ranging from several thousand dollars to a few dollars, were mailed to current and former customers starting in July.
Newly built hospitals should have all single rooms because they reduce infections and may reduce medication errors, according to the authors of a new paper. A focus on single rooms would increase construction costs, with one study finding that the cost for building a new ward with only single-patient rooms would be $182 to $400 per patient, versus $122 to $500 per patient for double rooms. But many of those costs are capital costs and would be recouped relatively quickly, say the paper's authors.
Nationwide, some insured patients are being asked by hospitals to pay larger portions of their bills upfront, and sometimes hospitals will not do the procedures until they get their co-payments. Hospitals administer emergency treatment without asking for payment first, but elective or scheduled procedures can be withheld depending on a patient's ability to pay. An informal survey of 22 hospitals in Florida's Broward and Palm Beach counties found that all have required upfront payments for elective surgeries for several years. Hospital officials said patients might be shocked by the larger amounts requested as insurance companies require patients to make higher out-of-pocket payments.
Due to increasing competition from national health insurers, some of the nation's nonprofit Blue Cross Blue Shield organizations may be feeling the pressure to merge or to convert to for-profit status. The conversions could, in turn, pave the way for acquisitions by large insurers such as WellPoint Inc. For large managed-care companies seeking smaller, independent insurers as acquisition targets, the independent Blue Crosses and Blue Shields are the most attractive ones because they have the best operations and the most people covered.
A hospital executive in my home state of Texas was telling me about a fairly minor surgery she had about 18 months ago. One of the things she remembers most about her recovery time at the hospital was how quiet it was. "I work in a hospital, I know how noisy it can be. I thought to myself, what is this hospital doing that we aren't?"
Her question got me thinking about hospital noise and how technology is being used to help reduce it. In this case, she later found out the hospital was using wireless voice-activated communication badges instead of an overhead PA system for the majority of their communications—a tool she later adopted for use at her own hospital.
Hospital noise-level might not be on the forefront of many executives' minds, and generally when I ask about priority lists, keeping decibel levels down doesn't quite make it to the top. But think about this: a team of Mayo Clinic nurses studying hospital noise found that during the morning shift change at Saint Mary's Hospital in Rochester, MN, noise levels reached 113 decibels—that's equal to the noise a jackhammer makes. And this: during a two-year research project, acoustics experts Ilene Busch-Vishniac and James E. West learned that hospital noise is among the top complaints of both patients and hospital staff members. During their studies, the researchers found that over the past four decades, average daytime hospital sound levels around the world have risen from 57 decibels to 72; nighttime levels have increased from 42 decibels to 60. All of these figures exceed the World Health Organization's hospital noise guidelines, which suggest that sound levels in patient rooms should not exceed 35 decibels.
Fast, reliable communication is vital in a hospital setting, and, thanks to technology, hospital workers have a variety of tools available them to facilitate instant communication. Smartphones, pocket-PCs, laptops, tablet-PCs, instant message, e-mail, remote voice and video communication are just a tiny sampling of how technology is being used to communicate faster. But since technology is often blamed for the increase in noise over the last few decades, I'm curious about how it's also being used to communicate quietly.
One of the most common and effective methods I've heard of is replacing the overhead intercom system with wireless communication badges, which can page staff anywhere in the hospital. At the hospital I mentioned above, the staff reported improvements in the quality and ease of communication after they started using the badges and patient satisfaction increased to 93%.
Some hospitals have begun to experiment with technology that is designed to mask sound by actually introducing noise into the environment. Saint Thomas Hospital in Nashville installed such a system after patient satisfaction surveys showed that their lowest score was "noise in and around the room."
Sound masking works by covering a distracting sound with a more soothing or less intrusive sound. A series of speakers installed in the ceiling distributes electronically generated background sound that serves to cover or reduce the impact of noise spikes. The result is that noises and conversations are nearly impossible to hear or comprehend. About four months after installing the soundmasking technology, Saint Thomas' follow-up survey showed a 33% increase in patient satisfaction.
If studies suggesting that a noisy environment slows healing aren't enough to make a hospital quiet down, perhaps being publicly outed will. In March the federal government's Hospital Compare site began posting patient satisfaction scores for individual hospitals. Among the items listed: "Percent of patients who reported that the area around their room was always quiet at night" and "cleanliness and quietness of hospital environment." And then there's the money factor. Medicare and Medicaid reimbursements are now tied to those patient satisfaction surveys because hospitals that fail to report the required quality measures may receive an annual payment update that is reduced by 2%, which could make your patient's sleepless stay an expensive stay.
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Doctors nationwide are increasingly utilizing high-tech medical and dental postcard mailing systems in order to attract upscale patients. "Today physicians and dentists can mail oversized postcards with high gloss, full color finishes which are targeted individually for recipients," says Healthcare Success Strategies' Co-Founder Stewart Gandolf. Healthcare Success Strategies recently entered into a joint venture with leading direct mail company DME in order to take advantage of these and other new mailing technology opportunities.
The 4th Annual World Healthcare Innovation and Technology Congress is scheduled for December 8-10 in Washington, DC. Organizers say the event will center on "the next generation of innovation and technology as defined through the analysis of a focused and growing set of best resources for innovation and creativity."
U.S. Rep. Jay Inslee has called for a congressional investigation into medical-device manufacturers and operators who use unproven "energy medicine" machines to exploit patients. Inslee said his request was in reaction to a Seattle Times investigation called "Miracle Machines." The series revealed how manufacturers and practitioners profit from treating people with the unproven machines, some of them potentially dangerous, others illegal. They have used these devices to misdiagnose diseases and divert critically ill people from life-saving care, as well as drain their bank accounts.
The market for Smartphones is becoming fierce, with Blackberry and the new iPhone competing for consumer attention. Now Palm is attempting to make a reentry into the market with the new Treo Pro. The Treo Pro is slimmer and more elegant than current models, and its larger keyboard and screen that is flush with the phone's chassis make it more user-friendly than Palm's old calculator-like design, according to this New York Times article.
