Doctors, nurses, technicians and managers at UCLA Medical Center will soon participate in the huge task of moving to a new hospital across the street. The shift to the new Ronald Reagan UCLA Medical Center will require military-style precision: Using 30 ambulances and 80 gurneys, three teams of professionals will transfer 350 patients at the rate of one every two minutes. Further complicating the move is that many of the patients are hooked up to monitors and respirators.
Hartford, CT-based Aetna plans to announce that it has opened a "representative office" in Shanghai, China. The move is the first step of a lengthy process for foreign companies interested in doing business in the country. Other insurers, such as UnitedHealth Group and WellPoint, have established such offices in China, and CIGNA has already hooked up with a Chinese company to sell supplemental health insurance there. U.S. insurers are fighting each other for members in their own nation's strained economy, and are searching for more growth opportunities and entering more countries around the world.
AT&T said it plans to expand nationwide an electronic health network it developed in partnership with Memphis, TN-based MidSouth eHealth Alliance and the Tennessee Governor's eHealth Council. The network is designed to reduce costs, improve quality of care, and put patients in control of their medical records.
Consumers would have greater access to mental healthcare and substance abuse treatment under a proposed Massachusetts law. The proposal would lift limits on hospitalizations and outpatient treatment for dozens of maladies, such as eating disorders, post-traumatic stress, and drug addictions. Supporters say the measure would ease the stigma on mental illness and allow patients to receive treatment. But a coalition of business and insurance groups say the bill would disproportionately hurt small employers at a time when they are struggling with rising healthcare costs.
Greetings from Las Vegas, where it seems not only that everyone in the healthcare finance universe is here, but darn near everyone in the universe period. I see more Japanese, English, Russians and others of a foreign persuasion than Americans, almost. Blame it on the cheap dollar. Seeing this sea of humanity gets me thinking about how, as one presenter said today in a presentation about the credit crisis that won’t go away, “everything has something to do with everything.”
Let me explain. Healthcare organizations, collectively, have lots of problems these days, but problems with their borrowing are not of their own doing. These organizations, mainly nonprofit health systems and hospitals, are suffering under problematic long-term financing in part because of a credit crisis caused by the easy money policy of the early part of this decade. That river of easy money fed a flood of cheap mortgages, where it seemed anyone who could put a red ‘X’ on a signature line of a mortgage application was able to get mortgages up to 120% of loan to value—if they wanted them—and many did. Further, financial institutions sliced up these mortgages into collateralized debt obligations, that hid the true value—or lack of value—of the mortgages that stood behind them.
When everyone woke up to the fact that many of these mortgages wouldn’t be paid back, the underlying financial instruments—CDOs—lost value precipitously, starting a vicious cycle of declining home values which further eroded the value of many CDOs, which in turn, couldn’t be sold because no one could estimate their true value anymore. That caused a seize-up in the financial markets that while contained, still isn’t over. Where it stops nobody seems to know. Even healthcare organizations, traditionally some of the most creditworthy institutions, were hurt by this cycle of decline. It showed up in March when many so-called auction rate securities couldn’t find buyers, which means an auction isn’t going to work. Hospitals, in many cases were stuck with debt that--because of covenants in the securities contracts covering auction failures—pushed interest rates in some cases up to 17% or so. Yikes.
And it’s not over yet. In fact, one of the presenters today acknowledged that despite turning in his slides less than four weeks ago, the ratings on bond insurers in the slide had slid even further, making the slide woefully inaccurate.
To try to get the markets working again, the Federal Reserve cut interest rates by more than three percent this spring, killing the value of the dollar as it measures up against other world currencies.
Perhaps that’s why I’m hearing so many foreign accents around here. Our goods are cheap, and so is travel. Flash back to Vegas and the casinos, where at least someone is making money off of all this. Table limits are as high as I’ve ever seen them.
But despite all this economic doom and gloom, there’s good attendance at HFMA this year, and conventioneers this morning were treated to a presentation by Steve Case, the America Online founder and current head of Revolution. One of Case’s companies is Revolution Health, as I’m sure you’ve heard. Case spent his time telling the audience that, essentially, 2008 might be remembered as the ‘Year of the Consumer’ in healthcare. I’ll buy that for reasons I’ll get into in tomorrow’s blog, but for now, I’m going to take some of my pesos—ummm, I mean, dollars—and hit the casino.
Wireless systems used by many hospitals to keep track of medical equipment can cause potentially deadly breakdowns in lifesaving devices, researchers warn. Some of the microchip-based "smart" systems are touted as improving patient safety, but a Dutch study of equipment suggests the systems could actually cause harm. The wireless systems send out radio waves that can interfere with equipment such as respirators, external pacemakers and kidney dialysis machines. A U.S. patient-safety expert said hospitals should respond immediately to the "disturbing" results and conduct safety tests.
The World Health Organization has issued its first guidelines aimed at reducing complications and deaths from operations. The guidelines consist of a list of simple safety checks that the health organization said could halve the rate of surgical complications. The list is intended to improve anesthetic safety practices, avoid infections, and improve communication among members of surgical teams.
Austrailian researchers have found overcrowding and understaffing can cause a breakdown in the control of MRSA in hospitals. "The drive toward greater efficiency by reducing the number of hospital beds and increasing patient throughput has led to highly stressed healthcare systems with unwelcome side effects," the researchers wrote. For example, overworked doctors, nurses and other hospital staff are less likely to wash their hands, researchers added.
Women who give birth at top-rated hospitals have fewer complications for Caesarean section and fewer complications for vaginal birth, according to a study. The report compared the quality of maternity and cardiac/stroke care for women at U.S. hospitals in 17 states. The analysis of maternity care included more than 12.5 million hospital delivery and newborn records from 2004 through 2006.
A report has found the higher death rate from colorectal cancer among U.S. minorities may be linked to socioeconomic, healthcare access, language, and cultural barriers that lead to less preventative screening among these groups. While 54% of those surveyed for the report received colorectal cancer screening, great disparities between ethnic and racial groups were apparent. These disparities disappeared, however, when researchers factored out demographics, socioeconomic status, language spoken at home, and healthcare access.
