President Obama's executive memorandum last week giving hospital patients the right to grant visitation to same-sex partners was as decent as it was overdue.
The president said he was moved to issue the memorandum after hearing about the plight of a woman denied access to her partner of 18 years who was dying in Jackson Memorial Hospital in Miami hospital after suffering from a brain aneurism.
However, in this highly partisan atmosphere, where every White House action prompts a dog fight, the reporter in me figured that somebody, somewhere in healthcare was going to be upset. After all, hundreds of hospitals in this nation are affiliated or operated by religious denominations, some of which explicitly denounce homosexuality as a sin.
It seemed like an easy story. Get a few quotes "pro" and "con," a little background, a little brouhaha, and hit the "send" button. The "pro" quotes were pretty easy to come by, but I was surprised when I tried to find someone in healthcare to speak out against the memo. Instead of controversy, I got acceptance.
My first instinct was to check with the Catholic Health Association of the United States, only because the Roman Catholic Church has been quite emphatic in its rejection of homosexuality. Would Obama's memorandum prompt a crisis of faith for some of the nation's largest group of not-for-profit health systems?
No.
"The Catholic Health Association has long championed the rights of all patients to designate who they want to speak for them in healthcare decisions when they are not able to speak for themselves," Sister Carol Keehan, president/CEO, said in a statement on the CHA Web site. "Having that person clearly designated is not only a basic human right, it also greatly facilitates care."
I checked with Baptist Health South Florida. No controversy there "From our perspective, it's not an issue because we have a very flexible and open family visitor policy that we established years ago," said Health system spokeswoman Christine Kotler. Kotler says she hasn't heard of any objections from Baptist employees. "We asked that question of our social work services, our nursing administrators. We did circulate that question and resoundingly everyone came back and said this has never been an issue," she said.
Jackson Health, the inspiration for Obama's memorandum, actually pre-empted the president's announcement by a few days with word that it had worked with with a coalition of lesbian, gay, bisexual, and transgender groups to create a more-inclusive visitation policy.
Let's be clear: I didn't conduct an exhaustive search on the issue—a few passes through Google and some media outlets—and I'm not saying that everyone within healthcare supports the President's memorandum. I'm saying I couldn't find any healthcare organizations that oppose it.
None of this is surprising. Visitation rights are not abstract talking points for healthcare professionals. Physicians and clinicians see first hand, every day, how important it is for same-sex couples to enjoy the same rights and access to loved ones as everyone else. I suspect that many healthcare professionals have also witnessed the heartbreak—the fundamental unfairness of it—when that access is denied.
Sister Keehan said it best: "All persons of goodwill can understand and agree that when a person is sick, they deserve to decide who they want to visit them."
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There were 12 mass layoffs impacting 50 or more jobs at the nation's nongovernment hospitals in March, resulting in 798 initial claims for unemployment insurance, the Bureau of Labor Statistics announced today.
March's mass layoffs, combined with 11 mass layoffs in February and 13 in January, are just one mass layoff event off the record pace set in the first quarter of 2009, a year that ended with 152 mass layoffs affecting more than 13,000 hospital jobs. In the first quarter of 2010, hospital layoffs resulted in 2,516 initial claims for unemployment, compared with 3,003 such claims in the first quarter of 2009, BLS data show.
In the overall healthcare and social assistance category, there were 33 mass layoffs in March, resulting in 2,066 initial claims for unemployment insurance, BLS data show.
Despite the layoffs, the healthcare sector remains one of the few job growth areas of the economy. Hospitals created 33,400 new jobs in 2009, while the overall healthcare sector has created 588,000 jobs since the recession began in December 2007. In that same period, the number of jobless people in the nation has risen from about 7.7 million to 15.3 million, BLS data show.
In March, in the overall economy employers reported 1,628 mass layoffs that resulted in job losses for 150,864 workers, seasonally adjusted, as measured by new filings for unemployment insurance benefits for the month. The number of mass layoff events across all industries in March increased by 58 from the 1,570 reported in February, and the number of initial unemployment claims fell by 4,854. Both events and initial claims have decreased in five of the last seven months, BLS said.
After 10 years on the job, IASIS Healthcare LLC CEO David R. White will retire by the end of this year but will continue to serve as chairman of the Franklin, TN-based hospital chain's board of directors, the company announced this week.
IASIS CFO W. Carl Whitmer has been named president and will become CEO when White retires. Whitmer, CFO since 2001, also will join the IASIS board, as will long-time IASIS COO Sandra McRee, who becomes vice chair.
"While there is likely never the perfect time to retire, this is certainly the right time to make this transition," White said in a media release. "IASIS is in a very strong position, has a well-planned growth strategy and has an excellent leader in Carl Whitmer, who is poised and ready to take IASIS to the next level."
"Our industry is undergoing tremendous change. IASIS is well situated to take advantage of its strengths, build upon its success and respond to change. Because of our advance planning, we are confident this will be a smooth transition," White said.
Since White took over at IASIS in 2000, annual revenues have grown from $815 million to more than $2.4 billion, and the hospital chain has spent more than $100 million to improve healthcare information technology, the company said.
A national search is underway to fill McRee's COO position, but no specific timeframe has been set. John Doyle, IASIS' vice president and CAO, replaces Whitmer as CFO.
IASIS owns or leases 15 acute care hospitals and one behavioral health hospital in six states, with a total of 2,848 beds. IASIS also owns and operates a Medicaid/Medicare managed health plan in Phoenix, AZ, with more than 198,000 members.
Barnes-Jewish Hospital, St. Louis Children's Hospital, and Washington University School of Medicine have created a joint Fetal Care Center for high-risk mothers and births.
The Fetal Care Center will coordinate access to the maternity center at Barnes-Jewish Hospital, the nearby neonatal ICU at St. Louis Children's Hospital, and medical and surgical services from Washington University for the nearly 10,000 babies born each year in Missouri and the surrounding eight states who have serious medical conditions requiring specialized care.
It is also the only center in the Midwest offering advanced fetal diagnosis, fetal surgical interventions, and newborn medicine on one medical campus, the three provider institutions said in a joint announcement.
"We don't think a mother-to-be should wait for answers," said Anthony Odibo, MD, co-director of the Fetal Care Center and associate professor of obstetrics and gynecology at Washington University. "That's why we've designed our program to provide results, develop a plan -- even begin treatment, if necessary -- right on the spot."
Barnes-Jewish Hospital and St. Louis Children's Hospital are adjacent, which will allow mother and baby to be on the same medical campus at the Fetal Care Center. "Delivering at a hospital that doesn't have the capacity to address some of these really important things then mandates the baby be transported from one facility to another," said Brad Warner, MD, surgical directory at the center. "That can be critical time and can sometimes make the difference between life and death."
The center has stress-reducing amenities, such as convenient appointment scheduling, personal nurse advocates, all tests done at one time and place, and an end-of-day physician conference to summarize test results and make team recommendations.
The center will specialize in surgical treatment, both in-utero and after delivery, to correct prenatal diagnoses including congenital heart defects, twin-twin transfusion syndrome, gastroschisis, omphalocele, and congenital diaphragmatic hernia.
North Shore-LIJ (NY) Health System and the Environmental Protection Agency used Thursday's Earth Day celebrations to sign a five-year agreement on wide-ranging environmental stewardship programs.
The memorandum of understanding, signed by EPA Regional Administrator Judith Enck and North Shore-LIJ President/CEO Michael Dowling, places the health system's hospitals in Queens, Long Island, and Staten Island into programs for energy and water conservation, solid waste recycling, environmentally sensitive landscaping, combined heat and power plants, sustainable building and construction projects, and green cleaning.
"With a workforce of more than 38,000, the North Shore-LIJ Health System is the largest employer on Long Island and the ninth largest in New York City. We play a leading role not only by providing top-notch healthcare but promoting sustainable business practices to improve public health and minimize our impact on the environment," Dowling said in a prepared release.
"Our collective actions make a tangible difference in terms of reducing greenhouse emissions, conserving energy, wisely using natural resources, and at the same time, benefit from significant cost savings."
Maurice E. LaBonne, North Shore-LIJ's senior vice president of facilities services, said there is an incentive to be energy efficient and cost effective because hospitals operate 24 hours a day, 365 days a year, and continually use power to heat and cool facilities year round.
"Hospitals are well suited to sustainable design and construction because patients often have compromised immune systems; sustainable healing environments contribute to better patient outcomes," LaBonne said.
The agreement calls on North Shore-LIJ to:
Reduce energy consumption by at least 10%.
Implement a recycling program that includes paper, plastic, aluminum and cardboard and explore other opportunities for waste reduction and recycling.
Re-use landscaping materials wherever possible and re-use industrial materials for construction projects.
Increase the use of coal combustion waste products in construction activities. For example, in the Katz Women's Hospital construction project at North Shore University Hospital, cement will consist of 40% fly ash.
Recognize that the use of combined heat and power reduces environmental impacts while meeting the demand for energy. At LIJ Medical Center, a combined heat and power plant supplies electrical energy to the campus boiler/chiller operations and supplementary heat for steam and hot water requirements. The health system will try to enhance this plant and explore the application of this technology to other hospitals.
Continue to certify construction projects that are registered with the US Green Building Council. North Shore-LIJ also plans to certify major construction projects under the Leadership in Energy and Environmental Design rating system.
Eight in 10 Americans know that President Obama signed the health reform legislation into law, but 55% say they are confused about it, and 56% say they don't understand how it will affect them personally.
That's according to a new Kaiser Health Tracking Poll issued today, the first such poll conducted by Kaiser since the passage of the healthcare reform laws last month.
The survey of 1,208 adults, conducted April 9-14, finds that the public supports many of the provisions of health reform that are set to be implemented in the short term. When asked about 11 specific provisions scheduled to take effect this year, in each case a majority of Americans viewed them favorably, often with bipartisan support.
Still, the public remains divided on the law overall, with 46% viewing it favorably, 40% unfavorably, and 14% undecided. Similarly, 31% of Americans say they expect personally to be better off because of the law, 32% say they will be worse off, and 30% say they don't expect to be affected. The national telephone poll included 801 landline interviews, and 407 cell phone interviews. The poll was carried out in English and Spanish, with a margin of error of plus or minus 3%.
"People are struggling to understand how the law will affect them and their families and to separate fact from political spin," said Kaiser President/CEO Drew Altman.
The new law includes provisions that take effect this year so that the public will feel immediate tangible results. The poll tested the popularity of many of these early measures and finds widespread support for them, including from Republicans and independents.
For example; nearly nine in 10 Americans favor tax credits for small businesses to provide coverage for their workers, and eight in 10 favor provisions for access to basic preventive care with no copayments, provide financial help to seniors who hit the doughnut hole gap in Medicare drug coverage, and prohibit insurance companies from dropping people with major health problems. In each of these cases, at least two-thirds of Republicans and independents join most Democrats in viewing the provisions favorably.
The poll found that 55% of Americans are confused by the health reform law, with 61% of those who aren't in favor of the reforms expressing confusion, and 44% of those who support the reforms expressing confusion.
Anger is reported by 30% of the public, including16% who say they are "very angry." Asked what about health reform made them angry, that 30% divided as follows: 9% did not like the way the policymaking process worked, 7% did not like the final content, and 12% did not approve of either.
Cable television news was the biggest source of information about healthcare reform for all respondents, regardless of their political leanings. More than one third (36%) cited cable TV news stations and their Web sites as their most important outlet, followed by network news (16%), newspapers (12%), friends and family (10%) and the radio (9%).
Republicans were more likely to name cable TV as their most important news source, with 45% saying so compared to 30% of Democrats. Democrats were twice as likely as Republicans and independents to say that they got most of their information from network news (23% of Democrats compared to 12% of the other two groups).
Overall sentiment about the new law breaks sharply along partisan lines. Nearly eight in 10 Democrats favor the new law, while about as many Republicans do not, a mix similar to that seen before the bill's passage in March. Independents tilt against the law—46% opposed compared to 37% in favor—while self-described moderates favor the measure 55% to 31%.
"The AMA is offering its support to physicians who are now receiving mailings containing details and claim forms regarding the historic UnitedHealth settlement," said AMA President J. James Rohack, MD, in a media release. "The new AMA guide provides physicians with step-by-step assistance in determining eligibility, assembling documentation and filing a claim under the terms of the settlement."
New York Attorney General Andrew Cuomo announced the settlement with UnitedHealth Group in January, 2009 after a year-long investigation into what Cuomo called "a scheme to defraud consumers" by underpaying patients by hundreds of millions of dollars over the last decade.
The investigation was initially sparked by a 2000 lawsuit from the AMA, which was concerned that the underpayments were driving a wedge between patients and doctors.
"The AMA's persistent efforts have earned significant results for physicians that extend far beyond the recovery of damages," Rohack said. "Every physician and patient will benefit from the stand the AMA took against UnitedHealth."
The UnitedHealth settlement is governed by a series of court-imposed deadlines that physicians must follow. The current settlement deadlines include the following key dates:
July 27 – Deadline for filing objections to the settlement or for opting out of the settlement.
Sept. 13 – Date for the final settlement hearing to consider any filed objections.
Oct. 5 – Deadline for filing a claim to share in the settlement fund.
Sanford Health is partnering with Rady Children's Hospital-San Diego to open a pediatric clinic in Oceanside, CA, the two health systems announced today.
Using a portion of a $2.5 million donation from philanthropists Pamela and Martin Wygod and the Rose Foundation, the health systems plan to jointly purchase and share a 28,500-square-foot building in Oceanside.
Sanford Children's will open a general pediatric clinic using 6,000 square feet of the building. Rady Children's will consolidate four nearby specialty clinics into the facility, providing primary care, psychiatry, developmental services, various specialty clinics, and the Chadwick Center. The building will also house a pediatric urgent care, after-hours clinic. The clinic is expected to open in early 2011.
"The variety of services offered—developmental evaluations, occupational therapy, urgent care, pediatric subspecialty physician services, the expertise of the Chadwick Center for Children and Families—will provide parents with an expanded and vitally needed range of care," said Kathleen Sellick, president/CEO of Rady Children's Hospital.
Sanford Children's Clinic in Oceanside is the third Sanford Children's World Clinic announced by Sioux Falls, SD-based Sanford Health as part of the initiatives outlined after a $400 million donation from Denny Sanford in 2007.
Sanford Children's Clinic in Duncan, OK, opened August 2009. Sanford Children's Clinic in Belize City, Belize, will open in 2011.
Overall drug price inflation will be 1.3% in 2010 for acute care hospitals, according to estimates released today by Novation Pharmacy Program.
The estimate, published in Irving, TX-based Novation's 2010 Drug Price Forecast, anticipates that the price change for contract products from July 1, 2010 through June 30, 2011 will be 0.99% while noncontract products will be 1.83%.
The forecast is focused on pharmaceutical use in acute care hospitals. The drugs analyzed represent the top 80% of pharmaceutical purchases through pharmacy authorized distributors from Nov. 1, 2008, through Oct. 31, 2009, by Novation Pharmacy Program participants.
The report usually includes estimates for volume and mix changes, and an estimate for additional new drug expense taken from the American Journal of Health-System Pharmacy's annual future drug expenditures report. However, the 2010 edition of the AJHSP report had not been published when Novation's report was finalized.
Novation said it will update its forecast with this information when it is available.
The Federal Trade Commission and the Justice Department have opened a month-long public comment period for a proposed revision of Horizontal Merger Guidelines.
The updated guidelines detail how the agencies evaluate the competitive impact of mergers and whether those mergers run afoul of antitrust law. The guidelines were issued in 1992 and were last revised in 1997. The current revisions are designed to reflect the way the FTC and DOJ now conduct merger reviews, the two agencies said in a joint statement.
"Eighteen years have passed since the Horizontal Merger Guidelines were revised. During that time, the agencies' approach has evolved significantly, and the guidelines should reflect that," FTC Chairman Jon Leibowitz said. "The proposed guidelines put out for comment today reflect the current state of merger analysis at the FTC and DOJ, and will help make the process more transparent to American businesses and courts. By inviting comments from all stakeholders, we'll make sure that the final Guidelines are clear and accurate in conveying the agencies' merger enforcement intentions."
The proposed revisions reflect public comments from five public workshops that the two agencies held over the past six months to determine whether an update is needed. Many parts of the proposed guidelines reflect changes identified in the Commentary on the Horizontal Merger Guidelines, which the agencies issued in 2006.
The proposed guideline changes would:
Clarify that merger analysis is a fact-specific process through which the agencies analyze the evidence to determine whether a merger may lessen competition.
Create a new section on "Evidence of Adverse Competitive Effects," using past experiences that the agencies have found predict the competitive effects of mergers.
Explain that market definition is not an end itself or a necessary starting point of merger analysis, but a tool that illuminates a merger's competitive effects.
Update the hypothetical monopolist test used to define antitrust markets and how the agencies implement that test in practice.
Expand discussion of how the agencies evaluate unilateral competitive effects, including effects on innovation.
Clarify that coordinated effects, like unilateral effects, include conduct not otherwise condemned by the antitrust laws.
Add new sections on powerful buyers, mergers between competing buyers, and partial acquisitions.
