Family physicians provide an excellent ROI, earning an average $241,000 as a starting salary but generating nine times that amount in hospital revenues.
Physicians each generate an average of nearly $2.4 million in revenues annually for their hospitals, a new survey finds.
Cardiovascular surgeons, on average, generated $3.7 million for their hospitals, topping the list of money makers among the 18 specialties examined in the survey of hospital chief financial officers, which was conducted by Dallas-based physician recruiters Merritt Hawkins.
The money includes net inpatient and outpatient revenue derived from patient hospital admissions, tests, treatments, prescriptions, and procedures performed or ordered by physicians.
"The value of physician care is not only related to the quality of patient outcomes," said Travis Singleton, Merritt Hawkins' executive vice president.
"Physicians continue to drive the financial health and viability of hospitals, even in a healthcare system that is evolving towards value-based payments," Singleton said.
Invasive cardiologists were No. 2 on the list of money makers for hospitals, generating an average of $3.5 million, followed by neurosurgeons at $3.4 million, and orthopedic surgeons at $3.3 million.
Primary care physicians pulled their weight too, according to the survey. Family physicians generate an average of $2.1 million in net revenue, while general internists generate an average of almost $2.7 million.
The average net revenue generated by all physicians in the survey, $2,378,727, is up 52% from 2016, the last year Merritt Hawkins conducted the survey.
Average revenue generated by each of the 18 medical specialties included in the survey increased compared to 2016, in most cases significantly.
Even though inpatient stays declined or flat-lined in recent years, Singleton attributed the increase in net revenues to more outpatient visits, which have more than tripled since 1975, higher costs per hospital stay, and sicker patients as the population ages.
"Demographics are our destiny," Singleton said. "New delivery models that promote prevention, population health and fee-for-value are laudable innovations but they don't change the basic facts. People get older and require more medical care, with much of it ordered by or directly provided by physicians."
While primary care physicians are not the top revenue generators for their hospitals, Singleton says they represent an excellent return on investment.
Family physicians average $241,000 as a starting salary, according to Merritt Hawkins' data, but they generate nine times that amount in hospital revenues. Orthopedic surgeons, with an average starting salary of $533,000, generate six times that amount for their hospitals.
An aging demographic, a strong economy driving a tight job market, and increases in the costs of medical goods and services are key reasons for spending growth.
National health expenditure growth is expected to average 5.5% annually through 2027, reaching nearly $6 trillion and consuming nearly 20% of the economy by then, according to federal actuaries.
The projections, issued Wednesday by the independent Office of the Actuary at the Centers for Medicare & Medicaid Services and published in Health Affairs, anticipate that growth in national health spending will outpace projected growth in Gross Domestic Product by 0.8 percentage points over the coming decade.
Because of that, the actuaries project that healthcare's share of the GDP to rise from 17.9% in 2017 to 19.4% by 2027.
"Long observed, key economic and demographic factors fundamental to the health sector are anticipated to be the major drivers of healthcare spending and coverage trends over the projection period," study lead author Andrea Sisko, an economist for the National Health Statistics Group, said Wednesday at a media teleconference.
Those key drivers include: an aging baby boomer demographic transitioning to Medicare; continued income and employment growth; and a 2.5% increase in prices for medical goods and services through 2027, which is more than twice the 1.1% rate of growth between 2014-2017.
Local, state, and federal governments are projected to pay for 47% of national healthcare spending, compared with 45% in 2017.
"This increases entirely accounted for by an increase in the federal government's share, which largely reflects faster growth in Medicare spending as the baby boom generation continues to transition into the program," Sisko said.
Owing to higher projected enrollment growth, Medicare's 7.4% average annual spending growth is expected to exceed that of Medicaid (5.5%) and private health insurance (4.8%).
"The differences in enrollment growth across the three coverage type primarily explain the differences in projected average annual growth," Sisko said.
"The contrast between the Medicare and private health insurance growth rate both for spending an enrollment is largely explained by the continued shift of the baby boom generation into Medicare. The average annual per enrollee growth rates across the payers are otherwise largely similar," she said.
Also among the projections:
Hospital spending growth will average 5.6% through 2027. This includes a projected acceleration in 2019, to 5.1% from 4.4% in 2018, owing to faster expected growth in both Medicare and Medicaid, but slower projected growth in private health insurance as enrollment declines slightly due to the repeal of the individual mandate.
For the remainder of the decade, hospital spending growth is projected to average 5.7%, with faster growth anticipated for all payers but led by Medicare and with the expectation of higher growth in wages reflecting tighter labor markets for hospital employees.
Physician and clinical services spending will grow an average of 5.4% per year over through 2027. This includes faster growth in prices over 2020-2027 for physician and clinical services due to anticipated rising wage growth related to increased demand from the aging population.
Net health insurance enrollment gains across all sources are generally expected to keep pace with population growth with the insured share of the population going from 91% in 2017 to 89.7% in 2027.
With Medicaid's recent expansion in Idaho, Maine, Nebraska, Utah, and Virginia, spending growth is then projected to average 5.5% for 2020 through 2027, owing to an older, sicker enrollment mix.
Private health insurance spending growth is projected to average 4.8%, the slowest among the major payers, due to slow enrollment growth as baby-boomers transition to Medicare.
Out-of-pocket expenditures are projected to grow at an average rate of 4.8% through 2027 and to represent 9.8% of total spending by 2027, a decrease from 10.5% in 2017.
Accelerated drug spending growth of 4.6% is expected in 2019 because of higher use of new and existing drugs. Through 2027, spending growth is expected to average 6.1%.
The ongoing financial crisis threatening rural hopsitals may be worsening. And stakeholders warn that it could get even worse if the economy cools off.
More than 20% of rural hospitals are at a "high risk of closing" due to wobbly finances, a Navigant analysis of publicly available data shows.
The study, released Wednesday, also shows that 64% of these at-risk rural hospitals are considered essential to the health and economic well-being of their communities.
The analysis examines the financial viability and community essentiality of more than 2,000 rural hospitals nationwide. It found that 21% of the rural hospitals are at high risk of closing based on their total operating margin, days cash on hand, and debt-to-capitalization ratio. This equates to 430 hospitals across 43 states that employ 150,000 people.
"Our analysis shines a new light on a rural hospital crisis that must be addressed and could significantly worsen with any downturn in the economy," study co-author David Mosley, managing director at Navigant, said in a media release.
"Local, state, and federal politicians, as well as health system administrators, need to act," he said.
The study also reviewed of the "community essentiality" of these cash-strapped rural hospitals, measuring factors such as trauma status, service to vulnerable populations, geographic isolation, and economic impact.
They determined that 64% or 277 of these hospitals are considered essential to their community's health and economic well-being. In 31 states, at least half of these financially distressed rural hospitals are considered essential.
Southern and Midwestern states, including Mississippi, Alabama, Kansas, Georgia, and Minnesota, are projected to be impacted the most, the data shows.
The study blamed "multiple factors" for the ongoing crisis with rural hospitals, including low rural population growth, payer mix degradation, excess hospital capacity due to declining inpatient care, and an inability for hospitals to leverage technology due to a lack of capital.
One possible solution involves collaborations between rural hospitals and academic and regional health systems, that leverages the larger systems' resources for telehealth, revenue cycle management, human capital, electronic health records, physician training, and clinical optimization.
Reintroduced in 2017 by Sens. Chuck Grassley, R-Iowa, Amy Klobuchar, D-Minn., and Cory Gardner, R-Colo., the REACH Act would create a new Medicare classification under which rural hospitals would offer emergency and outpatient services but no longer have inpatient beds.
A study involving 401 patients in seven ICUs across the nation found higher oxygen saturation using the bag-mask ventilation, and lower risk of vomiting stomach contents into the lungs.
Using bag-mask ventilation to force air into the lungs during tracheal intubation improves outcomes and has the potential to save lives, new research shows.
"When you place a breathing tube, you have to give patients medications to make them relaxed and sleepy. And those medications take about a minute to kick in," said Jonathan D. Casey, MD, a pulmonary and critical care fellow at Vanderbilt University Medical Center.
"After you give those medications, there is a big divide among doctors about whether to just wait and watch while their breathing slows and stops, or to provide ventilation (breath for the patient) with a bag-mask device," Casey said in comments accompanying the study.
"We found that providing ventilation with a bag-mask device is safe and very effective. Most importantly, it cut the rate of severely low oxygen levels in half," he said.
More than 1.5 million patients undergo tracheal intubation each year in the United States, during which 40% of patients with illness suffer low oxygen levels, which may damage the brain and heart. Two percent of people undergoing a tracheal suffer cardiac arrest, which is frequently fatal.
Vanderbilt's PreVent trial (Preventing Hypoxemia with Manual Ventilation during Endotracheal Intubation) study, published this week in the New England Journal of Medicine has the potential to fundamentally change the practice.
For the study, the multicenter trial was used in seven ICUs across the nation, with adult patients undergoing the procedure receiving either ventilation with a bag-mask device or no ventilation between induction and laryngoscopy.
Among the findings:
401 patients enrolled, the lowest median oxygen saturation was 96% in the bag-mask ventilation group as compared to 93% in the no-ventilation group.
A total of 21 patients in the bag-mask ventilation group had severely low oxygen levels, as compared with 45 patients in the no-ventilation group.
Vomiting stomach contents into the lungs occurred during 2.5% of intubations in the bag-mask ventilation group and during 4% of the group without bag-mask ventilation.
"Some doctors believe that when you squeeze the bag and force air into the lungs that will also put air into the stomach and put the patient at risk for vomiting of stomach contents into the lungs," Casey said.
"That is not what we found. Our study found that bag-mask ventilation didn't cause the vomiting that people were worried about, and it was very effective at preventing low oxygen levels," he said.
Based on the study findings, VUMC's ICU now uses bag-mask ventilation during placement of a breathing tube.
"It is important to act on what we learn," said study senior author Matthew W. Semler, MD, VUMC's ICU medical director.
"Not only did we immediately apply these important results to our practice, but we have started follow-up trials of other ways to improve the safety of tracheal intubation – and those new trials require that bag-mask ventilation be provided for every patient receiving a breathing tube," he said.
Study co-author David R. Janz, MD, added that "the best thing about this intervention is that it is free."
"This is a device that is already always available when you are placing a breathing tube," said Janz, assistant professor of Medicine at Louisiana State University.
"In the past, we only used the bag-mask device to assist patients' breathing if we had difficulty placing a breathing tube. Now we know that it should be used in every procedure even before we make our first attempt to place a breathing tube," he said.
A greater primary care physician supply was associated with lower mortality, but the per capita supply did not keep pace with U.S. population growth between 2005 and 2015.
Every 10 additional primary care physicians per 100,000 population was associated with a 51.5 day increase in life expectancy, according to a study published Monday in JAMA Internal Medicine.
Using that same metric, an increase in 10 specialist physicians per 100,000 population corresponded to a 19.2-day increase in life expectancy, the study found.
By linking mortality rates with the numbers of primary care physicians, the Stanford University research supports the validity of population health initiatives that emphasize and rely upon access to primary care.
Over the course or a decade, the primary care physician supply in the U.S. increased from 196,014 in 2005, to 204,419 in 2015. That number did not, however, keep pace with the overall population growth, which means the number of primary care physicians per capita in that span decreased from 46.6 per 100,000 population to 41.6 per 100,000.
Furthermore, the study found "disproportionate losses" of primary care physicians in some counties, particularly in rural areas.
"The authors suggest the decrease in primary care physician supply across counties could have important health implications, although conclusions about individual-level effects shouldn't be drawn from population-level associations," the study said.
In acommentary accompanying the study, Sondra Zabar, MD, Andrew Wallach, MD, and Adina Kalet, MD, said more must be done both to steer physicians in training toward primary care, particularly in underserved areas.
"To increase access to primary care, especially in underserved areas, we must align incentives to attract individuals into primary care practice, innovate primary care training, and greatly improve the primary care practice model," the physicians wrote. "Physician payment reform is a key to making all of this happen."
"Our reimbursement system needs to incentivize a realignment in the ratio between primary care and non-primary care that is associated with the best population health, such that primary care physicians no longer shoulder a disproportionate share of administrative work such as medication refills and prior authorizations," the physicians wrote.
The study looked at U.S. population data and individual-level claims data linked to mortality from 2005 to 2015 against changes in primary care and specialist physician supply from 2005 to 2015.
Data from 3,142 counties, 7,144 primary care service areas, and 306 hospital referral regions were used to investigate the association of primary care physician supply with changes in life expectancy and cause-specific mortality after adjustment for healthcare, demographic, socioeconomic, and behavioral covariates.
Prosecutors say two Pennsylvania hospitals owned by the California-based, for-profit health system billed Medicare for unneeded overnight hospital stays.
For the second time in less than one year, Prime Healthcare Services Inc. and founder and CEO Prem Reddy, MD, have reached an upcoding settlement with the U.S. Department of Justice.
Reddy and the for-profit health system, based in Ontario, California, this week agreed to pay $1.25 million to settle additional whistleblower allegations that two Prime hospitals in Pennsylvania—Roxborough Memorial Hospital in Philadelphia and Lower Bucks Hospital in Bristol—knowingly submitted false claims to Medicare, a violation of the False Claims Act.
Prosecutors said the hospitals allegedly admitted patients for overnight stays who needed only less costly, outpatient care. The hospitals also allegedly up-coded for more expensive patient diagnoses than needed.
"Charging the government for more-costly services than what the patient actually needs and billing the government for more serious diagnoses than what the patient actually has is a waste of taxpayer dollars," William M. McSwain, U.S. Attorney for the Eastern District of Pennsylvania said in a media release.
Prosecutors allege that from the time Prime acquired the two hospitals in 2012 through September 30, 2013, the hospitals admitted emergency room Medicare patients for costly and medically unnecessary one- and two-day overnight hospital stays, instead of treating the patients in less costly outpatient service or keeping them under observation.
In addition, from 2012 through Dec. 31, 2014, the hospitals up-coded inpatient diagnoses to increase Medicare payments.
In August 2018, Prime and Reddy paid $65 million to resolve whistleblower allegations that 14 Prime hospitals in California systematically overcharged Medicare. Prime admitted no wrongdoing in that settlement.
The Pennsylvania settlement resolves a whistleblower suit filed by an employee and a former employee at Roxborough Memorial.
"We expect health care companies to accurately bill federal healthcare programs for services they provide, not pad profits by charging for more expensive services than were actually provided," said Maureen Dixon, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.
Prime Healthcare Responds
Prime Healthcare on Friday afternoon acknowledged the settlement, and said it "dealt primarilty with the technical classification of the category under which patients were admitted and billed."
"Prime Healthcare agreed to resolve this matter as part of the larger resolution of the California qui tam lawsuit that Prime settled on August 3, 2018," the statement read. "This settlement contains no finding of improper conduct or wrongdoing, and Prime Healthcare's record of clinical quality care was never in question. The settlement also provides a full release to Prime Healthcare and does not affect its existing corporate integrity agreement."
Joel Richlin, Prime Healthcare's deputy general counsel, said "this settlement allows Prime Healthcare to continue to focus on its mission of providing quality, compassionate healthcare while saving hospitals, savings jobs, and saving lives."
The model will give providers the option of treating Medicare FFS patients at the scene, or using telehealth, and to transport them to less-costly care venues when appropriate.
The Department of Health and Human Services is launching a new payment model for ambulance services that federal officials believe could lower out-of-pocket costs for Medicare fee-for-service beneficiaries.
The Emergency Triage, Treat and Transport Model—ET3—allows ambulance companies to deliver on-the-scene or telehealth services to Medicare FFS patients, and transport them to alternative care venues, such as primary care doctors' offices or urgent-care clinics.
The model will encourage development of medical triage lines for low-acuity 911 calls in regions where participating ambulance companies operate. The ET3 model will have a five-year performance period, starting in early 2020.
Centers for Medicare & Medicaid Services Administrator Seema Verma said Thursday the model is designed to prod providers across the care continuum to more appropriately and inexpensively meet beneficiaries' care needs.
"This model will help make how we pay for care more patient-centric by supporting care in more appropriate settings," Verma said, "while saving emergency medical services providers precious time and resources to respond to more serious cases."
Currently, Medicare primarily pays for unscheduled, emergency ambulance services when beneficiaries are transported to a hospital ED. This creates a financial incentive to transport all beneficiaries to the more-expensive ED, even when a cheaper care option is more appropriate.
Two New Payment Options
The ET3 model will expand to include two new ambulance payments:
Payment for treatment with a healthcare provider, either on-the-scene or using telehealth;
Payment for unscheduled, emergency transport of Medicare beneficiaries to alternative destinations, such as 24-hour care clinics, other than destinations covered under current regulations, including hospital EDs.
Participating ambulance companies and providers to earn up to a 5% payment adjustment in later years of the model based on quality measures that will also minimize any new reporting requirements, HHS said.
Providers and alternative care venues that partner with ambulance companies would receive payment as usual under Medicare for services rendered.
The model will be phased in to maximize participation across the country, and CMS will encourage ET3 participants to partner with other payers, including state Medicaid agencies.
CMS expects to release a Request for Applications in mid-2019 to solicit Medicare-enrolled ambulance companies.
In Fall 2019, to implement the triage lines for low-acuity 911 calls, CMS expects to issue a Notice of Funding Opportunity for a limited number of two-year cooperative agreements, available to local governments, or other entities have authority over 911 dispatches in geographic locations where ambulance companies have been picked to participate.
Even as hospitals try to cut back on prescribing powerful antibiotics for their patients, many of those patients still head home with prescriptions for those same drugs.
Michigan hospitals that are actively trying to reduce use of fluoroquinolones were twice as likely to discharge patients with a new prescription for one of the powerful antibiotics, a new study shows.
One-third of the patients studied in the University of Michigan study received a fluoroquinolone prescription at the end of their hospital stay, despite the fact that current guidelines call for restricted use due to side effects.
In the 48 Michigan hospitals in the study, discharge-related prescriptions accounted for two-thirds of the entire fluoroquinolone supply prescribed to the nearly 12,000 patients treated for pneumonia or urinary tract infections, and 42% of all antibiotics prescribed at discharge.
"Fluoroquinolone antibiotics are easy to use, but carry a lot of risk for patients and society at large," Valerie Vaughn, MD, lead author of the study and a hospital medicine specialist at Michigan Medicine, said in a media release.
"These results show we need to focus on not just their use in hospitals, but also in the prescriptions that we send patients home with. Discharge prescribing is a big loophole," she said.
Fluoroquinolones include name-brands like Cipro and Levaquin as well as generic antibiotics whose names end in "floxacin." They have been linked to the rise of drug-resistant organisms and Clostridiodes difficile.
They've also been linked to ruptures of Achilles tendons, to dangerously low blood sugar levels in people with diabetes, and to mental health problems including disorientation and delirium.
The new study focuses on pneumonia and UTI because the two conditions account for almost half of antibiotic use in hospitals. Most patients with these conditions are cared for by hospitalists or general internists, rather than infectious diseases specialists who mainly focus on the most serious cases.
In all, more than 10% of patients in the study were switched to a fluoroquinolone antibiotic when they were discharged.
Vaughn said fluoroquinolones can treat a broad spectrum of infectious organisms, and can be used in patients who are allergic to penicillin. They also come in pill form, rather than needing to be delivered intravenously, which makes them much more attractive for discharge prescriptions.
But if patients are getting through their hospitalization without them, then they're likely not the right choice for treatment after they leave the hospital, she said.
Fourteen of the hospitals in the study had specific measures in place to require review of fluoroquinolone prescriptions during hospitalization.
In these hospitals, more than 78% of the supply of fluoroquinolones was prescribed at discharge, compared with 68% of the supply for the other 34 hospitals, nearly all of which had antimicrobial stewardship programs but didn't put special emphasis on fluoroquinolones.
The study authors speculate that while pharmacists and infection prevention specialists are keeping an eye on in-hospital prescribing, they don't have access to prescriptions written at discharge. Electronic health record systems track both inpatient and discharge medications, but they are often in separate sections of the record.
Since the data were shared, several hospitals in the consortium have begun paying special attention to discharge prescribing of fluoroquinolones, and others are preparing to.
Federal prosecutors say the physicians in the now-dissolved Mississippi medical group failed to return Medicare overpayments, but self-reported the infractions after an audit.
Jefferson Medical Associates, a now defunct multi-specialty medical practice group in Laurel, Mississippi and Aremmia Tanious, MD, will pay $817,635.06 to resolve claims under the False Claims Act arising from Medicare overpayments, the Department of Justicesaid.
According to federal prosecutors, from Jan. 1, 2012, through Dec. 31, 2014, Jefferson Medical Associates and Tanious failed to return Medicare overpayments.
In addition, from Feb. 1, 2013, through June 30, 2017, Jefferson Medical and Tanious allegedly billed Medicare using multiple medical codes when the medical documentation did not support the use of such billing practices.
Prosecutor said Jefferson Medical and Tanious cooperated with the investigation after they discovered through audits of patient files and claims data that Medicare had been overbilled for certain services.
"This settlement should serve as a reminder to medical providers receiving Medicare funds that they must timely report and return any overpayments owed to Medicare or be subject to liability under the False Claims Act," said Mike Hurst, U.S. Attorney for the Southern District of Mississippi.
The initiative hopes that improving access to affordable, nutritious food in underserved areas, particularly for diet-related, chronic conditions, will reduce avoidable ED visits and hospital admissions.
Chicago and Dallas residents living in "food deserts" will have easier access to nutritious, affordable food, thanks to a new initiative between Health Care Service Corp. and the Blue Cross Blue Shield Institute.
FoodQ is a delivery service open to anyone living in ZIP codes associated with the six-month pilot project, regardless of whether or not they have health insurance.
"We know a ZIP code is just as important as a genetic code in determining a person's health – impacting medical needs and access to care," said Trent Haywood, MD, president, BCBS Institute.
"As a physician, I know I can easily write a prescription, but what I don't know is how am I going to make sure patients have access to healthy meals they can afford and want to eat," Haywood said.
The hope is that the easy access to affordable, nutritious food will improve population health, particularly for diet-related, chronic conditions, while reducing avoidable ED visits and hospital admissions.
"With the alarming rates of obesity and diabetes in our country, we need a different approach to supporting healthy living, and this pilot program can help remove the barriers that keep people from accessing healthy, affordable and nutritious foods," Haywood said.
The consumers can access a mobile-optimized foodQ website and review the ready-to-heat lunch and dinner meal options. They enter their ZIP code in the foodQ site, which determines if they are eligible for the service.
When eligibility is verified, participants enter their payment information, select their meal choice, then choose a date and time for meal delivery.
Users select from five meal categories including beef, chicken, fish, pork and vegetarian options. Participants will receive a text message confirming the order, as well as notifications when the order is on its way and has been delivered.
Participants are encouraged to subscribe to foodQ for $10 per month, which includes free delivery and a buy-one-get-one option for every meal purchased. People who do not subscribe can buy individual meals for $10 with a $6 delivery fee.
Meal deliveries began in Chicago last week and start in Dallas in April.
HCSC supported the BCBS Institute's development of foodQ through an initiative to address the root causes of an expensive healthcare system, with investments in social determinants of health as one of the initial focus areas.
The BCBS Institute will pilot foodQ in 25 Chicago ZIP codes and 15 Dallas ZIP codes where HCSC operates health plans.
"Food deserts are one of the key social determinants of health impacting millions of Americans," said Manika Turnbull, vice president and community health and economic impact officer, HCSC, the nation's largest customer-owned health insurance company.
"With this program we are meeting people where they live to provide access, affordable pricing and education that can influence healthy behaviors, reduce health disparities and improve their quality of life," she said.
The pilot will work with Kitchfix in Chicago and Front Porch Pantry in Dallas to prepare and deliver meals.
The BCBS Institute tailored foodQ to the community's needs using its detailed data by ZIP code on the social and environmental factors influencing health.
Throughout the pilot, participants will be surveyed to measure the demand for foodQ service and assess any correlation between the pilot and reductions in avoidable hospital and ED visits.
A Growing Movement
Improving access to good food, particularly for economically disadvantaged areas, and addressing other social determinants of health is not a new idea, but the movement has been accelerating of late.
Last month, the Centers for Medicare & Medicaid Services announced that Medicare Advantage plans in 2020 would have the option of providing meals and supplemental benefits to beneficiaries with chronic illnesses.
"How can someone manage diabetes if they are constantly worrying about how they’re going to afford their meals each week?" Health and Human Services Secretary Alex Azar said in prepared remarks at the Hatch Foundation for Civility and Solutions last November.
Houston Methodist is running apopulation health initiative that includes a grant-supported program called Homeplate, which provides food and daily meals for inpatients after discharge.
"Food is one of the primary social determinants affecting health," says Janice Finder, MSN, BSN, director of population health and performance improvement at the health system.
"We have found that many patients who come out of the hospital do not normally require Meals on Wheels or similar programs, but they may need help with meals and a daily check for the first 14–30 days postop," she says.
Loel S. Solomon, PhD, KP's vice president for community health, says providers can no longer improve population health without looking beyond their own walls.
"Good clinical prevention is necessary, but insufficient to help our members eat better, which is critical to addressing obesity and diabetes and all sorts of chronic diseases," Solomon says.
