The American Medical Group Association warned this week that proposed rules governing accountable care organizations are "overly prescriptive" and "too burdensome," and will discourage physician participation.
In a letter to Centers for Medicare and Medicaid Services Administrator Donald Berwick, MD, AMGA President/CEO Donald W. Fisher warned that a survey of its members found that 93% would not enroll as an ACO under the proposed regulations.
According to the HealthLeaders Media Industry Survey 2011, more than half, (52%) of physicians surveyed said they expect to be part of an ACO within the next five years. That survey, however, was completed months before the proposed rules were released in April.
"Our membership's concerns were many and focused on issues such as the risk sharing requirement, static risk adjustment, retrospective attribution, quality measurement requirements, the Minimum Savings requirements and others," Fisher said in the letter. "Without substantial changes in the Final Rule, we fear that very few providers will enroll as ACOs and that CMS and the provider community will miss the best opportunity to inject value and accountability into the delivery system."
In an interview Thursday with HealthLeaders Media, Fisher said AMGA would provide a detailed critique of the proposed rules and a list of recommendations before the end of the public comment period on June 6. "We just sent this letter because we wanted to make sure that CMS was aware of the significant changes that need to be made, and let them know how serious these problems are. We didn't want to wait until the process had already started," he said.
Fisher detailed a list of concerns that AMGA would address in its formal comments.
Risk Adjustment: "We're concerned that CMS intends on adjusting the risks on ACOs costs calculations only for the first year, and these are three year agreements. Most of my members are very worried that they are going to get adversely selected against by frail and ill patients because the word will get out that these are high quality low cost organizations that do a terrific job taking care of patients. If you don't adjust after the first year and get an influx of patients that are much more severely ill than the first estimates gives, you are going to be risk adjusted incorrectly."
ACO Patient Attribution: "The attribution model that CMS is proposing is retrospective. They are going to do a look-back over three years to count the plurality of primary care visits to a facility. Whoever has the most gets that patient. They aren't going to have that until after the first year. So you are going to have to gear up to be an ACO, you are going to have to make an investment in the infrastructure, and you are not going to know who your patients are until after that first year. And, given that there is a 5,000 Medicare beneficiary minimum by statute, you might do all of these investments and find out you don't hit the 5,000 Medicare beneficiary threshold and you are out of the program. We would like to see them do a prospective patient attribution. Let's have these ACOs know who their patients are when they begin so they can make sure those patients are getting the care they need to improve quality and lower costs."
Minimum Savings Requirements: "If you go back to the group practice demonstration, which was 10 medical groups over five years, they had a 2% minimum savings to meet before they got into the shared savings program. In the proposed ACO regulations they have taken that 2% and raised it to 3.9%. If you talk to most of the medical groups who participated in the group practice demo, they had a difficult time getting to 2% over a five-year window. Many of them invested a lot more money than they ever got back. So when you take this up to 3.9% you are requiring a huge hurdle to be overcome by these medical groups financially before they get into the shared savings."
AMGA is the latest in a line of professional provider organizations that has raised concerns about the proposed rules for ACOs. Earlier this week, the College of Healthcare Information Management Executives complained that the ability of patients in accountable care organizations to restrict access to their personal health information is one of several huge hurdles.
In April, a slate of health leaders including the CEOs of Scripps Health, Alegent Health, Kaiser Foundation Hospitals, and Dean Health Systems weighed in with their responses to CMS' proposed regulations.
In its letter to Berwick, CHIME called for a re-examination of several sections of the proposed rules that it said would create significant pressures on ACOs.
Fisher told HealthLeaders Media that he is disappointed that CMS didn't use the lessons learned from the group practice demonstration project. "These requirements to become an ACO are much more stringent that what the group practice folks had to go through, and at the end of their five-year period they were able to demonstrate that they improved outcomes and saved money," Fisher said. "Why would you want to raise the bar even higher for the next level of participants in this experiment. The 2% minimum savings was the maximum for the group practice demo folks. Now we have raised it to 3.9%. They did have retrospective attribution and that was a real problem for them and they complained. We were hoping CMS would fix it, but they didn't."
Fisher said AMGA hopes to work with CMS to revise the rules, but AMGA is also prepared to go to Congress to ask for help if CMS is unwilling or unable to amend the rules. "This is the real opportunity in the Affordable Care Act to reform the healthcare delivery in this country. We want to see it work," he said.
WakeMed Health & Hospitals Thursday made a formal offer to buy Rex Healthcare from UNC Health Care System for $750 million, the Raleigh, NC-based health system said.
The offer, which had been under development by WakeMed for several months, was authorized by a unanimous vote of the WakeMed board of directors last week. An offer letter from Board Chair Billie Redmond and President and CEO Bill Atkinson was submitted Thursday to The University of North Carolina President Thomas Ross, WakeMed said in a media release.
"We strongly believe that the movement of Rex to the WakeMed system will greatly facilitate WakeMed's mission of service to the citizens of our area while also decreasing costs and providing efficiencies that would further support UNC's mission of providing academic-based patient care, research and teaching," Atkinson and Redmond said in their letter to Ross.
UNC Health Care and Rex Healthcare did not immediately return calls seeking comment Thursday. But the North Carolina News-Record quotes UNC Health CEO Bill Roper as saying in a phone interview Wednesday night, "Rex is not for sale. It's an institution that's a very important part of our mission to serve the entire state." The paper additionally reported that "Rex CEO David Strong sent an email to Rex employees late Wednesday dismissing rumors of a potential sale as 'outrageous and untrue.'"
Analyst Mark Reiboldt at the Coker Group, said in an email to HealthLeaders Media that "UNC has apparently said they're not interested in selling; however, WakeMed believes that Rex can be improved significantly under their model as opposed to a traditional academic system."
More specifically, Atkinson and Redmond said in their letter that the deal would benefit healthcare consumers and improve access in the Triangle area around Raleigh, because a combined system would cut duplicate services and coordinate complementary strengths of both systems.
"WakeMed has about $500 million in cash…and Rex makes the most sense at this point to gain a leg up on market share from competitors," Reiboldt said.
WakeMed said the $750 million offer represents "a significant percent return on investment" for UNC Health Care, the university system, and the state of North Carolina, which purchased Rex 11 years ago.
"WakeMed has proudly served the community for 50 years, and the system is currently in a very strong financial position with a healthy operating margin and significant cash reserves at a time when the state of North Carolina has a significant fiscal crisis affecting the state's university system and, as a result, UNC Health Care," the letter to Ross said.
"As consolidation is becoming more common, the traditional anti-trust regulations preventing not-for-profit hospitals from controlling too much share in a particular market is posing a major challenge that has already prevented deals from closing," Reiboldt said. He suggests anti-trust concerns may be weighing on the minds of the UNC board.
Reiboldt explained further, "The emerging trend is that more and more transaction bids are being guided by what is / is not likely to pass anti-trust hurdles. Sellers will not consider buyers that pose anti-trust concerns and vice versa. So, they will end up accepting an offer from another potential buyer that does not have the same regulatory barriers; however, this may not be what is best for either of the organizations, and the net result could be troublesome mergers that lead to poorer healthcare services and likely an eventual unwind or divestiture down the road."
While private, not-for-profit WakeMed was singing the praises of Rex Healthcare Thursday, the relationship between the two rival hospitals has not always been smooth.
Last November, WakeMed asked to look at the public records of UNC Health Care and Rex to determine if public money was used by either of the state-owned entities to duplicate and shift services to gain an unfair competitive edge. WakeMed alleged that UNC Health Care and Rex had taken "predatory actions" in Wake County that include recruiting doctors away from WakeMed.
Illinois state lawmakers are being urged to reject $463 million in proposed cuts to Medicaid payments that the Illinois Hospital Association says would cripple healthcare delivery and jeopardize patient access to care.
"These drastic cuts are wrong and unnecessary, and will only harm patients, hospitals, and the healthcare delivery system," IHA President Maryjane A. Wurth said in a media release. "Many hospitals across the state are already struggling to survive in the current economic downturn." The cuts are detailed in House Amendment #1 to House Bill 3717 – which was filed late Tuesday.
Late Wednesday the Illinois House Appropriations-Human Services voted 13 to 1 (and one present) to send its human services budget proposal, House Bill 3717, to the House floor. The proposal (which is a total of just under $12 billion) includes the Medicaid cuts.
Wurth pointed to a recent IHA survey that found that 90% of hospitals would be challenged to meet day-to-day operations, and nearly two-thirds would have to cut services and lay off staff if $300 million in Medicaid cuts were imposed under Governor Pat Quinn's budget plan. Quinn, elected in 2010, is a Democrat.
Illinois lawmakers are scrambling to fill a budget shortfall of between $1.5 billion and $2.4 billion by the end of May. A Senate budget bill calls for about $300 million in Medicaid cuts.
An IHA analysis this week found that the Medicaid cuts of $463 million, coupled with a $200 million cut to hospitals through proposed reductions to the workers' compensation medical fee schedule would increase by nearly 40% the number of hospitals operating in the red. That would mean nearly half of Illinois' 200 hospitals would be operating at a loss, IHA said.
The Medicaid cuts would be in addition to the $8 billion in federal Medicare reductions to Illinois hospitals that began last year under the healthcare reform law and that continue for another nine years, IHA said.
IHA also called on state lawmakers to use revenue projections provided by the nonpartisan Commission on Government Forecasting and Analysis in setting appropriate spending levels for the state budget. The commission this spring issued a state revenue projection of $34.3 billion, more than $1 billion above the estimate now being used by the House.
"Using understated revenue projections will lead to unnecessary and harmful spending cuts that will hurt our state's most vulnerable populations, including the young, the elderly, the disabled, expectant mothers, and the newly employed," Wurth said.
Rather than relying on "blunt cuts," IHA said it has identified more than $100 million in targeted savings, including reductions in preventable readmissions and unnecessary utilization.
IHA also called for the use of interfund transfers that would allow the state to quickly obtain $90 million in new federal Medicaid funds by maximizing the state's temporarily higher matching rate under the economic stimulus law. The House unanimously approved a bill to authorize the transfers, and that bill is now pending in the Senate.
Older, sicker heart-transplant patients are more likely to be alive a year after their operations if they've been treated at hospitals that do a lot of transplants, a Johns Hopkins School of Medicine study showed.
"There's growing evidence throughout medicine and surgery that the volume of cases done at a given medical center has an impact on outcomes," George J. Arnaoutakis, MD, a general surgery resident at the Johns Hopkins University School of Medicine and the study's leader, said in a media release. "Transplant teams more familiar with a procedure do a better job than those that only do a handful each year."
The findings will be presented at the American Association of Thoracic Surgeons' annual meeting in Philadelphia.
The researchers examined United Network of Organ Sharing data from all of the heart transplants done in the United States between January 2000 and December 2009. The researchers assigned each of the 17,211 patients a risk score, which took into account known risk factors for complications and/or death after heart transplant, including age, race, cause of heart failure, bilirubin and creatinine levels and whether they had been on life support. The higher the score, the greater risk of death one year after transplantation, the study said.
Researchers also ranked the 141 hospitals where the transplants took place into low-, medium- and high-volume centers. Low-volume centers did fewer than six heart transplants a year. High-volume centers performed more than 15 annually. Just 5.4% of heart transplants took place at low-volume centers over that 10-year period, while more than 67% were done at high-volume centers, the Johns Hopkins research showed.
High-risk patients transplanted at low-volume centers had a 67% increased risk of death after one year compared with high-risk patients transplanted at high-volume centers. Severity of condition alone did not account for the difference, which diminished among low-risk patients, the research showed.
"Patients at high risk of mortality should probably only be transplanted at high-volume centers," Arnaoutakis said.
Arnaoutakis said the findings aren't an indictment of the training and skill of surgeons at low-volume centers, but more likely reflect the systems and infrastructure of a center doing few heart transplants.
"There are certain processes that may be better performed at regional centers of excellence doing more of a certain procedure," he said. "People talk about it with airline pilots -- only at 10,000 hours of flying are they considered expert at flying. The experience of a center can be discussed in similar terms."
Nurses at a high-volume center, for example, may be quicker to recognize complications and intervene earlier, he said. Operating room teams might be better prepared to handle a transplant that occurs in the middle of the night.
"The more you do it, the better you become at doing it," he said.
Under proposed rules set down by the federal government for accountable care organizations, providers won't know who their patients are until they're through the first year of the new care delivery model. In addition, those anonymous ACO patients may seek healthcare anywhere they want. If they run up a healthcare bill somewhere else, their ACO is still responsible for the cost.
And those downside risks could be considerable when ACOs enter the "two-sided model" in their third year of operations. A report from PricewaterhouseCoopers shows that two-sided ACOs with 5,000 beneficiaries could earn as much as $1.3 million for generating savings of 5%, but could also be penalized $420,000 for cost increases of 5%. For ACOs with 60,000 beneficiaries, that incentive payment for 5% savings would be around $15.6 million, while the penalty for a 5% increase in costs would be $5 million.
With those kinds of numbers in play, some healthcare executives are openly skeptical about the benefits of joining a highly complex, untested, and potentially punitive healthcare model that prevents them from controlling – or even identifying – their patients.
"I think they are going to have to modify the rules. That's what we're hoping for," Dan Wolterman, president/CEO of Houston-based Memorial Hermann Healthcare System, told HealthLeaders Media. "Most entities out there in the U.S. are not a Mayo Clinic or Geisinger (Health System), where you have large groups and hospitals integrated for years. Most of them are like us, community hospitals, teaching hospitals, dealing with a lot of private practice physicians trying to move this thing forward."
Wolterman calls the proposed retrospective assignment of ACO beneficiaries "a difficult sell" that could discourage many providers from taking up the new model. "First and foremost they have to assign the Medicare beneficiaries ahead of time. You have to know who your patients are to be able to work with them to modify their lifestyle and manage their chronic diseases, and navigate that patient through the complex healthcare system," he said.
Wolterman says he was told that the federal government doesn't want to identify ACO beneficiaries ahead of time, because they don't want providers to skimp on care to keep costs down, a justification that he says doesn't hold water. "The whole concept that they aren't going to assign them to us because we are going to skimp on care -- that just says you don't trust the system," he says. "I don't believe that skimping will happen. You have these people for three years. If you skimp in the first or second year on a hypertensive patient they may come back with a stroke or a (myocardial infarction)and cost a lot more the third year."
Benjamin Isgur, director of PwC's Health Research Institute, told HealthLeaders Media that Wolterman and other healthcare executives are raising legitimate concerns. "That's why we're saying don't underestimate the infrastructure that is going to be required for a successful ACO model," he says. "If you look at the rules, if you aren't already a fairly integrated organization, there are some pretty daunting things there. You have to have EMR working well so you can analyze the data. You are going to have to meet more quality requirements than any other CMS program. You have to manage a population that might be difficult to manage because you might not know exactly who is in your ACO until after the first full year. There are a lot of infrastructure and sophistication issues that organizations should not underestimate."
Isgur identified several "huge barriers" for many fledgling ACOs. In addition to not knowing who their beneficiaries are until after the first year, ACOs also are not closed networks, and beneficiaries are free to seek treatment wherever they'd like. When beneficiaries get care out of network, that accrued cost is assigned to the ACO, even though they didn't provide the care, and probably had no say in the decision making. "You wake up one morning and a significant portion of your population is in Florida for the winter," he says. "When you are dealing with a Medicare population, especially in the upper incomes, you are dealing with a retiree population that may be living in more than one geographic place in one year."
Finally, Isgur says, demonstration projects have shown that Medicare beneficiary populations have significant "churn" -- about 25% turnover each year, further straining an ACO's ability to control costs.
Isgur says he would not be surprised to see "substantial changes" to the final ACO rules after the comment period ends on June 6. "Most people looking at these draft rules believe there are going to be at least some attempt to alleviate some of the burden," he says. "To be frank, there is negativity in the market place. When these were released, there were 500 pages of rules a lot of organizations threw up their hands and said 'we aren't ready to tackle this.' The government is going to have to revisit these and we can expect to see some change."
Because the federal government is pushing patient choice, Isgur says any change in the rules to help ACOs would more likely involve "a more prospective understanding of the beneficiary population so you can have more accuracy in beginning to manage that population off the bat." That could include some contingencies for ACOs whose patients get a certain percentage of care from outside the service area, perhaps not accruing those costs toward the ACOs average costs.
Wolterman says that even though the risk is capped in the two-sided model, healthcare providers are still on the hook for significant costs. "And the ability to collect that money from private physicians -- and they are proposing to do that with a 25% withhold off their current fee for service -- that is a pretty hard sell to doctors," he says. "Hopefully, they will come out with some more well thought out final regulations this summer. Right now there is a lot of pause out there. We may be willing to take the risk and use it as a three-year teaching demonstration project for our doctors and our system, or we may not if our doctors aren't happy with the terms."
If the federal government wants to grow the ACO model, Wolterman says it will have to return the concept to a shared savings program for all three years and reconfigure other financial incentives and risks. "Those who are far enough along and want to go at risk for three years, fine, let them. I have no problem with that. But allow the rest of America to use this as an opportunity to begin the change of working with their doctors. That is what this was supposed to be," he says.
The ability of patients in accountable care organizations to restrict access to their personal health information is one of several hurdles that could hinder the success of the new healthcare delivery models, the College of Healthcare Information Management Executives said this week.
In a letter Tuesday to Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services, CHIME called for a re-examination of several sections of the proposed rules that it said would create significant pressures on ACOs.
“If beneficiary claims data are withheld, the ACO’s ability to improve individual beneficiary health, as well as achieve the desired shared savings, could be compromised,” CHIME said in the letter, its public comments on the Notice of Proposed Rulemaking for governing ACOs.
“We believe that allowing ACO patients to opt out of data sharing, while maintaining their ability to see the primary care physician participating in an ACO, contraindicates efforts to provide accountable care.”
CHIME told CMS that patients who want to opt out of sharing claims data should be required to see a primary care physician not affiliated with an ACO, or that healthcare expenditures for these patients should not be counted against an ACO under shared savings payments.
“Technology will no doubt play a prominent role in the success of any ACO. The amount of data and information exchange between ACO participants will be enormous,” Bill Spooner, senior vice president/CIO at San Diego-based Sharp HealthCare, said in a CHIME media release. “But as the person responsible for lining up those data points, CIOs are really worried about patient data opt-out provisions. We think the simplest answer is to remove patients from ACO participation if they refuse to share their data.”
CHIME, in its comments to CMS, also objected to a requirement that 50% of an ACO’s primary care physicians meet all meaningful use standards for electronic health records by the beginning of the second year of the ACO’s agreement with CMS. “From both patient management and business perspectives, CHIME feels it would not be necessary for an ACO’s PCPs to meet all MU requirements. Similarly, CHIME sees no need for CMS to specify some minimum level of EHR MU performance for the hospitals participating in an ACO,” CHIME said.
Pam McNutt, senior vice president/CIO of Methodist Health System in Dallas, and chair of CHIME’s Policy Steering Committee, said concerns raised in the letter to Berwick “speak to the complex technical implications of CMS’s Shared Savings Program. As hospitals look to participate, they will depend on CIOs to understand how ACOs meet the data collection and reporting requirements. We urged CMS in our comments to avoid prescribing technology, such as requiring meaningful use, instead allowing ACOs to make determinations based off their business needs and patient populations.”
CHIME also asked CMS to:
Reconsider the proposed use of 65 performance measures in the first year of the ACO program. “CHIME also believes that CMS is underestimating the difficulty of the proposed data validation process,” the letter to CMS said.
Align performance measures across similar or related programs and outline a more consistent approach for measuring quality improvement for other programs that overlap. David Muntz, senior vice president/CIO at Dallas-based Baylor Health Care System and chair of CHIME’s Advocacy Leadership Team, said that healthcare organizations want to develop and monitor “the right performance measures” to improve healthcare delivery, “but some of the proposed performance measures for ACOs seem to be duplicative or unrelated to broader ACO tenets.”
Scale back expectations for health information exchange to give healthcare organizations more time to gain experience with the use of exchanged patient data in care delivery. “These proposed regulations portend a level of functional health information exchange and technology adoption that may be too aggressive for deployments in January 2012 and not yet ready for effective deployment,” CHIME said in its comments to CMS. “We believe this issue could be better handled by allowing ACOs to determine their own technology needs, given their market and their patient population.”
The letter was signed by CHIME CEO/President Richard A. Correll, and CHIME Board Chairman Lynn Vogel, MD, who is also vice president/CIO at the University of Texas, M.D. Anderson Cancer Center.
Because the U.S. population is aging, gaining weight, and thus requiring more healthcare services, conventional wisdom has it that the demand for healthcare workers will remain strong. To an extent, that has been true.
In April, for example, for the second consecutive month, job growth in the healthcare sector showed impressive gains, Bureau of Labor Statistics preliminary data shows. Healthcare sector consistently has been one of the few job-creating sectors in the recovery. And, The Conference Board monthly review of online job postings consistently shows that there are three jobs available for every skilled healthcare provider.
What's puzzling, though, is another report from The Conference Board this month which shows that post-recession job growth in the healthcare sector today is the slowest it's been during an economic recovery since 1960.
Healthcare sector job growth was 6.9% in the months after the recession of 1991, and 4.5% following the 2001 recession, but only 3.5% in the 21 months since the recession ended in June, 2009, The Conference Board research shows.
What's going on?
"If you look at the 21 months since the recession, the recovery in healthcare jobs is the weakest among all recoveries in healthcare jobs," Gad Levanon, associate director of macroeconomic research at The Conference Board, tells HealthLeaders Media. "It's one of the fastest growing industries, but it is always one of the fastest growing industries. But in relative terms healthcare is recovering more slowly than in any other recovery."
"It's a mystery to me," Lavanon says. "You would think that as the U.S. population is getting older the demand for healthcare services is going to get stronger as well. What we see is that in this decade, the increase in the number of healthcare workers is much slower.
"In many cases, the explanation could be outsourcing or productivity growth, but I don't think that is a good explanation for healthcare, where things can't be outsourced and it is labor intensive," Lavanon says.
Is the healthcare sector -- which already employs more than 14 million people -- becoming more efficient and productive, and thus not in need of as many workers? Or, is job growth slowing because there aren't enough people to fill the positions? Or, is job growth slowing because the healthcare sector can't afford to add to the labor force, nor can consumers continue to support that added cost? I suspect that the answer involves all three questions.
Slow job growth does have its upsides. It would appear that this halving of the rate of job growth in the healthcare sector has slowed the growth of healthcare inflation, at least in the short-term. Labor costs constitute about 60% to 70% of the budgets at many healthcare organizations.
As I reported a couple of weeks ago, Standard & Poor's Healthcare Economic Indices shows that the average per capita cost of healthcare services covered by commercial insurance and Medicare grew 6.19% over the 12 months ending in February. (The Consumer Price Index showed that overall inflation grew by 2.1% for the same period.)
That's high -- unsustainable, actually -- but the rate of growth in healthcare inflation has been steadily decelerating since it hit a high water mark of 8.74% for the 12-month period ending May 2010. S&P analysts have noted that hospital employment growth has correspondingly slowed significantly, falling from 2%-3% increases between 2008 and early 2009, to 1% since the middle of 2009. S&P analysts believe that slowing rate of inflation in healthcare is also tied to high unemployment in the overall economy, but they also warn that the slowing trend could quickly reverse.
So what's next? If we accept that labor costs are the biggest driver in healthcare inflation, does that mean that healthcare employment growth will slow even more? Will healthcare workers be expected to do more, with less help? Can healthcare workers expect to see their salaries and other compensation stagnate, as it has in most other sectors of the economy?
Once again, I suspect the answer lies in the questions. We're already seeing compensation costs decline for healthcare workers, a trend that has been around for the last 20 years or so, and hospital layoffs have become a daily event.
It's worth remember, however, that the healthcare sector grew 466,400 jobs in the 21 months since the recession ended, as the entire economy -- including healthcare -- grew 1.3 million jobs. Since June 2009, the financial, construction, and state and local government sectors lost 1.1 million jobs.
So, healthcare sector job growth is at record low levels in a post-recession recovery, but it is still growth.
Grossman Burn Center said it will open a burn center at St. Luke’s Medical Center in Phoenix this summer. It’s the fifth such center for West Hills, CA-based GBC, and its second outside California, GBC said in a media release.
“As both population and demand for additional burn care resources in Arizona continue to grow, there is a demonstrated need for another burn unit in the metropolitan Phoenix area,” GBC medical director Peter H. Grossman, MD, said in a media release. “We believe, based on our experience in Southern California where there are no fewer than eight operating burn centers, that we can address that need by complementing the existing burn center in Phoenix which is currently the only burn center in the state of Arizona.”
GBC will provide acute and reconstructive burn care, rehabilitation, and post-treatment emotional and psychological support. The collaborative center will be managed on a day-to-day basis by physicians on the medical staff at St. Luke’s Medical Center trained in restorative burn care.
“Partnering with the Grossman Burn Center gives St. Luke’s the unique opportunity to expand access to exceptional burn care in Arizona,” St. Luke’s Medical Center CEO Ed Myers in the media release. “We look forward to collaborating with GBC and with local fire departments, as well as community physicians and organizations, to bring additional burn care treatment and prevention education resources to our community.”
GBC is the largest plastic surgery-based burn practice in the western United States, and has had partnerships with IASIS Healthcare, Adventist Health, the Franciscan Missionaries of Our Lady Health System, HCA, and Integrated Healthcare Holdings, Inc. In addition to the agreement with St. Luke’s Medical Center, the GBC said it is also in talks to open a burn center in Texas.
For the second consecutive month, job growth in the healthcare sector showed impressive gains, Bureau of Labor Statistics preliminary data show.
Hospitals created 10,100 new jobs in April, after posting 10,200 new jobs in March. So far in 2011, hospitals have created 31,500 new jobs, compared with 8,900 new jobs in the first four months of 2010, BLS data and preliminary data show.
The healthcare sector – everything from hospitals to podiatrists' offices to kidney dialysis centers – created 37,290 new jobs in April, after posting 34,400 new jobs in March, and 112,100 new jobs in 2011. Healthcare created 80,500 new jobs in the first four months of 2010, BLS preliminary data and preliminary show.
Healthcare sector employment nudged over the 14 million jobs threshold in April, with more than 4.7 million jobs at hospitals, more than 6.1 million jobs in ambulatory services, and more than 2.3 million in physicians’ offices, BLS preliminary data show.
Ambulatory services accounted for more than half of the new jobs created in the healthcare sector in 2011, with 21,500 new jobs in April, and 59,800 new jobs in the last four months. Ambulatory services created more than 57,000 new jobs in the first four months of 2010, BLS data and preliminary data show.
Physicians' offices reported another strong month of job growth, with 6,600 new payroll additions reported in April, after posting 8,700 new jobs in March, and 31,500 new jobs in 2011. That compares with 8,900 new jobs in the first four months of 2010.
BLS data from March and April are preliminary and may be considerably revised in the coming months.
The healthcare sector continues to be one of the few areas of job growth in the sputtering economy. Since the start of the recession in December 2007, healthcare employment has grown by 931,000 jobs, while total nonfarm employment has fallen by about 7.2 million, BLS data show.
The larger U.S. economy gained 244,000 jobs in April but the nation's jobless rate edged up to 9%, up from 8.8% in March, with 13.7 million people unemployed. The number of long-term unemployed -- people jobless for 27 weeks or longer – was 5.8 million in April, a decrease of 280,000 from March, and their ranks decreased from 43.9% to 43.4% of the unemployed, BLS preliminary data show.
Health Management Associates, Inc., the University of Florida, and Shands HealthCare on Thursday jointly announced an alliance that they said will improve cardiac and stroke emergency services at three regional hospitals in central Florida.
The alliance brings the UF physicians, resources, and protocols to HMA's regional hospitals through the Heart and Stroke Emergency Specialists program. It will provide teleconferencing consultations between physicians, continuing education, and other hands-on exchanges. And patients requiring tertiary care will be transferred to Shands at UF, an academic medical center in Gainesville, FL, a media release said.
"By teaming up with UF and Shands, we further our mission to enable America's best local healthcare," Gary D. Newsome, president/CEO of Naples, FL-based HMA said in a statement. "We do this by providing the people, processes, capital and expertise necessary for our hospital and physician partners to fulfill their local missions of delivering superior healthcare services. The Heart and Stroke Emergency Specialists program will result in even better care, and an even better overall experience for our patients."
"We have been looking to extend our programs beyond Gainesville, and all three Health Management hospitals are highly-ranked facilities with accredited chest pain and/or certified primary stroke centers," said Tim Goldfarb, CEO of Shands HealthCare. "For us, it means working with a larger network of doctors on the front lines of Citrus and Hernando counties. For the regional hospitals it means quick access to our doctors and resources if they need us."
