Health Care News

New Hospital Compare data shows disparity in blood infection rates

Alicia Caramenico — Fri, 10 Feb 2012 12:47:09 -0500

Newly released blood infection data from the Centers for Medicare & Medicaid Services' Hospital Compare website has revealed a wide variation in central line-associated bloodstream infections across states, according to NPR's Shots blog.

It appears that central-line blood infections are more likely at hospitals in Maryland, Mississippi, Louisiana, Maine and New Hampshire, according to the new data, gathered from intensive care units at 1,146 U.S. hospitals in the first quarter of 2011.

Conversely, patients at hospitals in Hawaii, Alaska, South Dakota, Kansas and Indiana had the fewest bloodstream infections.

With zero as the perfect score, Hawaii came in at number one with 0.06, while Maryland had the worst central line infection rate of 0.91.

But bloodstream infections rate varied widely within states. For instance, in Virginia, Mary Washington Hospital scored 0.28, much better than the 0.6 state-wide average and the 1.0 benchmark score for all U.S. hospitals, reported The Free Lance-Star.

The discrepancies have led some hospital officials to warn consumers about using the new bloodstream infection data to compare individual hospitals, especially given the three-month timeframe, noted the Pioneer Press.

"I don't think you can look at this alone to get a picture of quality," said Boyd Wilson, director for infection control and prevention at HealthEast in Minneapolis-Saint Paul. "This data can be reported in different ways, so you have to be careful," he told the Pioneer Press.

To learn more:
- here's the NPR Shots blog post
- here's the Free Lance-Star article
- read the Pioneer Press article

Patient satisfaction equal for physician, hospitalist care

Alicia Caramenico — Fri, 10 Feb 2012 11:35:15 -0500

Patients reported similar satisfaction scores for hospital care provided by primary care physicians and hospitalists, according to a study published this month in the Journal of Hospital Medicine.

Telephone interviews with patients discharged from three Massachusetts hospitals affiliated with Baystate Health--Baystate Medical Center in Springfield, Franklin Medical Center in Greenfield and Mary Lane Hospital in Ware--from 2003 and 2009 showed that hospitalists and primary care physicians received equal satisfaction scores for behavior, pain control and communication. Patients appeared slightly more satisfied with the quality of care offered by primary care physicians than by hospitalists.

To further boost patient ratings, hospitals could implement a hospitalist-nurse rounding system such as the one at Ohio State University Medical Center (OSUMC). After only two months of the multidisciplinary rounding, OSUMC saw patient satisfaction scores jump, reported The Hospitalist.

As part of the system, the patient and family receive a daily feedback sheet containing a picture of the hospitalist, a list of the care-team members, daily goals, upcoming tests and the expected discharge date.

"Right now we're rounding with hospitalists and nurses only, but a long-term goal is to expand it to include the social worker and other ancillary professionals," lead author and OSUMC hospitalist Eric Schumacher told The Hospitalist.

To learn more:
- here's the study abstract
- read The Hospitalist article

West Penn posts widening losses

Ron Shinkman — Fri, 10 Feb 2012 11:05:27 -0500

Pittsburgh's West Penn Allegheny Health System has reported a loss of $55.9 million for the first half of a fiscal year that ends June 30, according to local news reports.

The financial results, which include a loss of $34.1 million between September and December 2011, is attributed primarily to lower patient volumes. Patient revenue fell 4.3 percent to $32.9 million between July 1 and Dec. 31. Admissions at the hospital declined nearly 10 percent, primarily because it closed its emergency room and moved other services to West Penn Hospital.

West Penn Allegheny entered into a deal last June to be acquired by regional insurance giant Highmark. Officials with that organization said that the current financial statement justifies an expedited approval of the deal from the Internal Revenue Service and a variety of Pennsylvania regulators.

"Highmark remains fully committed to this affiliation, and the sooner approvals are received, the sooner we will be able to work to further strengthen WPAHS and provide the people of Western Pennsylvania with continued access to a world-class health system," the insurer said in a statement.

Highmark has put about $150 million into the hospital system during the 2011 and 2012 fiscal years, primarily in the form of grants. West Penn Allegheny did not include a $100 million grant from Highmark last November in its financial results.

For more information:
- read the Pittsburgh Post-Gazette article
- read the Pittsburgh Tribune-Review article
- here's the West Penn Allegheny financial report (.pdf)

HHS panel calls for mandatory flu shots for healthcare workers

Alicia Caramenico — Fri, 10 Feb 2012 10:44:59 -0500

Shy of a full-scale national mandate, the U.S. Department of Health & Human Services' National Vaccine Advisory Committee yesterday urged hospitals to "strongly consider" making flu vaccination mandatory for employment, noted AHA News Now. However, hospital-based registered nurses plan to argue against mandatory flu shot policies at the Committee's public hearing next week, National Nurses United announced Wednesday.

Medicaid cuts loom despite overdue reimbursements

Alicia Caramenico — Thu, 09 Feb 2012 12:43:10 -0500

Hospitals across the country are preparing for looming cuts to Medicaid reimbursements, all while waiting for millions of dollars in owed payments.

In Maine, a deal passed unanimously yesterday will reduce MaineCare--the state's version of Medicaid--payments to hospitals by $10.1 million during the next two years, reported the Bangor Daily News. The hospitals could even face a second round of reimbursements cuts at an additional $3.1 million.

Thanks to the cuts, Eastern Maine Healthcare Systems will lose $11.8 million. Meanwhile, the system still hasn't been paid $85 million for services provided to MaineCare patients, the article noted.

Similarly, Illinois hospitals are worried about potential $2 billion reimbursement reductions, especially as the Medicaid program already owes them nearly $2 billion in payments, noted KWQC.

"We haven't received a hospital medicaid payment since the beginning of July," Trinity Hospitals President and CEO Richard A. Seidler told KWQC.

Hospitals in Florida are bracing for hundreds of thousands of dollars in funding cuts, according to the Jacksonville Business Journal. The House proposed a 7 percent cut, or about $291 million in lost Medicaid reimbursements, while the Senate plans to eliminate $218.7 million used to subsidize Medicaid HMO payments to hospitals.

Such cuts would devastate hospitals' ability to provide care to low-income, uninsured and vulnerable populations, Safety Net Hospital Alliance of Florida President Tony Carvalho told the Business Journal.

To learn more:
- read the Bangor Daily News article
- check out the Jacksonville Business Journal article
- read the KWQC article

Hospitals lose reimbursement for 'unnecessary' ER visits

Alicia Caramenico — Thu, 09 Feb 2012 11:54:02 -0500

Designed to curb the "overuse and abuse" of costly emergency care, Washington's hospitals will no longer receive Medicaid reimbursement for any "unnecessary" emergency room visits starting April 1, reported The Seattle Times.

In what could be the nation's most restrictive Medicaid ER policy, the program would stop payment for roughly 500 conditions, ranging from the obviously nonemergent diaper rash to the more complicated hypoglycemic coma and chest pain, the article noted.

Emergency physicians and hospitals would be left to foot the bill for treating those conditions.

But providers are urging lawmakers to halt the new policy, noting that Medicaid patients now will have to know what their diagnosis will be before going to the emergency department. "If we don't know without an X-ray or CT scan, how can they know it?" asked emergency physician Nathan Schlicher, legislative chairman of the Washington Chapter of the American College of Emergency Physicians.

Meanwhile, emergency departments at Utah hospitals are in hot water with the state's Medicaid program. They have allegedly overbilled Medicaid $22 million for charging emergency rates for non-emergency care between 2008 and 2009, reported The Salt Lake Tribune.

Utah's Medicaid inspector general has not revealed the hospitals in question and has yet to place some on official notice.

To learn more:
- read the Seattle Times article
- read the Salt Lake Tribune article

Compassionate care, high performance not limited to clinicians

Karen M. Cheung — Thu, 09 Feb 2012 11:50:03 -0500

The janitor at a hospital doesn't just take out the trash; he prevents infections. That was the message that Michael Frisina, head of the consulting firm The Center for Influential Leadership, had for the hospital employee who eventually won an honor by the new head of environmental services, according to a column in Hospitals & Health Networks. It's that kind of cultural change in thinking on the part of hospital leaders that could inspire staff and pave the way for high performance and compassionate care, according to the article.

Too often, hospital staff face challenges and go to work hanging their head, but it's up to the leaders to change that environment, H&HN noted.

For example, Barnes-Jewish Hospital in St. Louis created a training program, dedicated to fighting the problem of compassion fatigue--a phenomena in which traumatic stress and burnout can make caregivers rude and cynical, impair the caregiver-patient relationship and lead providers to dread caring for patients. Symptoms of compassion fatigue can be physical (e.g., feeling exhausted), psychological (feeling numb), emotional (being irritable) or professional (wanting to quit), Teresa L. Deshields, a licensed clinical psychologist and the manager of Psycho-Oncology Services for the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, wrote in a Hospital Impact blog post.

The Compassion Fatigue Resiliency Program, first launched on the oncology floors and the emergency department, is a one-day workshop that includes education on compassion fatigue, instruction on how to regulate it and self-care strategies, and discussions of personal missions.

"The managers were concerned about what they perceived as sagging morale among their staff," Deshields wrote. "From an organizational perspective, the program aims to increase staff engagement, reduce turnover and increase patient satisfaction. From a staff perspective, the goal is compassion satisfaction, or the ability to derive meaning and satisfaction from your work."

Barnes-Jewish Hospital then opened up the program to all hospital employees, not limited to clinicians. It's "a recognition that even if employees are not giving direct clinical care or treatment, they still may be involved in caring for the hospital's patients, and are vulnerable, too, to the cost of caring," she wrote.

For more information:
- read the H&HN column
- see the Hospital Impact blog post

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Hospital exec arrested in $116M Medicare scheme

Karen M. Cheung — Thu, 09 Feb 2012 11:15:25 -0500

Officials yesterday arrested and charged an assistant administrator of Houston's Riverside General Hospital for his alleged role in a $116 million Medicare fraud scam, involving false claims for mental health treatment and using kickbacks (including cigarettes and food) for patient referrals, the Department of Justice, the FBI and the Department of Health & Human Services said in a statement yesterday.

In an alleged three-year scheme that ended yesterday, Mohammad Khan is charged with one count of conspiracy to commit healthcare fraud, one count of conspiracy to pay and receive illegal healthcare kickbacks, and five counts of paying or offering to pay healthcare kickbacks. From 2008 and continuing until his arrest yesterday, authorities allege that Khan and his unnamed coconspirators submitted false and fraudulent claims for partial hospitalization program services--a form of intensive outpatient treatment for severe mental illness--to Medicare through the hospital.

"The defendant charged in this indictment is accused of stealing precious Medicare resources by billing for services that were medically unnecessary or never provided," Special Agent in Charge Stephen L. Morris of the FBI's Houston Field Office said in a statement.

Khan also allegedly paid kickbacks to patient recruiters and owners of group homes and assisted living, then billed Medicare for approximately $116 million. He allegedly paid one patient recruiter $5,000 twice in 2011 so the recruiter would refer Medicare beneficiaries to Riverside General's six Houston-area clinics offering outpatient psychiatric care, the Houston Chronicle noted. He also allegedly paid a second recruiter $300 a head for each patient referral.

Federal prosecutors also claim Khan used cigarettes, food and coupons redeemable for items available at the hospital's "country stores" to gain patients.

Riverside hospital officials said the hospital has done nothing wrong.

"I have no concerns at all," spokeswoman Tasha Armstead told Click2Houston. "I feel very comfortable knowing Riverside is doing all the right things, and there shouldn't be any issues at all. Our attorneys are handling the rest of it."

Khan's arrest is another recent example of the governmental crackdown on healthcare fraud. Since the Medicare Fraud Strike Force was introduced in 2007, authorities have charged more than 1,190 people who collectively have falsely billed Medicare for more than $3.2 billion.

"We will continue aggressively to pursue individuals who attempt to enrich themselves at the expense of the Medicare program," Assistant Attorney General Lanny A. Breuer of the Justice Department's Criminal Division said.

For more information:
- read the DoJ statement
- read the Houston Chronicle article
- see the Click2Houston video report

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Docs not always honest with patients

Alicia Caramenico — Thu, 09 Feb 2012 11:13:54 -0500

Honesty is the best policy, but according to a survey published in the February Health Affairs, that's not necessarily the case in healthcare. In fact, many physicians don't always follow the Charter on Medical Professionalism standards that promote physician honesty and openness with patients.

Of the 1,891 practicing physicians surveyed in 2009, about one-third did not completely agree that they should disclose serious medical errors to patients, and nearly two-fifths did not completely agree that they should reveal their financial ties to drug and device manufacturers, noted a Health Affairs blog post.

Further, more than one-tenth of physicians admitted they told patients something that was untrue within the past year, while more than half said they described a patient's prognosis with more optimism than justified, reported Medscape Today.

Such findings may throw a wrench into the industry's move toward patient-centered care, as they suggest patients may get incomplete and inaccurate information from their physicians.

"Until all physicians take a frank and open approach to communication, it will be very difficult to enact patient-centered care more broadly," wrote lead author Lisa Iezzoni, a physician and professor of medicine at the Harvard Medical School, the blog post noted.

The lack of honesty and openness with patients should serve as a "welcome wake-up call" to healthcare providers, Linda Emanuel, a medical ethicist from Northwestern University, told Medscape. "We need to do some serious interventions to return to our ethical values," she said.

The survey also revealed that honest communication may be driven by demographics, as women and underrepresented minorities in healthcare are more likely to adhere to the Charter on Medical Professionalism standards.

For more information:
- read the study abstract
- here's the Health Affairs blog post
- read the Medscape article

Visual social networks to catch on with hospital marketers

Karen M. Cheung — Thu, 09 Feb 2012 10:29:43 -0500

Hospital marketers need to think like graphic designers, meaning they should focus on images, today's Hospital Impact blog post noted. Jenn Riggle, associate vice president and social media leader of the Health Practice at CRT/tanaka, pointed to four social networks that aren't typically associated with hospital marketing: Pinterest, Inforgraphics, SlideShare and YouTube. For example, Pinterest, an image-based social network whose visitors grew 400 percent in just a few months, is an opportunity for healthcare marketers who are looking to target women (the predominate Pinterest user). "Next time you're developing a press release or marketing brochure, think again. In the age of information overload, strong visuals are needed to encourage people to act," Riggle wrote in the post. But the question is will these platforms work for the healthcare audience. --Read the full post on Hospital Impact

Nonprofit hospital exec pay getting heat from struggling city

Karen M. Cheung — Wed, 08 Feb 2012 14:07:07 -0500

Should struggling cities get a cut of the money otherwise directed toward executive pay of nonprofit hospitals? That's the debate going on in Rhode Island, where Providence is on the brink of bankruptcy and a healthcare exec is raking in millions.

Critics have long scrutinized executive pay but especially in struggling areas. Lifespan, parent company to Rhode Island Hospital, paid its CEO, George Vecchione, $9.5 million in 2009, $3.2 million in 2008 and just under $3 million in 2007, WRPI.com reported.

Providence Mayor Angel Taveras said the city could file Chapter 9 if hospitals don't start contributing more to the budget, the article noted.

But hospitals have contributed in community benefits, Ed Quinlan, president of the Hospital Association of Rhode Island, told WPRI.com last week. Total uncompensated care provided by Rhode Island's 12 hospitals rose from $105 million to $160 million during the last four years.

Nationally, nonprofit hospitals spend an average of 11.3 percent of their total spending toward community benefits, including free care, community health improvement programs and subsidized services, according to an American Hospital Association report last week.

As for the million-dollar pay, the state hospital association said it's based on performance.

"You have to look at the role hospitals play in their community," Quinlan said. "Executive compensation is determined by hospital boards based on the financial performance of the hospital, based on the financial stability of the hospital - there's multiple factors."

For more information:
- read the WRPI.com article
- here's the AHA report (.pdf)

Related Articles:
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14 hospitals to pay $12M over false surgical claims

Karen M. Cheung — Wed, 08 Feb 2012 13:34:17 -0500

Fourteen hospitals across the country will be shelling out a combined $12 million to settle allegations that they submitted false claims to Medicare, involving spinal fractures procedures, the U.S. Department of Justice said yesterday.

Four Florida hospitals under Adventist Health System/Sunbelt Inc. will pay a total of $3.9 million.

Hospital	Settlement
Plainview (N.Y.) Hospital	$2.3 million
North Shore Syosset (N.Y.) Hospital	$192,735
North Mississippi Medical Center in Tupelo, Miss.	$1.9 million
Mission Hospital in Asheville, N.C.	$1.5 million
Wenatchee (Wash.) Valley Medical Center	$1.2 million
Community Hospital Anderson (Ind.)	$500,561
St. John's Mercy Hospital in Creve Coeur, Mo.	$365,000
Gulf Coast Hospital in Fort Myers, Fla.	$173,005
Lee Memorial Hospital in Fort Myers, Fla.	$159,571
Cape Coral Hospital in Cape Coral, Fla.	$73,279
Florida Hospital Orlando	$3.9 million
Florida Hospital-Oceanside
Florida Hospital Fish Memorial
Florida Hospital Heartland Medical Center

The Justice Department alleged that hospitals in New York, Mississippi, North Carolina, Washington, Indiana, Missouri and Florida overbilled Medicare between 2000 and 2008 when performing kyphoplasties, procedures used to treat certain spinal fractures often due to osteoporosis, on an inpatient basis rather than the less-costly outpatient basis to reap the reimbursements.

"These hospitals put profits ahead of sound medical judgment, making decisions based on a desire to maximize Medicare reimbursement rather than on individualized assessments of medical necessity," said William J. Hochul Jr., U.S. Attorney for the Western District of New York in Buffalo.

The Justice Department has crack downed on false claims and reached settlements with more than 40 hospitals totaling more than $39 million related to kyphoplasty Medicare claims.

"Patients want reassurance that their health care provider is making treatment decisions based on the patient's best interests, not an interest in maximizing profits," Assistant Attorney General for the Justice Department's Civil Division Tony West said. "By recovering taxpayer dollars lost to improper billing, this settlement will help support the vital public health care programs we depend on."

For more information:
- read the DoJ statement
- read the AP article
- read the Bloomberg article

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CMS opens bloodstream infection data to public

Alicia Caramenico — Wed, 08 Feb 2012 12:06:35 -0500

Aiming to boost hospital transparency and accountability, the Centers for Medicare & Medicaid Services opened up blood infection data to the public. CMS has updated the Hospital Compare website to include hospital-provided data on central line-associated bloodstream infections, the agency announced yesterday.

"Including central line-associated bloodstream infections information on Hospital Compare will save lives and cut costs," acting CMS Administrator Marilyn Tavenner said in a press release yesterday.

According to the Centers for Disease Control and Prevention, central-line blood infections lead to 100,000 deaths and roughly $45 billion in hospital costs each year.

The CDC and CMS can use the bloodstream infection data to identify areas for improvement and appropriately target prevention efforts, CMS said.

The government plans to add more hospital-acquired infection data to Hospital Compare later this year, Consumer Reports noted last week. This month, hospitals began reporting surgical-site infection rates to the CDC, data to be posted on Hospital Compare quarterly starting in 2013.

Patient advocates applaud the new additions to Hospital Compare, highlighting that public disclosure will force hospitals to improve the quality of care they deliver and will help patients choose safer facilities, noted Consumer Reports.

To learn more:
- read the CMS statement
- find the data on the Hospital Compare website
- read the Consumer Reports article

Steward backs bill to lift 3-year wait on RI hospital purchases

Karen M. Cheung — Wed, 08 Feb 2012 12:05:33 -0500

A bill, backed by ever-expanding powerhouse Steward Health Care System, to eliminate a rule that for-profit hospitals must wait three years in between hospital acquisitions is up for a Senate hearing this afternoon.

Steward's support of the bill (2012-S 2180) follows its intent to purchase Landmark Medical Center in Woonsocket, R.I. Although Steward has not announced any official efforts in Rhode Island facilities, it did apply to purchase Landmark, according to a state house press release this week.

Introduced Jan. 24, the legislation, if enacted, would enable Steward to buy more nonprofit community hospitals in the state without having to wait the required three years, Providence Business News reported. Under the Hospital Conversions Act, for-profit companies, such as Steward, must wait three years before buying another nonprofit hospital.

"For distressed hospitals, there's a lot of urgency, and speed is a necessity," hospital spokesperson Chris Murphy told FierceHealthcare. The bill could open up options to struggling hospitals. Many community hospitals in Rhode Island are in challenging financial situations, including Landmark, which is in state-run bankruptcy, he explained. For example, if two hospitals in a system were looking to partner with an outside for-profit, under the Hospital Conversation Act, they could wait a minimum of six years to complete the transaction. "[The existing Act] removes an option for community hospitals desperately looking for sources of capital," Murphy said.

Blue Cross Blue Shield of Rhode Island expressed opposition to the proposed legislation, citing concerns about outsiders buying local medical centers, Rhode Island NPR reported. Blue Cross Blue Shield said it would support the legislation with amendments, such as reducing the waiting period from three years to six months between hospital deals, as well as a rule in which hospitals must negotiate individually with health insurance companies instead of as an entire system, the report noted.

The capital infusion from a larger system could help IT investments, physician recruitment and infrastructure and therefore patient care, Murphy noted.

Steward has acquired 10 hospitals in Massachusetts. "In about a year, Steward successfully saved 10 hospitals that were on the verge of going bankrupt, which includes saving 17,000 jobs, repaid $200 million in debt, fully funded the pensions of 13,000 retirees, and saved 10 vital community hospitals," Murphy said. Without Steward, a number of hospitals would have gone under, he continued.

Steward could acquire other Rhode Island hospitals down the road if the Landmark deal is successful, Murphy said, although there are no concrete plans as of yet.

The Senate Health and Human Services Committee is scheduled to hear the bill this afternoon.

For more information:
- see the House Corporation Committee press statement
- read the Providence Business News article
- listen to the RI NPR report
- read the Woonsocket Patch article

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Hospital withholds patient safety report, cites legal woes

Alicia Caramenico — Wed, 08 Feb 2012 11:22:27 -0500

In a move away from patient safety and transparency, Parkland Memorial Hospital in Dallas is withholding a federally mandated patient safety report for fear of lawsuits, reported The Dallas Morning News. On Monday, the hospital's board of managers met with an attorney and decided not to disclose the report on improving patient safety that it promised.

"Make no mistake, though - we are taking the report and its findings to heart," the board said in a statement, noted the Dallas Business Journal.

After multiple reported patient safety breaches, Parkland last fall reached an agreement with the Centers for Medicare & Medicaid Services for corrective actions to stay open.

As part of that agreement, Parkland hired consulting firm Alvarez & Marsal Healthcare Industry Group for almost $7 million to conduct outside safety monitoring. The safety monitors produced the report in question after almost three months of hospital-wide inspection, noted the Morning News.

They recommended immediate improvements for 15 departments, according to an Associated Press article last month. Those areas include outpatient clinics, inpatient critical care, radiology, the laboratory and even food services.

In January, Parkland's interim CEO Thomas Royer said the hospital would make the monitors' report public after CMS approval. But after meeting with legal counsel, the hospital changed its tune, citing concerns over civil rights litigation, noted the Morning News.

The federal agency hasn't decided whether it will release the safety monitors' report.

For more:
- read the Dallas Morning News article (subscription required)
- here's the Dallas Business Journal article
- read the AP article