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> The New York State Hospital Report Card will begin grading hospitals on their readmission rates. Article

> Senator Judd Gregg (R-NH) has proposed the Medicare Quality Enhancement Act, a bill that would allow certain quality ranking organizations access to CMS quality and cost data. …

Reader feedback: Is limiting industry gifts a smart policy?

Arguments in favor of Stanford’s policy
Gifts are a way of gaining preferred access and gifts are given to receptionists and nurses and others medical staff for the same reason--essentially bribing a company to get to see the doctor. With no gifts to influence access to doctors, doctors themselves can select the products, devices and techniques as well as the detail personnel who they wish to invite in to advise them of new developments. Why should access be gained by the highest bidder? – Anonymous
I strongly endorse the move to limit gifts to physicians. In the short term it will limit marketing costs for the companies and eliminate the biasing of physician opinion by flashy marketing campaigns. In the long run it will drive the expansion of CME type programs, sponsored by state health authorities/insurance companies that will provide balanced education on new therapies. It will also eliminate the incentive for companies to invest precious R&D dollars on marginally incremental innovations that cannot be supported on the basis of scientific evidence. It is a shame that this move has not been adopted sooner by a larger number of institutions. - Swami Subramaniam, M.D., Ph.D

Editor's Corner


"Let he who is without conflict-of-interest cast the first stone."

On Thursday, we ran a letter from Mike Wei, M.D., a FierceHealthcare reader who criticized Stanford University Medical Center's new policy …

SPOTLIGHT: Making smart CDHP members


During a speech at the Pittsburgh Business Group on Health, Ann Mond Johnson, president of Chicago-based Subimo, identified employers' responsibilities to their employees if they offer CDHPs instead of traditional health plans. Simply providing the health plans isn't enough: Employers must also make their employees smarter healthcare consumers, which means making sure that they have access to cost and quality data. Ms. Johnson heads a company that compiles publicly-available quality …

Report: Oncologists favor P4P

A study by OTN, a physician practice services company, has found that 66 percent of community-based oncologists believe that pay-for-performance (P4P) programs are a useful tool for oncologists and an overwhelming majority (94 percent) think that adopting P4P measures will improve patient outcomes. But whether they like them or not, 81 percent realize that P4P programs will eventually become part of their practice. "It is clear from the survey that clinicians are interested in P4P programs and are willing to work to develop them," noted John Amos, President and CEO of OTN in a press release. In addition to their views on P4P programs, almost all the oncologists surveyed (97 percent) felt that IT adoption would become necessary in order for them to manage their medical practice.

For more statistics from the study:
- see this press release

NY to require skilled translators

A New York regulation will now require hospitals to provide skilled medical translators for non-English speaking patients. Currently, doctors often have to rely on family members to communicate with their patients. However, this can be problematic, as the translator often can't interpret medical terminology accurately, and a close family member may unintentionally translate incorrectly in order to soften the blow of a poor prognosis. This, researchers say, causes serious problems for …

Verifying insurance just got easier

In a move to simplify providers' administrative tasks, the Council for Affordable Quality Healthcare (CAQH) has announced that twenty big-name healthcare organizations will work together to make it easier for doctors to verify a patient's insurance. Insurance verification is currently one of a provider's biggest administrative chores. "Today's announcement is the first wave of an industry campaign to reduce unnecessary administrative burden related to verifying patient insurance …

How to catch Rx problems early

At a meeting of the American College of Neuropsychopharmacology (ACNP), a group of brain and behavior researchers recommended a drug surveillance system to cut down on adverse effects related to prescription drugs. The researchers think that a computerized monitoring system would be able to quickly detect negative side effects, protecting patients from harmful drugs. At the moment, there is no such system in place. "The current U.S. health care system only accidentally detects rare but …

A different perspective on Medicare cuts

At Spot-On­­, Matthew Holt has some harsh words about the AMA's opposition to the impending Medicare cuts. Last week, the AMA released a statement saying that many Americans are concerned about the impending cuts. The AMA acknowledges that most Americans aren't even aware of the cuts, but claims that when informed about them, most expressed concern about what impact the cuts will have on healthcare. Holt takes issue with the AMA's methodology. "After the pollsters told them …

ALSO NOTED: UnitedHealthcare, HCA continue talks in FL; CO may get new VA hospital; and much more...

> In Florida, UnitedHealthcare and HCA are still discussing how to work out their differences. The massive contract dispute between the two healthcare industry giants has left thousands of patients in Colorado and Florida in limbo. Report

> The House has passed a bill to fund a new VA hospital in Colorado. …

SPOTLIGHT: Individual insurance won't work for most people

 
As more employers drop healthcare coverage for their employees, people are turning to individual insurance plans to protect themselves from high medical bills. But a new study finds that most people can't afford--let alone enroll--in individual healthcare plans. Article

Study: Seniors at risk for drug interaction

A study conducted by Medco Health Solutions, a prescription benefits manager, has found that adults over 65 are seven times more likely to be the victim of dangerous prescription drug interactions. It's not unusual for an elderly patient with chronic problems to visit several doctors and to be prescribed medications by each of them--roughly 25 percent of American seniors see five or more doctors. Unfortunately, doctors oftentimes aren't aware of the other physicians' activities. "Clearly, …

HFMA: Over half of hospitals struggling financially

According to a new Healthcare Financial Management Association (HFMA) study, over half of U.S. hospitals are facing financial struggles. Rural hospitals and those not affiliated with a health system--almost half of hospitals--are particularly at risk from competitors. Financial pitfalls come from many directions, including competition from doctor-owned facilities, lower government reimbursement rates, high debt and spending on necessary infrastructure and IT improvements. Some hospitals …

Surgery center accuses OSF of antitrust activity

Peoria Day Surgery Center in Illinois has filed a lawsuit against OSF Healthcare System, alleging that OSF's hospital Saint Francis Medical Center is trying to drive the surgery center out of business so that it can raise prices. Peoria Day Surgery Center wants to block a contract between OSF and insurers UnitedHealthcare and Blue Cross-Blue Shield of Illinois. The contract would make St. Francis the exclusive provider of ambulatory care for these health plans' members, which would cause …

Senate questions NIH conflict-of-interest punishment

There have been a number of reports of federal government researchers violating ethical standards by accepting money from drug and device industry players, as of late. But according to the NIH, of the 44 people accused of improper conduct, only two have faced criminal punishment--Doctors Trey Sunderland and Thomas Walsh. The rest received nothing more than a slap on the wrist or were asked to retire. Despite their conduct, the researchers in question can't be fired because they are …

Kaiser avoids Medicare funding loss

It looks like federal regulators have withdrawn their threat to cut off Medicare funding for kidney treatments at Kaiser Permanente's San Francisco hospital. In June, a government inspection of the HMO's Northern California transplant program turned up serious deficiencies in the way the provider managed the program. The inspection was accompanied by a warning that the hospital could lose …

ALSO NOTED: Former HealthSouth CFO gets prison sentence; GA in need of more docs; and much more...

> UnitedHealthcare and Froedtert & Community Health are trying to iron out an ongoing contract dispute. Report

> Authorities have arrested three Brooklyn, NY men--two brothers and an employee--for defrauding Medicaid of millions of dollars. One brother was a doctor, the other a pharmacy owner and the third man a pharmacy employee. The three allegedly billed Medicaid for …

Letter: Is limiting industry gifts a smart policy?

In a perfect world the policy made sense, but in the real world, this is another policy that some bio-ethicist who has nothing better to do dreamt up in his office.

The AMA was wrong years ago on this. For example, pharmaceutical companies can no longer support Continuing Medical Education (CME) dinner meetings if a spouse is to attend. The net result is that I do not attend these functions. I do not want these events to be another evening away from my family besides night calls. So the turnout for these functions have dropped dramatically. The flip side is that I do not have the slightest clue what products the pharmaceutical companies make, so there is the big hole in the "undue influence” argument.

The Society of Critical Care dropped pharmaceutical industry support for providing lunch at their annual meeting in order to avoid any possibility of being improperly influenced. The net result is the exhibit hall is like a ghost town during lunch hours whereas in the years before this policy was adopted the hall was usually full. I am equally helpless in telling you who was paying for lunch boxes in the prior years. This type of overly-cautious policy is detrimental to everyone. Pharma companies are not willing to pay high fees to rent exhibit hall space if no physician is around to talk to them. And we as physicians are missing the chance to be exposed to some genuinely new products at these meeting.

SPOTLIGHT: Cross Country Healthcare settles lawsuit


Cross Country Healthcare is settling a wage and hour class action lawsuit filed by California workers in 2003. Cross Country provides staffing services to healthcare facilities. The company will pay up to $10 million in damages to nurses, legal fees and administrative costs. Report

Charity care under fire

The level of charity care not-for-profit hospitals provide is under fire once again. In an in-depth study of 10 charity hospitals, Senate finance committee investigators have found that although charity hospitals offer free care, they often don't inform patients that assistance is available. Some charity hospitals also charge poorer patients more for care while charging well-off patients with coverage less. Additionally, hospital CEOs enjoy expensive perks, which calls into question …