Category Archives: Healthcare

“Hidden From View: The Astonishingly High Administrative Costs of U.S. Health Care” – The New York Times

“The complexity of the system comes with costs that aren’t obvious but that we all pay.”

med recordsMedical records at a health center in Rogersville, Pa., last year. American health administrative costs are largely hidden from view of the public. CreditBrendan Smialowski/Agence France-Presse — Getty Images”

by Austin Frakt

“It takes only a glance at a hospital bill or at the myriad choices you may have for health care coverage to get a sense of the bewildering complexity of health care financing in the United States. That complexity doesn’t just exact a cognitive cost. It also comes with administrative costs that are largely hidden from view but that we all pay.

“Because they’re not directly related to patient care, we rarely think about administrative costs. They’re high.

“A widely cited study published in The New England Journal of Medicine used data from 1999 to estimate that about 30 percent of American health care expenditures were the result of administration, about twice what it is in Canada.”

Click here to continue reading this New York Times article. 

“Startups Look to Mainstream Medical Tourism”

“New sites are partnering with Uber and Airbnb to help patients recuperate.”medical tourism

“ILLUSTRATION: ANDREA CHRONOPOULOS FOR BLOOMBERG BUSINESSWEEK”

by Ari Altstedter

“About 14 million people spent $68 billion on medical tourism in 2016, according to consulting firm PwC. A growing number are Westerners headed to developing countries for cosmetic surgery or dental work, procedures that are less expensive and invasive than major operations and often aren’t covered by insurance. PwC predicts that by 2021 the medical tourism market will reach $125 billion. The growth will be built not on nose jobs and dental implants but on costlier and riskier procedures with longer recovery times, such as knee replacements and heart surgeries.

“Startups from Berlin to Bangkok are trying to do for medical tourists what Airbnb or Hotels.com does for the general public. Instead of searching for a place to stay, users type in a medical procedure and get a list of clinics or doctors in nations that offer the surgery—scroll and click on a link to make an appointment. The companies charge providers a commission for bookings or a flat subscription fee to be on the platform. And they’re working on additional revenue streams, such as planning beach vacations for recuperating patients and their families, most likely by integrating their platforms with popular travel sites.”

Read this Bloomberg BusinessWeek article in its entirety here.

“Patient reports suggest it’s better to avoid catheters” – Futurity

catheters(Credit: Getty Images)

“More than half of hospital patients who get a urinary catheter experienced a complication, in-depth interviews and chart reviews from more than 2,000 patients show.

“The new study, published in JAMA Internal Medicine, puts large-scale evidence behind what many hospital patients already know: Having a urinary catheter may help empty the bladder—but it can also be painful, lead to urinary tract infections, and cause other issues in the hospital and beyond.”

Continue reading this article at Futurity.org, click here.

 

 

“Sepsis is the third leading cause of death. Can a new blood test change that?” – STAT

SepsisRonnie Roberts spends his spare time handing out leaflets on the dangers of sepsis. He lost his fiancee, Dorice Broughton, to sepsis in 2015. Aram Boghosian for STAT

In his spare time, when he feels up to it, Ronnie Roberts walks through hospital parking lots slipping informational flyers onto every windshield.

“Roberts wants people to know the signs of sepsis, the body’s overwhelming response to a blood infection, which can lead to organ failure and even death. If he had known the signs and insisted that his fiancee was treated appropriately, he believes she’d still be alive.

“Sepsis kills over 250,000 people a year in the United States — more than any cause other than cancer and heart disease. But still, many people have never heard of it. And hospitals often fail to notice the warning signs when a patient is spiraling downward.”

Read this article in at STAT.

 

Berks-Lancaster-Lebanon Link partners get preview of Community HealthChoices | “will improve services for hundreds of thousands of Pennsylvanians.”

collage

Here’s a link to the Community HealthChoices (CHC) Provider Resources including:

  • A Q&A document
  • Community HealthChoices documents
  • a link to subscribe to the latest CHC newsletters

CHC is due to come to our Service Area — Berks-Lancaster-Lebanon Counties — on January 1, 2020.

“Medicare changing nursing home incentives to deter poor care” – JustCare

medicare nursing homes

by Diane Archer

Kaiser Health News reports on a ghastly phenomenon that appears all too common for people with Medicare in some nursing homes. To increase their revenues, nursing homes create conditions that lead residents to be rehospitalized. Medicare is now changing its nursing home payment policies to try to align nursing home financial incentives to deter poor care.

“KHN describes one case in which a nursing home literally dropped a resident, causing a hip fracture, and creating a reason to move the resident to a nursing home. That led to a lawsuit from the patient’s family and a settlement of $1.4 million by Richmond Pines Healthcare and Rehabilitation Center in North Carolina.

“All too frequently patients are discharged from hospital to a nursing home and return to hospital in less than a month. One in five Medicare patients are back in hospital after discharge in less than 30 days.”

Read this JustCare article in its entirety, click here.

“Advice for Gawande as he takes up tall health care challenge” – The Boston Globe

gawandeDr. Atul Gawande. – Aram Boghosian for The Boston Globe

by Liz Kowalczyk – Boston Globe staff

“They’ve made a big splash, but three powerful business leaders who want to reinvent health care have been short on details about their venture. They took a notable step forward on Wednesday, recruiting Boston surgeon and prolific author Dr. Atul Gawande to head their new, still-mysterious company.

“Berkshire Hathaway chief Warren Buffett, Amazon’s Jeff Bezos, and JPMorgan Chase chairman Jamie Dimon aim to improve medical care and lower its cost for their employees, and become a national model. But exactly how they envision doing that is unclear — especially in a field with no shortage of ambitious plans and ideas.

“‘The lack of details makes it a little bit of a shot in the dark,’’’ … Continue reading this Boston Globe article, click here.

abc

ABC’s backers are: A is for Amazon, B is for Berkshire, and C is for Chase. ABC is a not-for-profit joint venture that those companies’ CEOs—Jeff Bezos, Warren Buffett, Jamie Dimon—have created to reinvent the way they provide and pay for health care for their employees.”

Atul Gawande, CEO? | The New Yorker writer and surgeon is an unconventional choice to lead the Bezos-Buffett health care startup, and a good one.” Slate.com

“Medicare Takes Aim At Boomerang Hospitalizations Of Nursing Home Patients” – California Healthline

nursing-home-lawsuitDeborah Ann Favorite sits in her Los Angeles apartment last month. Favorite’s mother died after a lapse in communication about the need to resume her thyroid medication. (Heidi de Marco/KHN)

“‘Oh my God, we dropped her!’Sandra Snipes said she heard the nursing home aides yell as she fell to the floor. She landed on her right side where her hip had recently been replaced.

“She cried out in pain. A hospital clinician later discovered her hip was dislocated.

“That was not the only injury Snipes, then 61, said she suffered in 2011 at Richmond Pines Healthcare & Rehabilitation Center in Hamlet, N.C. Nurses allegedly had been injecting her twice a day with a potent blood thinner despite written instructions to stop.

“‘She said, “I just feel so tired,”’ her daughter, Laura Clark, said in an interview. ‘The nurses were saying she’s depressed and wasn’t doing her exercises. I said no, something is wrong.’”

Click to read this California Healthline article in its entirety.

OPINION: “Current efforts to fight sepsis aren’t working. We need a bolder approach” – STATNews

sepsisGroup B streptococcus is one type of bacteria that can cause sepsis. James Archer/CDC

by Derek Angus

“If pharmaceutical and biotech companies gave up trying to find better treatments for stroke and Alzheimer’s disease, there would be public outrage. Yet that is essentially what has happened to sepsis, an infection that kills as many Americans each year — about 250,000 — as stroke and Alzheimer’s combined — with barely a whimper. If we can strive to fight a new scourge like opioids, we should be able to do the same for a much older killer.

“Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it’s easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right: We effectively prevent many infectious disease threats. Cholera and typhoid, which once killed one percent of Americans each year, are now virtually unheard of in the U.S. Yet nearly 1.5 million Americans are hospitalized for sepsis each year, and it accounts for 1 in 3 deaths that occur in hospitals.

“Sepsis is an old term.”

To read this STATNews article in its entirety, click here.

 

Community HealthChoices “delivery of service coordination”

chc delivery of services.jpg

Though the counties in Service Area 13 — Berks, Lancaster, Lebanon — are not impacted until January 2019, we wanted to share this information.

REMINDER: Many of our partners in Service Area 13’s footprint will be attending the special Community HealthChoices seminar on June 18.

In preparation for the launch of Community HealthChoices (CHC) in the Southeast region, the above CHC Fact Sheet explains the delivery of service coordination through the program. Under CHC, service coordination is a function of the managed care organizations (MCOs). A service coordinator is the MCO’s designated, accountable point-of-contact for each participant receiving long-term care services, their person-centered service plan, and service coordination. Therefore, the Office of Long-Term Living sees the service coordinators as part of the MCO under CHC.

Trainings | In addition to the fact sheets, the department has developed short, easily digestible overview trainings on CHC that can be found here. We encourage everyone to take the time to review the training and increase their knowledge in anticipation of the Southeast rollout and to familiarize themselves with the program.

Additional resources | To assist stakeholders in finding answers to questions more quickly, we recently consolidated all FAQs into a single CHC Questions and Answers Document.  The new document is in searchable PDF format and contains a table of contents that allows the user to easily move to different sections within the document.

The CHC Questions and Answers Document can be found on both the Participant and Provider sections of the CHC website by clicking on “View CHC Publications” or by following this link:

http://www.healthchoices.pa.gov/cs/groups/webcontent/documents/document/c_274784.pdf

Please note: | The individual FAQ documents have been removed from the CHC website.  All questions and answers are now on one document.

CONTACT:  If you have any questions, please visit www.HealthChoices.pa.gov or submit comments electronically to RA-PWCHC@pa.gov.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

Please share with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Quality and Provider Management Enrollment and Certification Section at 1-800-932-0939 Option #1.

To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.